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This article analyzes the ways in which processes of weapons acquisition and armed collectives formation contribute to shape rebel polities – with their populations and attendant political geographies – in frontier spaces. It argues that the acquisition of weapons and the formation of an armed ensemble are shaped by political rationalities and techniques of governing the entanglements between humans and weapons that are diffused throughout society as a whole. Drawing on biopolitical governmentality, I also show that by governing weapons acquisition and the formation of an armed force rebel movements shape the rebel polity's collective identity and political geographies of 'vital' space in frontiers. Harnessing fieldwork-based research to study Ta'ang rebel movements in Myanmar, I find that weapons acquisition and the formation of an armed ensembles have been inflected by govern-mentalities of narcotics eradication and ethnonationality. The article concludes that some forms of rebel rule at the edge of the state in Myanmar can be qualified as 'blunt' following work by anthropologist Elliott Prasse-Freeman. That is to say, rebel rule lacking the governmental apparatuses to intensively know and promote life at aggregate scales still operates massifications and divisions of biological populations and political space via the formation and governing of armed ensembles. [ABSTRACT FROM AUTHOR]

Myanmar, a nation situated between India, China and Southeast Asia, has long histories of colonialism, violence, and resource extraction. This special issue introduction, written in the midst of Myanmar's 2021 military coup and the COVID-19 pandemic, offers two critical and feminist interventions – 'remaking' and 'living with' – to understand the contested and embodied political geographies of extractive resource frontiers in Myanmar. 'Remaking' focuses on the long roots of resource frontiers, underscoring the historical and spatial processes through which Myanmar's plural authorities have restructured diverse territories for accumulation and extraction from the pre-colonial period to the recent 'democratic transition'. 'Living with' resource frontiers bring attention to people's everyday lives, and why and how they adapt, resist, comply, suffer and profit from resource frontiers. In bringing together a diverse set of literatures with original empirical research, the articles in this collection offer analyses of Myanmar's pre-coup period that inform contemporary post-coup politics. Together, they demonstrate the material, affective, and embodied nature of resource frontiers as they are (re)made and lived with – in and beyond militarised spaces like Myanmar. [ABSTRACT FROM AUTHOR]

Background: In Tak province, Thailand migrants and refugees from Myanmar navigate a pluralistic healthcare system to seek Tuberculosis (TB) care from a variety of government and non-governmental providers. This multi-methods qualitative study examined access to TB, TB/HIV and multidrug-resistant tuberculosis (MDR-TB) treatment with an emphasis on barriers to care and enabling factors. Methods: In the summer and fall of 2014, we conducted 12 key informant interviews with public health officials and TB treatment providers. We also conducted 11 focus group discussions with migrants and refugees who were receiving TB, TB/HIV and MDR-TB treatment in Tak province as well as non-TB patients. We analyzed these data through thematic analysis using both predetermined and emergent codes. As a second step in the qualitative analysis, we explored the barriers and enabling factors separately for migrants and refugees. Results: We found that refugees face fewer barriers to accessing TB treatment than migrants. For both migrants and refugees, legal status plays an important intermediary role in influencing the population's ability to access care and eligibility for treatment. Our results suggest that there is a large geographical catchment area for migrants who seek TB treatment in Tak province that extends beyond provincial boundaries. Migrant participants described their ability to seek care as linked to the financial and non-financial resources required to travel and undergo treatment. Patients identified language of health services, availability of free or low cost services, and psychosocial support as important health system characteristics that affect accessibility. Conclusion: Access to TB treatment for migrants and refugees occurs at the interface of health system accessibility, population ability and legal status. In Tak province, migrant patients draw upon their social networks and financial resources to navigate a pathway to treatment. We revised a conceptual framework for access to healthcare to incorporate legal status and the cyclical pathways through which migrants access TB treatment in this region. We recommend that organizations continue to collaborate to provide supportive services that help migrants to access and continue TB treatment. [ABSTRACT FROM AUTHOR]

This paper discusses neoliberalism's effects on migrants in Mae Sot, a town on the Thai-Myanmar border inhabited by approximately 200,000 migrants from Myanmar. Most literature on neoliberalism and borders focuses on how borders filter between "desired" and "unwanted" mobilities in the interests of capital accumulation. This paper takes a different approach; it argues that neoliberalism reconfigures the day-to-day social realities of migrants, who are embedded in families, communities, and a larger social system along the Thai-Myanmar border. During the 1980s, when a war economy thrived along the Thai-Myanmar border, migrants in Mae Sot established a semi-legal social system comprising schools, clinics, and community organisations, that allowed migrants to access functions ordinarily provided by a state. However, Myanmar's transition to a nominally civilian government in 2010 resulted in two changes on the border. Firstly, the Thai state is implementing projects to connect Mae Sot to transcontinental transport networks. Secondly, Western donors that funded community organisations in Mae Sot began re-routing their resources to supporting in-country programmes in Myanmar. Neoliberalism is the driving force for both these phenomena. Using the concepts of bordering and borderscapes, this paper discusses their combined effects on migrant children, families, and communities. Migrant children are increasingly denied opportunities to go to school, even as their parents become more deeply integrated into the border economy. Leaders of community organisations decrease their reliance on Western donors, but increase the burdens they place on other community members. The case of the Thai-Myanmar border demonstrates that a comprehensive understanding of neoliberalism's relationship with interstate borders must consider the ways in which socio-spatial identities are produced in dynamic relation with top-down efforts to regulate interstate boundaries. Concepts of bordering and the borderscape are central to this endeavor. • The Thai state seeks to capitalise on migrant labour on the Thai-Myanmar border. • Western governments withdraw their support from migrant organisations in response to political transitions in Myanmar. • Both these phenomena can be understood as neoliberal. • Neoliberalism alters the day-to-day social relations between migrants and between migrants and community organisations. • Borderscapes and bordering provide conceptual tools to understand these changes. [ABSTRACT FROM AUTHOR]

The Mogok continental foreland region and Katha-Gangaw range (KGR) are located in the north-central section of the Myanmar plate, which is a component of the Eurasian plate. The origin of KGR, exposed along northern Myanmar (SE Asia), is still up for argument, despite numerous prior studies. Based on the petrography, geochemistry, and detrital zircon U-Pb geochronology of metamorphic rock samples, the current study focuses on the tectonic evolution of the KGR. The study also emphasizes the phenomenon of microcontinents rifting from the Gondwanan supercontinent and their subsequent amalgamation with Asia. Detrital zircon ages from four samples in the southern region of KGR peak at 634 Ma, 525 Ma, 290 Ma, and 248 Ma, and two samples yielded > 40% of the grains of younger than 400 Ma. Similar results were obtained from three samples (out of six) from the central region of the KGR. All of the samples from the northern part of KGR are older than 400 Ma, with the exception of MT-02A, which contains nearly all of the younger grains. These younger peaks are identical to the zircon U-Pb ages of the Indochina block, the Sibumasu block, and the Pane Chaung Formation of the Myanmar plate, as well as the Langjiexue Formation (southeastern Tibet). This similarity raises the possibility of either these units being a source region of strata in northern Myanmar or sharing a similar source. The geochemistry of metamorphic rocks samples from KGR revealed loss-on-ignition (LOI) values of 0.29–4.18 wt%, emphasizing the modest to moderate alteration. The samples are enriched in large-ion lithophile elements (LILEs), and depleted in high-field strength elements (HFSEs). All metamorphic samples are peraluminous, indicating the linkage with collisional orogenies. This result is most comparable to upper continental crustal provenance. Hence, the metamorphic rocks in KGR regions must be associated with the crustal materials. [ABSTRACT FROM AUTHOR]

Background: Burma/Myanmar was controlled by a military regime for over 50 years. Many basic social and protection services have been neglected, specifically in the ethnic areas. Development in these areas was led by the ethnic non-state actors to ensure care and the availability of health services for the communities living in the border ethnic-controlled areas. Political changes in Burma/Myanmar have been ongoing since the end of 2010. Given the ethnic diversity of Burma/Myanmar, many challenges in ensuring health service coverage among all ethnic groups lie ahead. Methods: A case study method was used to document how existing human resources for health (HRH) reach the vulnerable population in the ethnic health organizations' (EHOs) and community-based organizations' (CBHOs) service areas, and their related information on training and services delivered. Mixed methods were used. Survey data on HRH, service provision, and training were collected from clinic-in-charges in 110 clinics in 14 Karen/Kayin townships through a rapid-mapping exercise. We also reviewed 7 organizational and policy documents and conducted 10 interviews and discussions with clinic-in-charges. Findings: Despite the lack of skilled medical professionals, the EHOs and CBHOs have been serving the population along the border through task shifting to less specialized health workers. Clinics and mobile teams work in partnership, focusing on primary care with some aspects of secondary care. The rapid-mapping exercise showed that the aggregate HRH density in Karen/Kayin state is 2.8 per 1,000 population. Every mobile team has 1.8 health workers per 1,000 population, whereas each clinic has between 2.5 and 3.9 health workers per 1,000 population. By reorganizing and training the workforce with a rigorous and up-to-date curriculum, EHOs and CBHOs present a viable solution for improving health service coverage to the underserved population. Conclusion: Despite the chronic conflict in Burma/Myanmar, this report provides evidence of the substantive system of health care provision and access in the Karen/Kayin State over the past 20 years. It underscores the climate of vulnerability of the EHOs and CBHOs due to lack of regional and international understanding of the political complexities in Burma/Myanmar. As Association of Southeast Asian Nations (ASEAN) integration gathers pace, this case study highlights potential issues relating to migration and health access. The case also documents the challenge of integrating indigenous and/or cross-border health systems, with the ongoing risk of deepening ethnic conflicts in Burma/Myanmar as the peace process is negotiated. [ABSTRACT FROM AUTHOR]

Objectives: Methylene blue, once discarded due to its unsettling yet mild side effects, has now found a renewed place in the pharmacopoeia of modern medicine. The continued spread of drug-resistant Plasmodium vivax and Plasmodium falciparum has also led to a recent re-examination of methylene blue's potent antimalarial properties. Here we examine the ex vivo susceptibility profile of Plasmodium spp. isolates to methylene blue; the isolates were from a region on the Thai-Myanmar border where there are increasing rates of failure when treating vivax malaria with chloroquine.Methods: To do this we used a newly developed ex vivo susceptibility assay utilizing flow cytometry and a portable flow cytometer with a near-UV laser.Results: P. vivax (median methylene blue IC50 3.1 nM, IQR 1.7-4.3 nM) and P. falciparum (median methylene blue IC50 1.8 nM, IQR 1.6-2.3 nM) are susceptible to methylene blue treatment at physiologically relevant levels. Unfortunately, the addition of chloroquine to combination treatments with methylene blue significantly reduces the ex vivo effectiveness of this molecule.Conclusions: Our data support further efforts to employ methylene blue as a safe, low-cost antimalarial to treat drug-resistant malaria. [ABSTRACT FROM AUTHOR]

It has become widely acknowledged by scholars and practitioners that women's participation in peace-building is essential to building sustainable, inclusive peace. The question remains, however, what is 'women's participation' in practical terms? What does it look like? What does it feel like? Following feminist scholarship that has argued for attention to the politics of emotion in International Relations, I call for an emotion-aware approach to thinking about women's participation in peace-building and the recognition that emotion has real, material effects on how women participate and the impact of their participation. Drawing on fieldwork experience in Burma and on the Thailand-Burma border I reflect on the process of asking such questions and the possibilities of taking affect seriously in the study of peace. What emerges from this reflection is a methodological consideration that centres emotion and recognises it as simultaneously politically meaningful and gendered. Exploration of the challenges of such an approach grounds this contribution in the realities of data collection and interpretation in the field, while also demonstrating the richness that emerges from such inquiry. [ABSTRACT FROM AUTHOR]

Cross-national media freedom comparison is often based on Western-biased indices published by organizations such as Freedom House or Reporters Without Borders. Additionally, Eurocentric analysis and comparison are endorsed by the application of hegemonic media systems models to compare media environments. This study argues that cultural contextualization is indispensable to challenging the prevailing Eurocentrism. Comparison of the 'connotative' contexts of Malaysia, Myanmar and Thailand demonstrates the analytical and explanatory power of inductively inferred variables to understand the formation of political communication. The comparison highlights factors which go beyond the comparison of media systems using predefined categories and models. [ABSTRACT FROM AUTHOR]

This triptych uses academic literature, poetry, and personal reflection to illustrate the impact of the invisible currents of power that run through society and history on three fictional individuals—a Native Hawaiian woman on the Hamakua coast of the Island of Hawai'i, a girl in a refugee camp on the Thailand-Myanmar border, and a military general in a government building in Naypyidaw, the capital of Myanmar. [ABSTRACT FROM AUTHOR]

This article deals with a question foregrounded by historian Willem van Schendel in his seminal 2002 article 'Geographies of Knowing, Geographies of Ignorance': how do arms, arms flows, and associated regulatory practices reshape the geometries of authority and power in borderlands? The rich transdisciplinary literature on borderlands has fruitfully deployed van Schendel's insights to re-spatialise areas and states but has devoted scant attention to such question. Drawing from 'new materialist' scholarship in IR and the concept of scale in political geography, the paper argues that fluid and fractionally coherent combinations of weapons as technical objects that come from somewhere, rationalities, and techniques of arms control reproduce multiple scales of territorial authority and struggles over scaled modes of governing violence in borderlands. Such struggles of scales and about scale constantly reconfigure the territorial arenas of authority on violence at the edge of the state. Based on fieldwork in Ta'ang areas of northern Shan State, Myanmar, the article develops an empirical analysis of encounters between explosive devices/landmines and the subjects and spaces they target. Delving into the processes and practices of 'making' and controlling the 'landmine', I find that different socio-political orders confront themselves through rationalities, techniques, and practices of humanitarian arms control via which they navigate/jump across scales, forge new ones, or mobilise multi-scalar alliances. Different types of 'dead' and 'alive' landmines nonetheless defy these attempts at rescaling territorial authority over violence by acting in unforeseen manners at the scale of their own ecologies of violence. [ABSTRACT FROM AUTHOR]

There are 117 living languages in Myanmar (Lewis et al., 2016). In a country of 53 million people, over 23 million are fluent in one of the seven main indigenous language clusters: Shan, Mon, Rakhine (Rohingya), Chin, Kachin, Karenni (Kayah), and Karen (Kayin) (World Bank, 2018). Even during the January 2011 - January 2021 period under a democratically elected civilian government, the official language of oral and written instruction in all government schools remained rigidly singular. In many of Myanmar's ethnolinguistic minority communities, the national language is only first encountered in schools and rarely used at home. An assessment of multilingual education (MLE) teacher competencies was used to assess the specific proficiencies needed to effectively promote multilingual education with 16 teachers working in areas under ethnic administration in southeastern Myanmar, as well as one temporary shelter on the Thai-Myanmar border, with the goal of identifying existing abilities and areas for growth. Overall, 94% of observed ethnic and refugee teachers demonstrated meeting minimum MLE competency requirements to support children to build a strong bridge from their mother tongue to their L2 (Burmese or English, depending on the context). The study was conducted together with the Karen Education and Cultural Department (KECD), Kayan New Generation Youth (KNGY), the Karen Teacher Working Group (KTWG), the Mon National Education Committee (MNEC), Rural Indigenous Sustainable Education (RISE), and the Karen Refugee Committee-Education Entity (KRC-EE) and World Education Thailand and Myanmar. [ABSTRACT FROM AUTHOR]

Globally, attacks on and interferences with health workers and healthcare delivery, including targeted violence towards providers, attacks on hospitals and delays and denial of health care, represent a serious humanitarian and human rights issue. However, gaps in research about these events persist, limiting the evidence base from which to understand and address the problem. This paper focuses on experiences of local health workers in eastern Burma's chronic conflict, including their strategies for addressing security and ensuring access to vulnerable ethnic communities in the region. Face-to-face in-depth interviews were conducted in June and August 2012 with 27 health workers from three health organizations that operate throughout eastern Burma, with their operational head quarters located in Mae Sot, Tak Province, Thailand. Qualitative analysis found that health workers in this setting experience violent and non-violent interferences with their work, and that the Burmese government's military activities in the region have severely impacted access to care, which remains restricted. Data show that innovative security strategies have emerged, including the important role of the community in ensuring securer access to health care. This study underscores health workers' concern for improved data collection to support the rights of health workers to provide health care, and the rights of community members to receive health care in conflict-affected settings. Findings will inform the development of an incident reporting form to improve systematic data collection and documentation of attacks on health in this setting. [ABSTRACT FROM AUTHOR]

Background: The collection and utilization of surveillance data is essential in monitoring progress towards achieving malaria elimination, in the timely response to increases in malaria case numbers and in the assessment of programme functioning. This paper describes the surveillance activities used by the malaria elimination task force (METF) programme which operates in eastern Myanmar, and provides an analysis of data collected from weekly surveillance, case investigations, and monitoring and evaluation of programme performance. Methods: This retrospective analysis was conducted using data collected from a network of 1250 malaria posts operational between 2014 and 2021. To investigate changes in data completeness, malaria post performance, malaria case numbers, and the demographic details of malaria cases, summary statistics were used to compare data collected over space and time. Results: In the first 3 years of the METF programme, improvements in data transmission routes resulted in a 18.9% reduction in late reporting, allowing for near real-time analysis of data collected at the malaria posts. In 2020, travel restrictions were in place across Karen State in response to COVID-19, and from February 2021 the military coup in Myanmar resulted in widescale population displacement. However, over that period there has been no decline in malaria post attendance, and the majority of consultations continue to occur within 48 h of fever onset. Case investigations found that 43.8% of cases travelled away from their resident village in the 3 weeks prior to diagnosis and 36.3% reported never using a bed net whilst sleeping in their resident village, which increased to 72.2% when sleeping away from their resident village. Malaria post assessments performed in 82.3% of the METF malaria posts found malaria posts generally performed to a high standard. Conclusions: Surveillance data collected by the METF programme demonstrate that despite significant changes in the context in which the programme operates, malaria posts have remained accessible and continue to provide early diagnosis and treatment contributing to an 89.3% decrease in Plasmodium falciparum incidence between 2014 and 2021. [ABSTRACT FROM AUTHOR]

Based on conflict data, interviews and media monitoring, this study of Myanmar's non-inclusive ceasefires develops a four-step argument about the effect of ceasefires in complex conflict systems. First, non-state armed groups rarely co-ordinate their actions strategically. This makes it easy for governments to obtain ceasefires with some groups while fighting others. Second, when ceasefires ensure armed groups' survival, they mostly hold. Third, non-inclusive ceasefires do not reduce a country's overall level of violence, since fighting tends to escalate with excluded groups. On this basis we conclude that non-inclusive ceasefires do not present a viable alternative to an inclusive peace process. [ABSTRACT FROM AUTHOR]

History, ethnicity, culture, and religion have played a key role in India-Myanmar bilateral relations. Whether it is linkages to Buddhism or geographical proximity, the two countries understand the significance of their bond despite the complications. The inconsistent democracy in Myanmar has created "ups and downs" in bilateral relations while posing many challenges for India. India's policy with respect to Myanmar lacks clarity and a long-term vision unlike China's strategic framework. India's patient and quiet diplomacy towards Myanmar lacks long-term visions. Hence, anything short-term necessitates punctual transitions. India must adopt a realist policy but with a smidgen of idealism. This idealism would not be against the Indian national interest and would definitely pay off in its rivalry with China. The paper focuses on how India's relation with Myanmar is influenced by the absence of a proper democratic institution. It explores the influence of Tatmadaw's rule on the Sino-Indian energy conflict in Myanmar. The paper draws insights from the history of India-Myanmar relations to analyze India's current potentiality to outplay China in gaining diplomatic advantage and reaping greater advantages. [ABSTRACT FROM AUTHOR]

In Thailand, a health-promoting school (HPS) program is in place nationwide. However, this policy has not covered Burmese migrant schools. Therefore, to ensure the feasibility of the implementation of a HPS program, we conducted evaluations and an intervention on school health in migrant schools in Thailand. We included 44 primary-level schools in the Tak province in 2008. We were able to evaluate the results of the intervention in 43 of 44 schools in the subsequent year. For measurement, we used a comprehensive school-health checklist with five components: ‘personal health and life skills’, ‘healthy school environment’, ‘health and nutrition services’, ‘common disease control and prevention’, ‘school and community partnership’. The checklist contained 59 items; item scores ranged from 0 to 3. We compared the results of the two surveys (performed before and after the intervention) by calculating the mean score of each item. A 1.3-fold increase was seen in the mean of all items measured in the evaluation (from 1.7 to 2.2, n= 43). Out of the five components, the greatest difference was detected in ‘school and community partnership’, which increased from 1.0 to 2.4. Notably, the mean score of item 4 of component 5, ‘clear definition of the roles and responsibilities with the Burmese community’, increased from 0.4 to 2.7. Although further study is necessary to investigate the association between our intervention and the improvements among schools, our school health evaluation and intervention were successfully implemented in Burmese migrant schools. [ABSTRACT FROM PUBLISHER]

Since 2007, I have been travelling regularly to the Thai /Burma border to run creative writing workshops with Burmese women refugees. The stories that eventuate from the workshops are published and distributed internationally. I have never been inside Burma so my knowledge of the country has come to me via other peoples' stories. Recent changes that have taken place in Burma give glimpses of hope for a democratic future and yet I remain on the edges of this country I feel I know intimately. In his memoir From the Land of Green Ghosts (2004) Pascal Khoo Thwe writes about the layers of distinctly different cultures that make up the country of Burma. After attending university in Mandalay Pascal was forced to flee after the arrest of his activist girlfriend. He joined the guerilla forces on the border and then through a chance encounter with academic, John Casey, finally made his way across the border into Thailand then on to England. This extraordinary story is more common than many people realize. When one considers the more than half a million refugees who have fled across the Burmese borders into neighboring Thailand over the last decade it is easy to see the tremendous ramifications that the political situation has had on the people of Burma. This paper is a meditation on the Burma of my imagination and the many permutations of country, culture and landscape that I have come to know through the people of Burma and their relationship to the lands of their birth. As a facilitator of other people's stories I reflect on the ways in which the personal stories of lives lived inside Burma and on the borders of the country as refugees have helped me understand the situation there. The paper also explores the way narrative and advocacy, storytelling and capacity building have played a part in the democratic changes that are now taking place after more than sixty years of civil war inside Burma. [ABSTRACT FROM AUTHOR]

Background: Malaria remains a major public health threat and tools sensitive to detect infections in low malaria transmission areas are needed to progress elimination efforts. Pregnant women are particularly vulnerable to malaria infections. Throughout pregnancy they access routine antenatal care, presenting a unique sentinel population to apply novel sero-surveillance tools to measure malaria transmission. The aim of this study was to quantify the dynamic antibody responses to multiple antigens during pregnancy so as to identify a single or multiple antibody response of exposure to malaria in pregnancy. Methods: This study involved a secondary analysis of antibody responses to six parasite antigens [five commonly studied merozoite antigens and the variant surface antigen 2-chondroitin sulphate A (VAR2CSA), a pregnancy-specific erythrocytic antigen] measured by enzyme-linked immunosorbent assay (ELISA) over the gestation period until delivery (median of 7 measurements/woman) in 250 pregnant women who attended antenatal clinics located at the Thai-Myanmar border. A multivariate mixture linear mixed model was used to cluster the pregnant women into groups that have similar longitudinal antibody responses to all six antigens over the gestational period using a Bayesian approach. The variable-specific entropy was calculated to identify the antibody responses that have the highest influence on the classification of the women into clusters, and subsequent agreement with grouping of women based on exposure to malaria during pregnancy. Results: Of the 250 pregnant women, 135 had a Plasmodium infection detected by light microscopy during pregnancy (39% Plasmodium falciparum only, 33% Plasmodium vivax only and 28% mixed/other species), defined as cases. The antibody responses to all six antigens accurately identified the women who did not have a malaria infection detected during pregnancy (93%, 107/115 controls). Antibody responses to P. falciparum merozoite surface protein 3 (PfMSP3) and P. vivax apical membrane antigen 1 (PvAMA1) were the least dynamic. Antibody responses to the antigens P. falciparum apical membrane antigen 1 (PfAMA1) and PfVAR2CSA were able to identify the majority of the cases more accurately (63%, 85/135). Conclusion: These findings suggest that the combination of antibodies, PfAMA1 and PfVAR2CSA, may be useful for sero-surveillance of malaria infections in pregnant women, particularly in low malaria transmission settings. Further investigation of other antibody markers is warranted considering these antibodies combined only detected 63% of the malaria infections during pregnancy. [ABSTRACT FROM AUTHOR]

This article applies the concept of frontier to analytically understand the forms of border governance that are developing in a former combat zone after the signing of a ceasefire agreement between the Myanmar government and the Karen National Union (KNU). In particular, it explores border governance through the lens of judicial interventions, moral ordering, and control of crime. Based on ethnographic fieldwork in 2016–2018, it shows how a Karen-populated area changed from being a military combat zone to an area that is the target of civilian state-making efforts by both the KNU and the Myanmar state. These efforts intermingle and compete, and yet each form of state-making remains incomplete and contested. This has resulted in pluralized authorities and partly overlapping forms of what I conceptualize as 'frontier border governance'. With its focus on two competing state-making actors, the article adds new insights to the burgeoning literature on frontiers, which predominantly focuses on a single expansionary state. [ABSTRACT FROM AUTHOR]

This article focuses on cross-border medical connections between Myanmar and Manipur, India. Non-state actors have been instrumental in creating the networks to bring bodies and body parts back and forth, first bypassing, then enmeshing, state actors. I focus on the movement of patients and medical samples across the border—from western Myanmar to Imphal city and back again—and the health infrastructure that enables it. Analysing these connections makes several contributions to the study of border governance. First, movement from Myanmar to Manipur is primarily for treatment or diagnosis, and these connections project particular ways of thinking about each place—western Myanmar as poor and remote, Manipur as advanced and networked. Second, both Manipur and western Myanmar can be considered in 'transition'—as territories being recalibrated by political dynamics emanating elsewhere yet becoming connected through shared needs. Third, patients and samples move through territories controlled by paramilitary forces, underground groups, and different tribal councils. Routes are sometimes blocked or passage treacherous, testing the limits of conventional notions of bilateral border governance. Finally, cross-border medical connections between Manipur and Myanmar draw attention to the risky cross-border medical mobility of the poor. Rather than seeking to minimize cost, patients utilize Manipur's health infrastructure out of necessity, providing insights into the contours of cross-border medical care in times of transition. [ABSTRACT FROM AUTHOR]

A new genus of the millipede family Pachybolidae from Southeast Asia is described: Macrurobolus gen. nov., with Spirobolus macrurus Pocock, 1893 as type species. This latter species is DNA barcoded (COI) and redescribed based on male morphological characters, which hitherto were unknown. The new genus differs from other pachybolid genera by having (1) the preanal ring process long and protruding beyond the anal valves and (2) the anterior gonopod telopodite distally abruptly narrowed, forming an extremely long, slender, elevated process curved caudad. Given that Macrurobolus gen. nov. is a monotypic genus, it is aphyletic and thus requires further taxonomic revision. [ABSTRACT FROM AUTHOR]

This article investigates a concern among encamped elder Karen refugees (an ethnic minority from Myanmar) living along the Thai–Myanmar border that the youth are disconnected politically and culturally. I argue that Karen youth are creative, active participants reimagining and revitalising Karen politics and culture in their image. I explore how displaced youths have found a voice in Karen rap and how they express this voice in the digitally mediated lived space of YouTube. I consider YouTube as a lived space where citizenship is reimagined and long-distance nationalism is articulated. Finally, I contend that YouTube is transforming Karen youths' political experiences and mobility and that they are actively political – just not in the way the elders expect. [ABSTRACT FROM AUTHOR]

The events that followed the military coup of February 2021, and the violence that ensued throughout 2022 serve as stark reminders that any notion that Myanmar is and operates as a single polity are a fiction, and one that neither captures the complex reality on the ground nor serves to guide policy to contain violence and assist the population on the ground. Instead, Myanmar is currently home to a variety of constantly evolving geographies of war (‘warscapes’), each distinctive in terms of actors involved and outcomes. An analysis of the political dynamics in these warscapes, the economic situation therein, and the degree of transnational ties and involvement suggests the emergence of a condition of fragmented sovereignty across the territory of the Republic of the Union of Myanmar. Just like in the pre-2011 period, when the prevailing narrative was one of Myanmar’s international isolation, the regime actually entertains a wide range of relations with countries both close and afar. Russia, in particular, has emerged as the junta’s strongest backer. The military regime is among the staunchest supporters of Russia’s invasion of Ukraine. The economy and the livelihoods of millions have been devastated by the violence. Western investors have mostly retreated. The economy barely functions. Aid supply has become difficult to provide due to increasing regulation and restrictions. No side was able to prevail in 2022, with multiple conflicts protracted, when not intractable, and violence escalating. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to assess the health outcome of four epidemic-prone infectious diseases, in the context of a Primary Health Care project implemented in a protracted refugee setting along the Thai–Myanmar border. Background: Refugees settled at the Thai–Myanmar border are fully dependent on support for health services, shelter, food, education, water, and sanitation. The Non-Governmental Organization Malteser International developed an integrated Primary Health Care program in close cooperation with trained camp residents over 25 years in the two settlements under its supervision. The project has been funded by the European Commission Civil Protection and Humanitarian Aid Operations (DG ECHO). Methods: This was a retrospective primary health care project evaluation. All-cause mortality; morbidity trends in malaria, lower respiratory tract infections (LRTIs), watery diarrhea, and dysentery; and health service utilization covering a time span of 18 years were assessed. Programmatic changes in the Primary Health Care (PHC) project and events with a potential effect on health of the target population were examined. Findings: Despite the continuous drain of trained health care workers, the volatile influx of refugees, and the isolated location of the two camps, the initial basic curative health care developed into an integrated and comprehensive PHC project including a SPHERE-compliant water, sanitation, and hygiene program. Malaria, LRTIs, watery diarrhea, and dysentery morbidity dropped twelve, three, two, and fivefold, respectively, over the 18-year period evaluated while the health services utilization dropped from 7.1 to 2.9 consultations per refugee/year. The international community may face situations where integration of refugees into the health services of the host country is not possible. In such a context, integrated and evidence-based PHC adequately funded and implemented by one health agency is an effective and relevant approach to reduce the infectious diseases burden under the constraints of semipermanent living conditions. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B infection is a major health concern in Myanmar. Hepatitis B birth dose vaccination to prevent mother-to-child transmission is not universal, especially in births outside of health care facilities. Little is documented about delivery of immunization programs in rural Myanmar or in conflict-affected regions. To address this gap, this study describes the implementation of a novel community delivered neonatal hepatitis B immunization program in rural Karenni State, Myanmar. Methods: A mixed-methods study assessed the effectiveness and feasibility of hepatitis B birth dose immunization program. 1000 pregnant women were screened for hepatitis B virus (HBV) infection using point of care testing. Neonates of HBV positive mothers were immunized with a three dose HBV vaccine schedule at birth, 1, and 6 months of age. HBV testing was completed for children at 9 months to assess for infection. Descriptive statistics were collected including demographic data of mothers, neonatal vaccination schedule completion, and child HBV positivity at 9 months. Qualitative data examining barriers to implementation were collected through semi-structured interviews, participant-observation, and analysis of program documents. Themes were codified and mapped onto the Consolidated Framework for Implementation Research. Results: 46 pregnant women tested HBV positive leading to 40 live births. 39 women-child dyads were followed until the 9-month age mark. With the exception of two neonates who received their birth dose past 24 hours, all children received their vaccines on time. None of the 39 children tested positive for HBV at nine months. Themes regarding barriers included adaptability of the program to the rural setting, friction with other stakeholders and not meeting all needs of the community. Identified strengths included good communication and leadership within the implementing ethnic health organization. Conclusion: A community delivered neonatal HBV vaccination program by ethnic health organizations is feasible and effective in rural Myanmar. [ABSTRACT FROM AUTHOR]

Background: Many countries aspiring to achieve universal health coverage struggle with how to ensure health coverage for undocumented migrants. Using a case study of maternal health care in a Thailand-Myanmar border region this article explores coverage for migrants, service provision challenges and the contribution of a voluntary health insurance program.Methods: In 2018 we interviewed 18 key informants who provided, oversaw or contributed to maternal healthcare services for migrant women in the border region of Tak province, Thailand.Results: In this region, we found that public and non-profit providers helped increase healthcare coverage beyond undocumented migrants' official entitlements. Interview participants explained that Free and low-cost antenatal care (ANC) is provided to undocumented migrants through migrant specific clinics, outreach programs and health posts. Hospitals offer emergency birth care, although uninsured migrant patients are subsequently billed for the services. Care providers identified sustainability, institutional debt from unpaid obstetric hospital bills, cross border logistical difficulties and the late arrival of patients requiring emergency lifesaving interventions as challenges when providing care to undocumented migrants. An insurance fund was developed to provide coverage for costly emergency interventions at Thai government hospitals. The insurance fund, along with existing free and low-cost services, helped increase population coverage, range of services and financial protection for undocumented migrants.Conclusions: This case study offers considerations for extending health coverage to undocumented populations. Non-profit insurance funds can help to improve healthcare entitlements, provide financial protection and reduce service providers' debt. However, there are limits to programs that offer voluntary coverage for undocumented migrants. High costs associated with emergency interventions along with gaps in insurance coverage challenge the sustainability for NGO, non-profit and government health providers and may be financially disastrous for patients. Finally, in international border regions with high mobility, it may be valuable to implement and strengthen cross border referrals and health insurance for migrants. [ABSTRACT FROM AUTHOR]

Context: Maintaining landscape connectivity for large felids by preserving and restoring corridors between core habitats is crucial to their long-term conservation. Tiger, leopard, and clouded leopard populations occur in isolated habitat patches across the Dawna-Tanintharyi Landscape (DTL) of Kawthoolei (all Karen National Union administrative areas in Myanmar) and Thailand. Objectives: We analyzed connectivity among 18 habitat patches in this transboundary region based on large felid presence and expert opinion of large felid dispersal requirements. Methods: Least-cost corridor and circuit theory analyses were used to identify corridors, determine corridor quality and their relative importance to connectivity in the landscape, and pinpoint bottlenecks to movement. Results: Forty-eight corridors were identified. Lower resistances to dispersal were in forested montane areas. High-quality corridors remained in the northern DTL and south of Tanintharyi Nature Reserve in Kawthoolei based on cost-weighted distance to least-cost path ratio. Pairwise current pinch point analyses revealed a possible landscape level bottleneck to movement north of Thailand's Western Forest Complex. Area corrected centrality scores indicated smaller habitat patches disproportionately contributed to landscape connectivity. Conclusions: The DTL may retain connectivity across the landscape if conservation actions are taken to protect integral habitats and corridors. Conservation efforts that expand the protected area network in Kawthoolei, either by increasing the size of current protected area habitats or by demarcating new protected areas in regions with confirmed felid presence, will aid DTL connectivity. The DTL should be managed to preserve connectivity on both sides of the border, entailing international governmental, indigenous community, and non-governmental collaboration. [ABSTRACT FROM AUTHOR]

Population risks for neonatal hyperbilirubinaemia (NH) vary. Knowledge of local risks permits interventions that may reduce the proportion becoming severe. Between January 2015 and May 2016, in a resource-limited setting on the Thailand-Myanmar border, neonates from 28 weeks' gestation were enrolled into a prospective birth cohort. Each neonate had total serum bilirubin measurements: scheduled (24, 48, 72 and 144 hours of life) and clinically indicated; and weekly follow up until 1 month of age. Risk factors for developing NH were evaluated using Cox proportional hazard mixed model. Of 1710 neonates, 22% (376) developed NH (83% preterm, 19% term). All neonates born <35 weeks, four in five born 35–37 weeks, and three in twenty born ≥38 weeks had NH, giving an overall incidence of 249 per 1000 livebirths [95%CI 225, 403]. Mortality from acute bilirubin encephalopathy was 10% (2/20) amongst the 5.3% (20/376) who reached the severe NH threshold. One-quarter (26.3%) of NH occurred within 24 hours. NH onset varied with gestational age: at a median [IQR] 24 hours [24, 30] for neonates born 37 weeks or prematurely vs 59 hours [48, 84] for neonates born ≥38 weeks. Risk factors for NH in the first week of life independent of gestational age were: neonatal G6PD deficiency, birth bruising, Sgaw Karen ethnicity, primigravidae, pre-eclampsia, and prolonged rupture of membranes. The genetic impact of G6PD deficiency on NH was partially interpreted by using the florescent spot test and further genotyping work is in progress. The risk of NH in Sgaw Karen refugees may be overlooked internationally as they are most likely regarded as Burmese in countries of resettlement. Given high levels of pathological jaundice in the first 24 hours and overall high NH burden, guidelines changes were implemented including preventive PT for all neonates <35 weeks and for those 35–37 weeks with risk factors. [ABSTRACT FROM AUTHOR]

Background: Providing at-risk communities with uninterrupted access to early diagnosis and treatment is a key component in reducing malaria transmission and achieving elimination. As programmes approach malaria elimination targets it is critical that each case is tested and treated early, which may present a challenge when the burden of malaria is reduced. In this paper we investigate whether malaria testing rates decline over time and assess the impacts of integrating malaria and non-malaria services on testing rates in the malaria elimination task force (METF) programme in the Kayin state of Myanmar.Methods: A retrospective analysis was conducted using weekly collected data on testing rates from a network of more than 1200 malaria posts during the period from 2014 to 2020. To determine whether monthly testing rates changed over the years of programme operations, and whether integrating malaria and non-malaria services impacted these testing rates, we fitted negative binomial mixed-effects regression models to aggregate monthly data, accounting for malaria seasonal variation.Results: In the first year of malaria post operation, testing rates declined, correlating with a decline in attendance by people from outside the malaria post catchment area, but then remained fairly constant (the Rate Ratio (RR) for 2nd versus 1st year open ranged from 0.68 to 0.84 across the four townships included in the analysis, the RR for 3rd to 6th year versus 1st year open were similar, ranging from 0.59-0.78). The implementation of a training programme, which was intended to expand the role of the malaria post workers, had minimal impact on testing rates up to 24 months after training was delivered (RR for integrated versus malaria-only services ranged from 1.00 to 1.07 across METF townships).Conclusion: Despite the decline in malaria incidence from 2014 to 2020, there has been no decline in the malaria testing rate in the METF programme after the establishment of the complete malaria post network in 2016. While the integration of malaria posts with other health services provides benefits to the population, our evaluation questions the necessity of integrated services in maintaining malaria testing rates in areas approaching elimination of malaria. [ABSTRACT FROM AUTHOR]

Dieser Artikel beantwortet die Frage, wie Rechtsordnungen ohne staatlich verfasste Rechtssysteme etabliert werden. Basierend auf ethnographischen Feldforschungen in burmesischen Flüchtlingslagern in Thailand wird gezeigt, dass lokale Gewohnheitsrechte in der Rechtspraxis und Fallbearbeitung dominieren, obwohl plurale Rechtssysteme präsent sind. Das Gewohnheitsrecht entwickelt sich über modifizierte Prä-Lagerstrukturen und -praktiken der Geflüchteten, passt sich an das Lagerleben an und transformiert sich über die zunehmende Präsenz internationaler sowie staatlicher Akteure. Ferner zeigt sich, dass weitere lagerspezifische Mechanismen einen entscheidenden Beitrag zur Aufrechterhaltung von Recht und Ordnung leisten. Indem diese rechtssoziologische Studie das Konzept des doing law in den Mittelpunkt der Analyse stellt, wird ein neues Verständnis von Rechtsordnungen in Flüchtlingslagern entwickelt, das die gängige Vorstellung von Lagern als rechtsfreie Räume in Frage gestellt. This article answers the question of how legal orders are established in spaces where state law sovereignty is suspended. Ethnographic research in Burmese refugee camps in Thailand shows that local customary laws dominate in case processing, even though plural legal systems are present. Customary camp law is informed by pre-camp structures, adapted to camp life and increasingly transformed by the presence of international and state actors. Furthermore, other social camp-specific mechanisms make a decisive contribution to the maintenance of law and order. These results contrast with research that problematizes refugee camps as spaces with a legal vacuum. This sociological study of law places the concept of "doing law" at the center of analysis and thus enables a new understanding of legal order in refugee camps. [ABSTRACT FROM AUTHOR]

Background Lower respiratory infections constitute a major disease burden worldwide. Treatment is usually empiric and targeted towards typical bacterial pathogens. Understanding the prevalence of pathogens not covered by empirical treatment is important to improve diagnostic and treatment algorithms. Methods A prospective observational study in peri-urban communities of Yangon, Myanmar was conducted between July 2018 and April 2019. Sputum specimens of 299 adults presenting with fever and productive cough were tested for Mycobacterium tuberculosis (microscopy and GeneXpert MTB/RIF [ Mycobacterium tuberculosis /resistance to rifampicin]) and Burkholderia pseudomallei (Active Melioidosis Detect Lateral Flow Assay and culture). Nasopharyngeal swabs underwent respiratory virus (influenza A, B, respiratory syncytial virus) polymerase chain reaction testing. Results Among 299 patients, 32% (95% confidence interval [CI] 26 to 37) were diagnosed with tuberculosis (TB), including 9 rifampicin-resistant cases. TB patients presented with a longer duration of fever (median 14 d) and productive cough (median 30 d) than non-TB patients (median fever duration 6 d, cough 7 d). One case of melioidosis pneumonia was detected by rapid test and confirmed by culture. Respiratory viruses were detected in 16% (95% CI 12 to 21) of patients. Conclusions TB was very common in this population, suggesting that microscopy and GeneXpert MTB/RIF on all sputum samples should be routinely included in diagnostic algorithms for fever and cough. Melioidosis was uncommon in this population. [ABSTRACT FROM AUTHOR]

Background: Myanmar has had a long history of civil wars with its minority ethnic groups and is yet to see a sustainable peace accord. The conflicts have had a significant impact on health in Myanmar, with ethnic populations experiencing inequitable health outcomes. Consequently, to meet the health needs of ethnic people, Ethnic Health Organisations and Community-Based Health Organisations (EHO/CBHOs) created their own health system. The EHO/CBHO and Government health systems, provided by the Myanmar Ministry of Health and Sports (MoHS), remain parallel, despite both stakeholders discussing unification of the health systems within the context of ongoing but unresolved peace processes. EHO/CBHOs discuss the 'convergence' of health systems, whilst the MoHS discuss the integration of health providers under their National Health Plan. Methods: A qualitative study design was used to explore the challenges to collaboration between EHO/CBHOs and the MoHS in Kayin state, Myanmar. Twelve health workers from different levels of the Karen EHO/CBHO health system were interviewed. Semi-structured, in-depth interviews were digitally recorded, transcribed, and coded. Data was analysed thematically using the Framework method. Topic guides evolved in an iterative process, as themes emerged inductively from the transcripts. A literature review and observation methods were also utilised to increase validity of the data. Results: The challenges to collaboration were identified in the following five themes: (1) the current situation is not 'post conflict' (2) a lack of trust (3) centralised nature of the MoHS (4) lack of EHO/CBHO health worker accreditation (5) the NHP is not implemented in some ethnic areas. Conclusions: Ultimately, all five challenges to collaboration stem from the lack of peace in Myanmar. The health systems cannot be 'converged or 'integrated' until there is a peace accord which is acceptable to all actors. EHO/CBHOs want a federal political system, where the health system is devolved, equitable and accessible to all ethnic people. External donors should understand this context and remain neutral by supporting all health actors in a conflict sensitive manner. [ABSTRACT FROM AUTHOR]

Migrant and refugee women are at risk of perinatal depression due to stressors experienced before, during and after migration. This study assesses the associations between social support and perinatal depression among migrant and refugee women on the Thai-Myanmar border. We conducted a cohort study of pregnant and post-partum women. Depression status was assessed using a structured clinical interview. Received support, perceived support and partner support were measured in the third trimester. Logistic regression was used to calculate associations between social support measures and perinatal depression controlling for demographic, socioeconomic, migration, obstetric and psychosocial factors. Four hundred and fifty-one women (233 migrants; 218 refugees) were included. The prevalence of perinatal depression was 38.6% in migrants and 47.3% in refugees. Migrants had higher levels of received, perceived and partner support than refugees. After controlling for all other variables, higher levels of received support remained significantly associated with a lower likelihood of perinatal depression in migrants (adjusted odds ratio 0.82; 95% CI 0.68-0.99). In both groups, depression history and trauma were strongly associated with perinatal depression. Our study highlights the importance of received social support to perinatal depression in migrant women on the Thailand-Myanmar border. The perinatal period offers a valuable opportunity to ask women about their support and offer community-level or public policy interventions to nurture support networks in current locations and resettlement destinations. [ABSTRACT FROM AUTHOR]

Malaria prevalence in Myanmar is highest among remote and ethnic minority populations living near forest fringes along the country's international borders. Insecticide-treated nets (ITNs) are a key intervention used to prevent malaria transmission, but insufficient ITN availability and low use can hinder effectiveness. This study assessed age and sex disparities in ITN possession, access, and use among household members of ethnic minority and internally displaced populations in eastern Myanmar. Cross-sectional data from the 2013 Eastern Burma Retrospective Mortality Survey were used to describe prevalence of ITN possession, access, and use. The association between a household member's biological sex and their ITN use was assessed using multilevel log binomial regression. Age and household ITN supply were tested as potential effect modifiers. Of 37927 household members, 89.8% (95% CI: 89.5, 90.1) of people lived in households with at least one ITN. Approximately half belonged to households with sufficient ITN supply and used an ITN. Pregnant women and children under five had the highest proportion of ITN use regardless of sufficient household ITN status. Female adults aged 15 to 49 years old (Risk ratio or RR: 1.4, 95% CI: 1.29, 1.52) were more likely to use ITNs. This relationship did not differ by sufficient household ITN status. The findings suggest that among ethnic minority populations in areas where ITN use is indicated, many households do not have adequate ITN supply, and many individuals are not using ITNs. Children under five and pregnant women appear to be prioritized for ITN use and overall, women are slightly more likely to use ITNs than men. This study's findings can support efforts ensuring that all household members belonging to ethnic minority and displaced populations in Eastern Myanmar benefit from sufficient ITN access and use for malaria prevention. [ABSTRACT FROM AUTHOR]

Background: Artemisinin and artemisinin-based combination therapy (ACT) partner drug resistance in Plasmodium falciparum have spread across the Greater Mekong Subregion compromising antimalarial treatment. The current 3-day artemether-lumefantrine regimen has been associated with high treatment failure rates in pregnant women. Although ACTs are recommended for treating Plasmodium vivax malaria, no clinical trials in pregnancy have been reported.Methods: Pregnant women with uncomplicated malaria on the Thailand-Myanmar border participated in an open-label randomized controlled trial comparing dihydroartemisinin-piperaquine (DP), artesunate-mefloquine (ASMQ) and a 4-day artemether-lumefantrine regimen (AL+). The primary endpoint for P. falciparum infections was the PCR-corrected cure rate and for P. vivax infections was recurrent parasitaemia, before delivery or day 63, whichever was longer, assessed by Kaplan-Meier estimate.Results: Between February 2010 and August 2016, 511 pregnant women with malaria (353 P. vivax, 142 P. falciparum, 15 co-infections, 1 Plasmodium malariae) were randomized to either DP (n=170), ASMQ (n=169) or AL+ (n=172) treatments. Successful malaria elimination efforts in the region resulted in premature termination of the trial. The majority of women had recurrent malaria (mainly P. vivax relapses, which are not prevented by these treatments). Recurrence-free proportions (95% confidence interval [95% CI]) for vivax malaria were 20.6% (5.1-43.4) for DP (n=125), 46.0% (30.9-60.0) for ASMQ (n=117) and 28.7% (10.0-50.8) for AL+ (n=126). DP and ASMQ provided longer recurrence-free intervals. PCR-corrected cure rates (95% CI) for falciparum malaria were 93.7% (81.6-97.9) for DP (n=49), 79.6% (66.1-88.1) for AMSQ (n=55) and 87.5% (74.3-94.2) for AL+ (n=50). Overall 65% (85/130) of P. falciparum infections had Pfkelch13 propeller mutations which increased over time and recrudescence occurred almost exclusively in them; risk ratio 9.42 (95% CI 1.30-68.29). Among the women with falciparum malaria, 24.0% (95% CI 16.8-33.6) had P. vivax parasitaemia within 4 months. Nausea, vomiting, dizziness and sleep disturbance were more frequent with ASMQ. Miscarriage, small-for-gestational-age and preterm birth did not differ significantly among the treatment groups, including first trimester exposures (n=46).Conclusions: DP was well tolerated and safe, and was the only drug providing satisfactory efficacy for P. falciparum-infected pregnant woman in this area of widespread artemisinin resistance. Vivax malaria recurrences are very common and warrant chloroquine prophylaxis after antimalarial treatment in this area.Trial Registration: ClinicalTrials.gov identifier NCT01054248 , registered on 22 January 2010. [ABSTRACT FROM AUTHOR]

Intractable long-term or chronic refugee communities present serious challenges to common refugee-management strategies. We argue that they are best understood and managed by using adaptive techniques drawn from complexity theory. To illustrate this strategy, we use the refugee communities situated along the Thai–Myanmar border as a case study. The article outlines the key elements of complexity theory, the complexity lens, for use in analysis of the problem. It then applies the complexity lens to the case study: identifying and describing the actors and networks that compose the complex system of the Thai–My refugees (the complex system) and the dynamic developments within that community over time (dynamic development). Based on this analysis, the article utilizes the complexity lens to evaluate the policy options commonly offered for the management of this ongoing refugee situation. [ABSTRACT FROM AUTHOR]

This article draws on feminist perspectives on the everyday to explore women's everyday experiences of peace in Kayah state in Myanmar. We locate the daily practices women engage in to maintain life and minimise violence, making visible women's contributions to everyday peace. In addition, we examine the ways in which women are disproportionally affected by war and prevented from benefitting from post-war changes. Our findings demonstrate that practices of care and silence are key avenues for women's everyday peacebuilding, through which women sustain peace, ensure survival, and minimise violence in their families and wider communities. At the same time, however, these practices are conditioned by and may contribute to gendered insecurity and marginalisation for women. Through this focus, our analysis shows how women's positioning in gendered relations of power may both enable their agency in peacebuilding and reinforce their gendered inequality and marginalisation in the post-war period. We conclude that while everyday peace practices may hold the potential for positive change, these can also contribute to the reproduction of inequality, oppression and structural violence. [ABSTRACT FROM AUTHOR]

Background: Malaria and hypertensive disorders of pregnancy (HDoP) affect millions of pregnancies worldwide, particularly those of young, first-time mothers. Small case-control studies suggest a positive association between falciparum malaria and risk of pre-eclampsia but large prospective analyses are lacking.Methods: We characterized the relationship between malaria in pregnancy and the development of HDoP in a large, prospectively followed cohort. Pregnant women living along the Thailand-Myanmar border, an area of low seasonal malaria transmission, were followed at antenatal clinics between 1986 and 2016. The relationships between falciparum and vivax malaria during pregnancy and the odds of gestational hypertension, pre-eclampsia, or eclampsia were examined using logistic regression amongst all women and then stratified by gravidity.Results: There were 23,262 singleton pregnancies in women who presented during the first trimester and were followed fortnightly. Falciparum malaria was associated with gestational hypertension amongst multigravidae (adjusted odds ratio (AOR) 2.59, 95%CI 1.59-4.23), whereas amongst primigravidae, it was associated with the combined outcome of pre-eclampsia/eclampsia (AOR 2.61, 95%CI 1.01-6.79). In contrast, there was no association between vivax malaria and HDoP.Conclusions: Falciparum but not vivax malaria during pregnancy is associated with hypertensive disorders of pregnancy. [ABSTRACT FROM AUTHOR]

Background: Soil-transmitted helminth (STH) infections are widespread in tropical and subtropical regions. While many STH infections are asymptomatic, vulnerable populations (e.g., pregnant women) face repercussions such as aggravation of maternal anaemia. However, data on prevalence and the effect of STH infections in pregnancy are limited. The aim of this analysis was to describe the burden of STH infections within and between populations of pregnant women from a local refugee camp to a mobile migrant population, and to explore possible associations between STH infection and pregnancy outcomes. Methodology: This is a retrospective review of records from pregnant refugee and migrant women who attended Shoklo Malaria Research Unit antenatal care (ANC) clinics along the Thailand-Myanmar border between July 2013 and December 2017. Inclusion was based on provision of a stool sample during routine antenatal screening. A semi-quantitative formalin concentration method was employed for examination of faecal samples. The associations between STH mono-infections and maternal anaemia and pregnancy outcomes (i.e., miscarriage, stillbirth, preterm birth, and small for gestational age) were estimated using regression analysis. Principal findings: Overall, 12,742 pregnant women were included, of whom 2,702 (21.2%) had a confirmed infection with either Ascaris lumbricoides, hookworm, Trichuris trichiura, or a combination of these. The occurrence of STH infections in the refugee population (30.8%; 1,246/4,041) was higher than in the migrant population (16.7%; 1,456/8,701). A. lumbricoides was the predominant STH species in refugees and hookworm in migrants. A. lumbricoides and hookworm infection were associated with maternal anaemia at the first ANC consultation with adjusted odds ratios of 1.37 (95% confidence interval (CI) 1.08–1.72) and 1.65 (95% CI 1.19–2.24), respectively. Pregnant women with A. lumbricoides infection were less likely to miscarry when compared to women with negative stool samples (adjusted hazard ratio 0.63, 95% CI 0.48–0.84). STH infections were not significantly associated with stillbirth, preterm birth and born too small for gestational age. One in five pregnant women in this cohort had STH infection. Association of STH infection with maternal anaemia, in particular in the event of late ANC enrolment, underlines the importance of early detection and treatment of STH infection. A potential protective effect of A. lumbricoides infection on miscarriage needs confirmation in prospective studies. Author summary: Soil-transmitted helminths (STHs) are parasitic worms transmitted through the faecal-oral route. STHs are ubiquitous in tropical and subtropical regions where access to clean water, improved sanitation, and hygiene are lacking. STH infections are often asymptomatic; however, heavy infections can cause adverse effects such as abdominal discomfort and anaemia. Anaemia in pregnancy can increase the risk of pregnancy problems such as miscarriage, preterm delivery, and poor fetal growth. This retrospective analysis of routinely collected data from more than 12,000 pregnant refugee and migrant women who attended antenatal care clinics along the Thai-Myanmar border shows that one in five pregnant women were infected with STHs. Moreover, pregnant women with a STH infection were more likely to present with anaemia, suggesting that early presentation to antenatal care as well as anthelmintic treatment with subsequent anaemia prophylaxis may reduce the risk of anaemia. Interestingly, our data also indicate that STH infections may have beneficial effects on pregnancy outcomes, as miscarriage was less likely to occur in pregnancies with maternal STH infections. This finding was significant for infection with the roundworm Ascaris lumbricoides. Verification of these findings in prospective studies is warranted. [ABSTRACT FROM AUTHOR]

This article argues that imprisonment is a liminal experience and that recognition is needed to establish a new social status to enable parity of participation after one's release. The article builds on photographic action research done with four former political prisoners in Myanmar, and analyzes three of the photos from the project and the process of creating and exhibiting photos. The article shows how former prisoners experience prolonged liminality, and it argues that recognition and access to parity of participation are key to prevent such prolonged liminality and to offer redress for the injustice and misrecognition that former political prisoners experienced. [ABSTRACT FROM AUTHOR]

Extensive drug-resistant tuberculosis (XDR-TB) is highly life threatening and its diagnosis is usually difficult and time-consuming. Here we present the first two cases of XDR and pre-XDR-TB diagnosed in 2018 on the Thailand-Myanmar border, more specifically in Tak province. Rapid detection of XDR-TB was performed by loop-mediated isothermal amplification (LAMP), Xpert MTB/RIF, and line probe assays. Mutation analyses targeting rpoB, katG, inhA, gyrA and rrs genes showed an association with drug-resistant phenotypes, except for rifampicin resistance. Spoligotyping revealed uncommon Beijing and T2 genotypes and the analysis of M. tuberculosis interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) showed the presence of more polymorphisms. This report highlights the importance of the early detection of drug-resistant tuberculosis by molecular tests followed by phenotyping assays. Based on the up-to-date definition of XDR- and pre-XDR-TB, the susceptibility testing for bedaquiline and linezolid is required and the two reported cases may correspond to putative XDR-TB. [ABSTRACT FROM AUTHOR]

Background Research ethics guidelines set a high bar for conducting research with vulnerable populations, often resulting in their exclusion from beneficial research. Our study aims to better characterise participants' vulnerabilities, agency, resourcefulness and sources of support. Methods We undertook qualitative research around two clinical studies involving migrant women living along the Thai–Myanmar border. We conducted 32 in-depth interviews and 10 focus group discussions with research participants, families, researchers and key informants. Results We found that being 'undocumented' is at the core of many structural vulnerabilities, reflecting political, economic, social and health needs. Although migrant women lead challenging lives, they have a support network that includes family, employers, community leaders, non-governmental organisations and research networks. Migrant women choose to participate in research to access quality healthcare, gain knowledge and obtain extra money. However, research has the potential to exacerbate existing vulnerabilities, such as the burdens of cross-border travel, foregoing work and being more visible as migrants. Conclusions Our study confirms that research is important to provide evidence-based care and was viewed by participants as offering many benefits, but it also has hidden burdens. Migrant women exercised agency and resourcefulness when navigating challenges in their lives and research participation. [ABSTRACT FROM AUTHOR]