Statelessness Working Paper Series 2016/04 effective system of healthcare if they are not only prohibited from accessing hospitals outside of their township, but in addition cannot build up their own internal medical work force? Health professionals, such as doctors and nurses, are a fundamental pillar to any effective health care system and Myanmar’s restrictive provisions barring them from education and employment in this arena directly undermines the Rohingya’s capacity to realise positive health outcomes. 4. The stateless Rohingya and the challenges to their right to health 4.1 The right to reproductive freedoms (i): The two child policy Both the national government of Myanmar and the local governments within Rakhine State have facilitated a system that subjects the Rohingya to restrictions that could not be legally applied to citizens of the state, both compromising their right to health and basic freedoms. One example of this is the prohibitive two-child policy instigated in 2005; although it came into place 10 years ago, it is still believed to be enforced in certain townships within Rakhine State.47 In 2005, the local authorities within the townships of Maungdaw and Buthidaung—two towns with predominantly Rohingya populations—imposed a strict two-child policy. Fortify Rights, a human rights organisation, obtained a leaked document from the Township Peace and Development Council in Maungdaw, entitled ‘Regional Order 1/2005’, which revealed a key tenet of the policy that “those who have permission to marry must limit the number of children, in order to control the birth rate so that there is enough food and shelter.”48 In conjunction to Regional Order 1/2005, another addendum was created to outline enforcement mechanisms for this policy which instruct that: …if there is suspicion of someone being substituted [in the family registry] children in the household will be compared in age and in appearance. If the child is an infant, the mother will be made to breastfeed the child. Young children will be questioned separately.49 These restrictions contravene norms of international law and preclude substantive equality for women.50 The significance of ‘reproductive rights’ was set out at the UN’s International Conference on Population and Development in 1994, which outlined the need for states to ensure that “couples and individuals have a basic right to decide freely and responsibly the number, spacing and timing of all their children…and the right to attain the highest standard of sexual and reproductive health.”51 Myanmar has dismissed the international human rights norms that protect the right to health and reproductive rights for both citizens and non-citizens, and have consequently fostered widespread fear and angst amongst stateless Rohingya women. Brad Adams, executive director of the Asia Division within Human Rights Watch, states that “fear of punishment under the two-child rule compel far too many Rohingya women to risk their lives and turn to desperate and dangerous measures to self-induce abortions.”52 Induced abortions are illegal within Myanmar and safe modern birth control options are often difficult to access. Therefore, many Rohingya women have no other option than to pursue an abortion in an unsanitary environment, commonly using the ‘stick method’; this process involves the insertion of a stick into the uterus to terminate the pregnancy. When post-abortion complications arise, many women are too afraid to consult medical professionals in case they are exposed for having had an abortion, or for living with their partner without marriage permission. Both of which are 47 Fortify Rights, ‘Policies of Persecution: Ending Abusive State Policies Against Rohingya Muslims in Myanmar (2014) Township Peace and Development Council, Regional Order 1/2005. 8th Day of the Waning Moon of Dagoo 1367, Maungdaw (2005) 49 Addendum to internal order 1/2005. 2005. Drawing Maps, Making a Record of Buildings, and Reviewing Household Registration. Letter No: 3/24-1/U 6. 1057. Number 5, on file with Fortify Rights 50 Office of the High Commissioner for Human Rights (OHCHR), The Right to Health: Fact Sheet 31 (2008) 51 United Nations, Programme of Action for the UN International Conference on Population and Development (ICPD) (1994) 52 Human Rights Watch (HRW), ‘Burma: Revoke ‘Two-Child-Policy’ For Rohingya’ (2013) 7 48