In Myanmar, healthcare's collapse takes its own toll

The crisis comes at a potentially critical moment in the Covid-19 pandemic for Myanmar. - Reuters

YANGON (NYTIMES via The Straits Times/ANN): Hla Min, a rice farmer in central Myanmar, was getting regular radiation therapy for cancer when the military seized power Feb 1. Initially expected to survive, he lasted less than three months.

His treatment ended when doctors at Mandalay General Hospital walked off the job to protest the coup. Soldiers soon occupied the hospital and others across Myanmar, using them as bases for their bloody crackdown on resistance to their rule.

Many medical workers and would-be patients, fearing arrest or worse, stayed away.

Even as his health deteriorated, Hla Min supported the doctors' decision to stop working at state-run facilities, which helped start a general strike that has brought the economy to a near-halt.

"I know I'm dying," he said in an interview in late April. "But I will never blame the doctors, because young people are dying in the street after being shot by the police and soldiers. Compared to them, my death will be nothing." He died a week later, at 46.

Since the coup, more than 860 people are believed to have been killed by the security forces, who have gunned down protesters, bystanders and even young children. But health experts say the breakdown of Myanmar's public healthcare system is taking a greater toll.

Hundreds of lives are lost each week because emergency surgeries are not being performed, doctors say. Disease prevention programmes have halted, including a child vaccination campaign.

Many physicians who refuse to work for the regime are treating patients at private hospitals or underground clinics, but those facilities cannot provide the specialised care that major public hospitals like Mandalay General can.

"I know there are hundreds of people dying per week," said Dr Kyaw Moe, one of the striking Mandalay General surgeons, who now sees patients at a private clinic. "Of course, I feel sorry and very sad for that, but the most important thing for our country is to bring down the military. If not, our future generations and our country will die."

The crisis, which a United Nations official has called a "health emergency," comes at a potentially critical moment in the Covid-19 pandemic for Myanmar. There are reports of significant outbreaks in towns near the border with India, where a new variant has raged, but testing and vaccinations in Myanmar have nearly stopped.

Experts fear the virus could spread undetected and overwhelm understaffed hospitals and clinics in the coming months.

In the 10 years before the coup, during which the military shared power with elected civilian leaders, Myanmar made significant improvements to its healthcare system, especially in preventive care. But many of these gains have been lost, health experts said.

Successful programmes aimed at stopping the spread of HIV, tuberculosis and malaria, run by the now-ousted civilian government, have stalled. More urgently, so has a campaign to vaccinate nearly 1 million children this year against measles and other diseases.

Unicef, which provides vaccines for the programme, fears that could mean deadly outbreaks in the coming months, after the monsoon season ends.

"The continuing use of force against healthcare workers, including the reported occupation by security forces in hospitals, is taking a devastating toll on Myanmar's health care system, slipping from the achievements of the last decade to a health emergency since the crisis began," said Andrew Kirkwood, the acting United Nations resident coordinator for Myanmar.

Doctors, who are highly respected in Myanmar, were among the early leaders of the civil disobedience movement, which has virtually shut down the economy in an effort to force the regime from power.

The first protest against the generals, three days after the coup, was led by a doctor, Tayzar San, in the city of Mandalay. The junta has issued a warrant for his arrest.

In February, as the security forces began shooting protesters in large numbers, volunteer doctors, nurses and students organised to treat the wounded.

A 20-year-old nursing student, Ma Thinzar Hein, was shot and killed in March while helping protesters in Monywa, a city west of Mandalay.

The World Health Organisation has reported a dramatic surge in attacks on healthcare personnel and facilities in Myanmar this year, resulting in 14 deaths, though its published statistics provide few details. Some doctors and medical students have joined a fledgling armed resistance to the military.

Soldiers have been stationed at more than 50 hospitals and other healthcare centres at various times since the coup, according to the United Nations. Their presence has deterred many people from seeking care. Some said they feared being shot if they approached a hospital. Others said they would rather die than get treatment or a Covid-19 vaccine at a hospital under army control.

The hospitals were among many institutions occupied by the military, including schools, universities, monasteries and temples across the country. The occupations - some of which lasted for days, others for months - enabled it to embed soldiers in communities rife with protest. - NYTIMES via The Straits Times/ANN
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Myanmar , Healthcare , In Bad Shape , Junta , Coup , February


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