Beyond the delta, aid projects miss out

The positive aspects of the Cyclone Nargis response in the Ayeyarwady Delta have yet to translate into better access or more funds for aid operations in the rest of Myanmar, where needs are great and often unmet, according to aid workers.

“The needs in the country are large and very little is done,” said Frank Smithuis, country director of Médecins Sans Frontières (MSF) Holland. “Myanmar is the lowest recipient of overseas development aid in the world. Much more money is needed for the health of the people.”

After a frustratingly slow start, aid agencies say the humanitarian response to Cyclone Nargis, which struck Ayeyarwady Delta in May 2008 and left close to 140,000 dead or missing, has been highly effective.

Much of this is credited to the Tripartite Core Group (TCG), comprising the government, the Association of Southeast Asian Nations (ASEAN) and the UN, whose mandate has been extended for another year.

The government eased bureaucracy and restrictions on access for humanitarian agencies in the delta, and money and resources have poured in.

Outside the cyclone area

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However, this is not the case in the rest of Myanmar, where more than 100,000 children under five die each year, most of them from preventable diseases.

One third of under-fives are underweight, says the UN, and malnutrition is a contributory factor in about half those deaths.

“When Nargis happened it was impossible to focus elsewhere,” Chris Kaye, the head of the World Food Programme (WFP) in Myanmar, told IRIN in Yangon. WFP had a huge US$115 million programme to feed those who had lost their livelihoods in the cyclone.

“That was at some cost it seems now, because we have not been able to follow through and get the attention of donors elsewhere [in Myanmar].”

Last year, WFP raised half of its funding needs for areas such as Northern Rakhine State, near the border with Bangladesh.

“We had to cut back on certain activities – a very difficult decision to take – and in the end decided to cut support for vulnerable households through schools,” said Kaye.

This Food for Education project provided a family food ration to a child who attended school 80 percent of the time, often forming a major component of the daily diet during the lean June-October monsoon season.

Ongoing restrictions

The TCG mechanism does not apply outside the delta, and long-standing government restrictions on aid agencies are unchanged. Aid workers must seek permission to travel to project sites, which takes three weeks.

Photo: Stacy M Winston/ECHO
young boy in Myanmar's cyclone-affected Ayeyarwady Delta carries a bag
of donated rice. WFP says it has reached nearly one million people in
the Delta and Yangon area

Some NGOs have not been able to secure agreements to work in Myanmar at all, and operate informally through local partners. Many UN agencies do not have access to much of the country.

“There are huge developmental deficits,” said Kaye.

Such constraints have added to the reluctance of donors to provide aid to Myanmar, which receives far less assistance than other countries in the region with similar poverty levels.

Laos, for example, receives $50 per person per year, and Cambodia receives $40. Myanmar, by contrast, receives $2-$3.

Healthcare needs

But the needs are great. MSF Holland estimates there are between five and 10 million malaria patients each year, in a country of 53 million. Only a small proportion receive effective treatment and thousands die each year.

“As a consequence, the people of Myanmar suffer, in particular the poorest, who can't afford to pay for their healthcare,” said Smithuis.

He argues that MSF’s 17 years in Myanmar, plus the more recent cyclone response, prove that aid can be delivered effectively.

“If there is a good monitoring system that guarantees the population benefits directly, then there is absolutely no reason to withhold large-scale assistance to Myanmar people,” he said.

Mark Canning, the British ambassador to Myanmar, said the relative success of the Nargis aid operation could inspire greater confidence among major donors such as the UK.

“The issue of confidence is fundamental,” Canning told IRIN. “A virtuous circle can be created - the more donor money is used effectively, the more money is drawn in. But the reverse also applies. Assistance needs to be whiter than white.”