Myanmar’s front-line health care workers are finding themselves in a volatile position, torn between patients and working for military affairs to carry out brutal crackdowns on the country.
Moe * is 53 years old and has stage 3 breast cancer.
She was receiving radiation therapy every three weeks at the state-owned Mandalay General Hospital in northern Myanmar.
However, the hospital closed the door the day after the military testified to Myanmar’s elected government in a coup d’etat on February 1. Doctors, nurses and other health care workers all went out in protest and never returned.
Currently, Moe cannot afford to pay about $ 700 (£ 502) needed to complete the rest of the treatment cycle at a private hospital.
Without it, she believes she has about a year to live.
Nevertheless, she does not blame the doctor: “It’s the military’s fault,” she told the BBC.
“If I die of cancer, I can accept it. The rest of Myanmar deserves democracy.”
“On the verge of collapse”
Myanmar’s health system was one of the most affected sectors in the aftermath of the February 1 coup, where the military seized control of the country and caused widespread protests.
Thousands of doctors have participated in the country’s civil disobedience movement, refusing civil servants and other state officials to work under the new military junta.
Myanmar’s public health system accounts for about 80% of all hospitals and clinics and provides heavily subsidized health care to 54 million people in the country.
This virtually disappeared overnight-and in the midst of a pandemic.
“It’s a tough situation,” says Dr. Mitchell Sanma, who is at the site of Doctors Without Borders (MSF) in Yangon, Myanmar’s major city. “The public health system is on the verge of collapse.”
However, doctors feel that they have few options.
“As long as the junta is in power, I won’t go back to work,” says Kyi Kyi *, a Mandalay doctor who has been on strike for nearly three months.
“I never want to recognize their authority.”
In the first few weeks after the coup, Kyi Kyi offered free consultation at a private hospital.
But she soon realized that this was too dangerous. “We started seeing soldiers stationed around the hospital waiting for us to arrive.”
Target healthcare professionals
The military has reportedly targeted medical workers on strike, attacking voluntary medical facilities, arresting and detaining workers, and in some cases violently beating them.
“We have to be very careful,” says Kyi Kyi.
“After the coup, we were all forced to leave the government accommodation near the hospital, so now we have to be with friends in another part of the town. We Is very scary. “
Some public sector medical facilities that are still in operation are occupied by soldiers.
The military tried to persuade some doctors to come back-several proceedings to senior directors of major hospitals-but they have had little or no success so far.
Dr. Sangma says efforts have been made to perform basic operations inside the less staffed ward and outside the hospital parking lot.
However, observers say that many citizens are so scared that they cannot even access this basic care because they are wary of the military or fear the impact of the community on their involvement with the military. say.
This situation completely overwhelmed private hospitals, which are concentrated in major cities. Initially, some tried to absorb the patient’s financial costs, but this too almost stopped.
“This has made it impossible for most people to receive important and often life-saving care,” said Joy Shinhal, head of the Myanmar delegation to the International Federation of Red Cross and Red Crescent Societies.
And pandemics have even more complex problems.
Dr. Shinharu said Myanmar’s healthcare system began rolling out vaccination programs in January. But the people involved in this are now “not there anymore.”
“We are facing an imminent crisis at the forefront of Covid,” says Dr. Singhal.
“Large protest rallies, virtually no tests, and lack of access to treatment all pose a great risk to public health.”
Official statistics from the Ministry of Health and Sports, which are currently under military control, are no longer reliable, but a glance at the reported infection rates shows that the testing system is broken.
In January, the month before the coup, Myanmar recorded 15,515 cases of Covid-19.
In March, the month following the coup, only 538 cases were recorded, a clear decrease of 97%. Experts say that without an epidemiological overview, the disease is likely to spread uncontrolled and have fatal consequences.
The aftermath of the coup is also felt for other infectious diseases. According to doctors, Myanmar’s slow but steady progress over the last two decades on deadly diseases such as HIV and tuberculosis has already reversed.
HIV, for example, was a new crisis in Myanmar in the 1990s, but new infectious diseases and AIDS-related deaths have declined, thanks in part to government-run programs supported by international aid. It was.
However, as a result of the coup, the program was effectively suspended, said Pablo Korobos, former MSF director of the Myanmar legation.
“That’s scary,” said Korobos. “It’s really tragic to see all the progress Myanmar has made in terms of public health disappearing so rapidly.”
He added that large international donors who are reluctant to deal with the Ministry of Health and Sports are also beginning to withdraw from major programs that have provided important safety nets for millions of long-term patients. It was.
The question now for people at home and abroad is how long Myanmar can last like this.
“We are walking towards the edge of the cliff, but we don’t know how to solve it,” says Dr. Shinharu.
“Primary health care is the backbone of the right society and is now collapsing.”
Kyi Kyi hasn’t been paid since January, but she says she still has enough savings and parental support to maintain herself for some time.
But she knows that it is the patient who ultimately pays the price.
“The more I think about my patients, the more I suffer, but I’m suffering, but I never rest,” she says.
“We believe our country is of utmost importance now, because otherwise we know we will suffer another 20 or 30 years.”