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Paper short abstract:

For decades, indigenous medics in southeastern Myanmar struggled for the health and rights of ethnic minorities. With fledgling peace and democracy, the medics' ongoing quest for recognition illustrates how the subjectivity of the 'victim' can be redefined to empower marginalised communities.

Paper long abstract:

Over the past twenty-five years, a network of indigenous medics has grown into a strong parastate system for health service delivery in Myanmar's contested borderlands. Working as part of community-based and ethnic health organisations, indigenous medics have provided vital care in areas where ethnic minorities were subjected to state violence and abuses. Their positioning as, simultaneously, victims of the state and survivors struggling for the health and rights of their communities shaped the subjectivities of these marginalised actors. At the same time, the medics' quest for health and human rights in southeastern Myanmar was inextricably linked with a political struggle for the recognition of ethnic minority governance systems as legitimate.

As Myanmar now undergoes fledgling democratisation and as peace discussions proceed unsteadily between the new government and different ethnic armed organisations, the medics' ongoing struggle for recognition highlights what is at stake in the country's contemporary health systems reform. Indeed, the state's new National Health Plan is framed within a centralised political model, which does not recognise ethnic governance systems. Current expansions of state systems for health into the borderlands are perceived as renewed attempts by the state to control ethnic minority communities and their resources. The reactions of indigenous medics to these evolutions - and their attempts to advance an alternative model for health systems reform - in turn illustrate how local actors are redefining the subjectivity of the 'victim' in their quest for empowerment as political subjects with a role in the construction of a new Myanmar.