Myanmar’s Health System Is in Collapse, ‘Obliterated’ by the Regime

The surgeon was in the middle of operating on a patient when the squad of soldiers entered the hospital looking for doctors to arrest. A receptionist alerted the surgeon, Dr. Kyaw Swar, but it was too late for him to stop the procedure.

Hoping to avoid attention, he ran out into the hallway and collected the shoes that he and his colleagues had left outside the operating room door — a telltale sign that surgery was underway. Moments later, the soldiers walked noisily past the operating theater.

“If they had found us, they would have arrested us,” Dr. Kyaw Swar said. “But I will not run away while I am operating on a patient. It is not a crime for a doctor to treat patients.”

Dr. Kyaw Swar’s close call last month came as Myanmar’s security forces intensify their crackdown on doctors who oppose the military junta that seized power 14 months ago. Doctors have been at the forefront of a nationwide civil disobedience movement that has crippled the economy, and the regime has targeted health care workers from the start.

In recent weeks, the security forces have arrested doctors at their homes and hospitals, revoked the licenses of prominent physicians, searched hospitals for wounded resistance fighters and threatened to close health care facilities that employ doctors opposing the regime.

For Myanmar soldiers, who are notorious for stealing from citizens, going after doctors is also a convenient way to make money, since doctors are among the country’s wealthier people. During arrests, soldiers have seized cash, gold, jewelry and vehicles worth tens of thousands of dollars. In some cases, army officers have demanded as much as $5,000 not to shut down a private hospital, hospital officials said.

Since the coup on Feb. 1, 2021, soldiers and the police have arrested 140 doctors for participating in the nationwide protest movement, according to the Assistance Association for Political Prisoners, which is monitoring arrests. Of these, 89 remain behind bars.

At least 30 doctors have been killed, according to the New York-based Physicians for Human Rights, which called Myanmar one of the most dangerous places in the world to be a health worker.

The harassment and arrest of doctors who oppose the regime comes as the country faces a continuing health emergency because of a severe shortage of doctors, a chronic lack of resources and the closing of many hospitals and clinics.Image

Medical students, doctors and engineers  in February 2021 protesting against the military coup that month in Myanmar.
Credit…The New York Times
Medical students, doctors and engineers  in February 2021 protesting against the military coup that month in Myanmar.

In a statement earlier this month marking World Health Day, a rights group, Network for Human Rights Documentation Burma, said the Myanmar military has “destabilized the country beyond repair.”

“The health care sector is one of many which has been obliterated,” the group said.

Nearly one million children are not receiving routine immunizations, leaving them vulnerable to measles and other diseases, and nearly 5 million children are missing out on vitamin A supplements, putting them at risk of infections and blindness, according to UNICEF.

Throughout the country, barely 40 percent of the population is fully vaccinated for Covid-19, and many patients are left without routine care. Needed operations are difficult to schedule.

Doctors say that health care has improved somewhat in recent months in Yangon, Myanmar’s largest city, with many physicians returning to work. But anti-regime doctors estimate that hundreds of people are still dying each week because of the collapse of the health care system.

One regime tactic has been to release doctors from prison on the condition that they disavow the civil disobedience movement and agree to work at a military-controlled, government hospital, doctors said.

“In conflict-torn areas, it’s worse than in cities because the government hospitals are not running at all and people are mostly in refugee camps in the jungle,” said Dr. Wai Myo, who was fired from Mandalay General Hospital last year for joining the protest movement. “So, if something happens to them, the chance of death is very high.”

A spokeswoman for the junta’s health ministry declined to comment.

After the coup, thousands of doctors refused to work for the regime and left jobs in government facilities. Many began offering their services free at private hospitals and underground clinics.

In its attempt to force doctors to work in facilities it controls, the military has shut down at least a dozen clinics offering free medical treatment and demanded that private hospitals and clinics hand over the names of patients and their medical history.

As it hunts down anti-regime doctors and wounded combatants, the regime has branded people seeking care from underground clinics as “illegal patients.”

“What is the reason to arrest us?” asked Dr. Wai Myo. “Just for giving treatment? It’s total nonsense. I want to be a good citizen, so I joined the civil disobedience movement. I want to be a good doctor, so I’m giving free medical treatment to patients.”

Mandalay General Hospital, a major teaching hospital in Myanmar’s second-largest city, has been at the center of the protest movement since the start. Doctors in Mandalay have been much slower than those in other regions to return to work at government-controlled centers.

Last month, the city’s health director and the army general who is Mandalay’s chief commander summoned private hospital owners to a meeting and informed them that the licenses of 14 medical professors and leading specialists at Mandalay General Hospital would be revoked, according to hospital owners who attended the meeting.


Medical staff watched from a hospital rooftop as security forces cracked down on protestors in Mandalay in February 2021, the month of the coup in Myanmar.
Credit…The New York Times
Medical staff watched from a hospital rooftop as security forces cracked down on protestors in Mandalay in February 2021, the month of the coup in Myanmar.

They warned that any private hospital that hired them — or other doctors known to support the civil disobedience movement — would be shut down.

The loss of highly trained doctors can have life-or-death consequences for some patients.

Lieu Shin, a rice farmer from Kalay, 160 miles northwest of Mandalay, is in desperate need of a kidney transplant, and his brother has agreed to donate one. But Mandalay General Hospital, the only place in the region where such surgery could be done, no longer has a team of doctors capable of performing the operation.

Mr. Lieu Shin, 64, was given only days to live, but continues to hang on with dialysis, which is exhausting his family’s savings. He blames the regime for his inability to get treatment, not the doctors.

“The doctors said I need an emergency operation,” he said. “But there are not enough doctors at the hospital. All I can do now is wait for my turn to die.”

The New York Times