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Secret health service: Myanmar’s military junta drives medics underground

Health workers take part in a demonstration against the military coup in Bagan, on Feb 11, 2021 - AFP
Health workers take part in a demonstration against the military coup in Bagan, on Feb 11, 2021 - AFP

One year on from its bloody military coup Myanmar is now one of the most dangerous places in the world to be a doctor or nurse.

Figures released today show 286 health workers have been arrested in the past 12 months, 128 health facilities attacked and 30 doctors, paramedics and nurses killed.

Hospitals have been occupied, raided and shot at. Workers have been beaten and arrested while providing care. Aid and medical supplies have been blocked by soldiers.

The attacks have been highlighted in a report ‘Our Health Workers are Working in Fear’, written by the Physicians for Human Rights, Insecurity Insight, and the Johns Hopkins Center for Public Health and Human Rights.

Demonstrators protest against a military coup in Mandalay, Feb 22, 2021 - Reuters
Demonstrators protest against a military coup in Mandalay, Feb 22, 2021 - Reuters

One of the authors, Lindsey Green, told The Telegraph: “Healthcare has been under attack at every level – street medics during the pandemic, attacks on ambulances, charity organisations which provide support. They’ve faced a deliberate tactic of intimidation, with killings and arrests.”

Doctors and nurses have been brutally targeted for their role as leaders of the civil disobedience movement that sprang up in the early days of the military takeover. They led nationwide strikes and widespread civil protests.

Health care continues to come under attack and today much of it has moved underground – groups are said to be well-organised, mobile and operating from secret locations – while many workers have fled to other countries. Those abroad fear their lives will be in danger if they return.

Medical staff make a three finger salute with red ribbons on their uniforms inside a hospital in Yangon - AFP
Medical staff make a three finger salute with red ribbons on their uniforms inside a hospital in Yangon - AFP

Doctors with a ‘death sentence’

The Telegraph spoke to two doctors working in the UK, whose identities are being concealed to protect their families in Myanmar.

Myia*, a young doctor now working in an NHS respiratory ward, said she felt like she had travelled back in time. She witnessed the immediate fallout of the coup – soldiers roaming the streets, the internet blackout. “The TV was playing military songs, which I hadn’t heard since I was a child,” she said.

“Then they were shooting at protestors, who were demonstrating peacefully. We wanted democracy, a fair election. We could count, at the beginning, how many were arrested, but after a few days we couldn’t keep up,” Myia said. “We had no idea this could happen in the 21st century.”

In the face of guns and handcuffs, ordinary people showed their anger in peaceful ways. “Every day at 8pm we would bang pots as a nation – there’s a myth in Myanmar that when you bang pots you threaten away the bad souls, the Evils,” Myia said.

A nun pleading with police not to harm protesters in Myitkyina, March 2021 - AFP
A nun pleading with police not to harm protesters in Myitkyina, March 2021 - AFP
A demonstrator holds a placard in front of a police line, Feb 18, 2021 - Reuters
A demonstrator holds a placard in front of a police line, Feb 18, 2021 - Reuters

Myia, who before the coup was in the process of applying to work in the UK – as many doctors do for a short spell – struggled to leave the country.

“The airport was like a zombie movie,” she said. “Only a few counters were open. It was hot and dark. People were queuing outside the airport. I couldn’t say goodbye to my family. Normally we would be waving until the plane took off.”

Since arriving in the UK, Myia has been working with Covid and pneumonia patients on the Medical Support Worker programme. It was introduced during the pandemic to plug NHS staffing shortages and help doctors whose visas were due to expire but were unable to travel home.

Medical support workers mirror junior doctors – completing tasks like cannulation and taking a patient’s history – under the supervision of senior doctors. Myia has since completed the exams required to practise medicine in the UK, and will do so when the programme ends in March.

Myia worries she will not be able to return to Myanmar until democracy is restored. She fears her role as a doctor holds a death sentence.

“Once they find out that I’m a doctor, they can arrest and investigate me for no reason,” she said. Sitting in blue scrubs in her hospital accommodation, Myia looked down at her hands, and added: “If I return and I am killed, my family would have no way to report it. When the soldiers are the police, and all authority, who could they speak to?”

A wounded protester in Mandalay, March 2021 - Anadolu Agency
A wounded protester in Mandalay, March 2021 - Anadolu Agency

Fellow medical support worker Lwin was already living in the UK in February 2021, completing his medical exams which would allow him to practise here, when the coup left him stranded in the country.

He’s close to his parents and calls them most days.

“It’s been very, very scary, especially the times when I haven’t been able to get in touch with my family,” he said. “I miss my parents and my home. I am always thinking about them, and how they will manage.”

Lwin has been placed on the programme too. Without it, and because of the danger in Myanmar, he would have been forced to apply for refugee status, which restricts the ability to work and earn an income.

He had always intended to return to Myanmar after gaining experience in a western hospital but he is unlikely to go home any time soon. Many of his friends from medical school are now in prison.

Protesters carry a wounded man shot with live rounds by security forces during a crackdown on demonstrations, August 2021 - AFP
Protesters carry a wounded man shot with live rounds by security forces during a crackdown on demonstrations, August 2021 - AFP

One friend was arrested in February 2021 and is still being held in Insein prison, infamous for its harsh conditions and torture. It currently holds more than double its 5,000-person capacity, with the military recently packing in pro-democracy protestors, journalists and elected leaders. Lwin receives letters from his friend sporadically but hasn’t had one for some months.

“The last letter had many ticks where his words had been checked,” he said.

Under constant attack

Back in Myanmar, the civilian population is struggling to get health treatment and more than 60 per cent of households report access has worsened since the start of the coup.

Doctors defended their decision to abandon their public work in a letter to the medical journal, The Lancet.

“Our duty as doctors is to prioritise care for our patients – but how can we do this under an unlawful, undemocratic, and oppressive military system?” they wrote.

“Fifty years of previous military rule failed to develop our health system and instead enshrined poverty, inequality, and inadequate medical care. We cannot return to this situation.”

Thousands died – mostly at home, without access to any health support – in a devastating third Covid wave last summer.

Myanmar was one of the first low income countries to begin a vaccine programme, but it came to a halt after the military seized power. The head of the programme was reportedly arrested last June.

The authors warn of the serious long-term implications, as health treatments and interventions like immunisations remain paused. All professional training has stopped too, they said.

But patients are reluctant to seek health care for fear of putting themselves in danger. In November, a nurse named San Thida was shot dead by someone who pretended to buy medicine. And in the same month a charity clinic in Karenni state was raided by military and police: 17 health workers were arrested, including a surgeon and seven nurses, while patients were told to go elsewhere.

Medical workers wearing red ribbons pose during a protest against the coup - Reuters
Medical workers wearing red ribbons pose during a protest against the coup - Reuters

The attacks on health care violate human rights and breach international law. The report’s co-authors said it is “worrying that there has not been a sufficient response from the international community about these crimes”.

They have called on countries to support the rollout of Covid-19 vaccines, and provide humanitarian support to the people of Myanmar.

“Given the escalating conflict, increasing numbers of internally displaced people and refugees, and the effective collapse of the public health care system, there is no end in sight to this human rights and health crisis for the people of Myanmar,” the report concludes.

Myanmar’s military junta threatened to act against anyone who takes part in the “Silent Strike” to mark the one-year anniversary of the coup, but members of the public said the protest would go forward as planned.

Applauding, honking car horns or playing drums in support of the strike planned for Feb 1 are acts punishable by up to life imprisonment, according to a statement issued by the junta on Tuesday.

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