The Transboundary Impacts of Conflict on Bhutan’s Border Districts: Insurgency, Border Malaria and Cross-Border Healthcare

The perspectives that have been brought out until now, indicate that the extensive humanitarian challenges facing the region and particularly the study area, was compounded by the gradual exit of externally based organizations and the closure of relief camps. As the wave of conflicts receded after 2015, communities that were displaced temporarily or dislocated permanently, sought to rebuild their homes and livelihoods. The story of recovery is complex and chapter unfolds through two parallel narratives. The Indo-Bhutan border, although unfenced in most locations, is still well demarcated. From the Indian side, the boundary can be deciphered visually through Border Pillars, Border Out Posts (BOPs) and Border Gates. The existing open border regime has over time resulted in complex web of socio-economic relationships across the main border gate. From the perspective of the book, the breakdown of health systems that was experienced in Milon and its surrounding villages, was in contrast, mirrored by the gradual strengthening of Bhutan’s health system in its southern districts (especially in Sarpang District and Gelephu Thromde area) that are contiguous to Kokrajhar and Chirang, respectively. Located a few kilometres from Milon, the border gate after Dadgiri marks the edge of Indian territory. Paradoxically, both sides of the border experienced intense episodes of civil strife, but had completely different outcomes in health. For Bhutan, the ingress of the armed organizations (between 1992 and 2003) onto its territory and establishment of camps by the militants (who numbered between 3,000 and 4,000) was a major foreign policy challenge. This culminated in a brief but intense armed conflict (Operation All Clear) in 2003, between the Bhutanese armed forces and the major Indian militant groups (ULFA, NDFB and KLO) based in Bhutan. The Dzongkhag of Sarpang was severely impacted as a consequence. Utilizing a cross-border perspective, which links together the community histories on both sides of the border gate, the chapter examines the problem of Conflict and Border Malaria and traces out the manner in which Bhutan’s health system transformed despite the occurrence of large-scale violence on the Indian side. It also provides some insight into the importance of the open border in rebuilding lives and livelihoods for communities living near Milon. The chapter presents key learnings from Bhutan’s experience and the possibilities emerging from local-level health cooperation.