Dire straits: A woman sitting next to a cat in front of her damaged house following fighting between Myanmar’s military and the Kachin Independence Army in Nam Hpat Kar, Kutkai township in the country’s northern Shan State. Myanmar’s maternal healthcare conditions took a turn for the worse after the coup, when medical staff in the public service left junta-run facilities across Myanmar for private medical outlets or volunteer outfits not controlled by the military regime. — AFP
Ma Hla May, a farmer in northern Sagaing region, gave birth to her fourth child in January.
Unlike her first three children who were delivered in a public hospital in Pale township, her youngest child was born at home in Kyaung Than village with the help of a midwife.
Yet, she counts herself lucky for managing a safe delivery amid a raging conflict in the region.
Pregnant women face perilous childbirth circumstances in northern Myanmar, where some of the fiercest fighting is taking place between the military junta and ethnic armed organisations allied with resistance groups that have emerged to oppose the 2021 military coup. The fighting means that villagers have to constantly stay alert to military raids and bombardment.
Unable to travel 8km to the hospital for medical check-up, May could not obtain prenatal supplements and had to subsist on plain rice for most of her pregnancy. But it was the lack of rest that affected her most.
“I couldn’t get enough sleep. People are so tired because they can’t sleep,” said the 38-year-old woman, who used a pseudonym for security reasons.
Fleeing military bombardment and often malnourished, many miscarry or resort to dangerous childbirth with little medical attention in the forests, said volunteer medics.
Before the coup, Myanmar ranked 50th in the world in maternal mortality, with an estimated 179 deaths per 1,000 live births in 2020, which put it ahead of Cambodia and Timor-Leste in the region.
Myanmar’s neonatal mortality rate, which measures the number of infant deaths in the first 28 days of their lives, was estimated to be 22 per 1,000 live births in 2020.
But conditions took a turn for the worse after the coup, when medical staff in the public service left junta-run facilities across Myanmar for private medical outlets or volunteer outfits not controlled by the military regime.
The junta has responded by arresting and prosecuting these healthcare workers and forbidding international healthcare organisations from working with resistance groups.
According to a Feb 2024 report by Switzerland-based research group Insecurity Insight, at least 897 health workers have been arrested over the past three years amid frequent raids of the parallel healthcare facilities.
But Insecurity Insight noted that resistance groups opposing the regime are also increasingly using drones armed with explosives to attack hospitals and health centres occupied by the military – adding to the devastation on medical care.
Life is particularly tense for pregnant women in Sagaing region’s Pale township, which is home to many People’s Defence Forces opposing the junta, as well as villages inhabited by Pyu Saw Htee militias supporting the military. A doctor who treats people in camps housing locals fleeing war in Sagaing, who would only give his name as Ko Soe Aung, said, “Miscarriages are common for the women fleeing this war.”The healthcare group in Pale that he works for, which he declines to name for security reasons, treats about 100 expectant mothers every month.
While medical treatment is better in Pale town, locals say they avoid going there because junta troops, stationed at the town’s entrances and exits, frequently search or beat them when they try to buy medicine there.Outside the town, in the rural areas where armed resistance against junta is fierce, locals rely exclusively on the healthcare services provided by medical workers taking part in the civil disobedience movement (CDM).
The Pale Health Group is made up of volunteer medics who provide mobile healthcare services under the escort of the People’s Revolution Front, an armed group from the nearby Pauk township opposing the junta.
This group currently consists of six medical assistants, two midwives and some nursing trainees.
Ko Loon Nyi, a spokesperson for the People’s Revolution Front, said it is trying to raise money to build a hospital that will provide emergency surgery and healthcare for villagers and resistance fighters, as well as childbirth facilities.For now, the Pale Health Group conducts 10 deliveries every month in villages and war refugee camps located in the forested areas. Given the frequent military raids on these parallel healthcare services, it’s a constant cat and mouse game.For expectant mothers, this just means being prepared to give birth on the run. It is a gamble they make with their lives.
In June 2023, a heavily pregnant Ma Thet Mar (not her real name), 36, found herself having to escape on motorcycle from a clinic in Sagaing because it came under the threat of an attack by the military. She decided to travel to the public hospital in Monywa – Sagaing’s largest city – over 60km away for her delivery.
However, what should have been a two-hour car ride took six hours because of interrogation at military checkpoints along the way. Both mother and child did not survive the childbirth, said Mar’s sister.
Meanwhile, in November 2023, a mobile medical team controlled by the shadow National Unity Government opposing the junta provided healthcare services out of a car to villagers in Sagaing when the military happened to raid a village nearby.
At that time, the team was attending to five patients who needed urgent treatment, one of whom was due to give birth.
The medics had to transport all five of them in the same car to another village about 1.6km away.
The group was forced to park the car on a small village road while a doctor and nurse attended to the childbirth.
The delivery was successful, and a baby boy was born.
They named him Poe Lan Sone, which means “crossroad” in the Burmese language. — The Straits Times/ANN
