Letters from Burma by Aung San Suu Kyi.

Pay As You Go

On my release from house arrest last year, people gathered outside the gates of my home to greet me and to demonstrate their support for the movement for democracy. It was the monsoon season and the crowds would stand and wait in the dripping rain until I went out to speak to them. This continued day after day for more than a month; then I negotiated with our supporters an arrangement which was more convenient for all concerned: We would meet regularly at four o'clock on Saturdays and Sundays. Thus were born the public rallies that have been taking place outside my house every weekend.

A few months after the weekend rallies had become established as a regular political feature, I invited the audience to write to me about matters they would like me to discuss. The response was immediate and enthusiastic. Letters on a wide range of subjects, political, economic, social and religious, were put into the mailbox we hung outside the gate for that purpose. A recurring theme in these letters, which continue to come in, is the widespread corruption among civil servants, in particular in the sectors of health and education.

In Burma, health care is ostensibly provided free of charge by the state. But in recent years, the contributions expected from the community have risen to such an extent that it is no longer possible to think of health care as "free." By "contributions" I do not mean just monetary donations made by the public toward health care projects, although such donations are not inconsiderable. I am referring to the fact that government health care facilities now provide merely services while patients have to provide almost everything else: medicines, cotton wool, surgical spirits, bandages and even equipment necessary for surgery.

Patients not only have to make their own arrangements for getting the necessary medical supplies, they also have to bribe the hospital staff in order to receive satisfactory service.

It is not just doctors and nurses who have to be sweetened with gifts; hospital orderlies also have to be paid if one's time as an invalid is to be passably comfortable. Apparently it is a common practice for orderlies to neglect their cleaning duties unless they are duly compensated. And they are also said to give patients who have to be wheeled from one part of the hospital to another a rough ride until a requisite sum of money has changed hands. Then there are the door keepers and other administrative staff whose hands have to be greased to smooth the path of family members who need to go in and out at all hours to delivery necessary supplies.

While nothing can excuse callousness in those who should be giving succor to the ill and dying, it cannot be ignored that the deterioration in state health care is largely the result of maladministration. High motivation cannot be expected of grossly underpaid staff working with poorly maintained equipment and dilapidated, unhygienic surroundings.

In recent years, the emergence of a private sector has made health care at expensive clinics and nursing homes available to those who are well off. There are indications that among those who cannot afford private health care, that is to say, the large majority of the population, there is an increasing tendency to rely on folk or traditional medicine rather than place themselves at the mercy of the state health care system.

Even more than letters about the unsavory conditions in our hospitals, I receive letters about the disgraceful state of our education system. Education, like health care, is ostensibly free in Burma but again, as with health care, the contribution exacted from the community is getting higher by the day.

Inadequate school funds are supplemented by "donations" collected for various purposes: sports day, new buildings, school furniture, teacher-parent association funds, religious festivals. Underpaid teachers supplement their incomes by giving tuition outside school hours. The fees range from 1,000 kyats to 10,000 kyats for each pupil, depending on the grade in which they are studying and the number of subjects in which they are coached. The poor quality of teaching in the school forces all parents who can afford the fees to send their children to such tuition classes.

Examinations provide teachers as well as employees of the education department with opportunities for lucrative business. Examination questions, advance information on grades achieved and the marking up of low grades can all be obtained for price.

There was a time when civil servants in our country were seen as an elite corps: well educated, well-trained and well-paid, capable of giving good service to the community. Now they are generally regarded with fear and revulsion, or with pity. State employees who have not become part of the syndrome of daily corruption, either from a matter of principle or from lack of opportunity, are unable to maintain a standard of living appropriate to their functions. They are the nouveau poor of Burma.