Myanmar: MSF implores military & armed groups to ensure unimpeded access to healthcare

As Myanmar approaches four months of military rule, public health services remain severely disrupted. Many public hospitals and clinics are closed or occupied by the military, and those that are open have limited services available while medical staff are on strike. MSF has few options for referring people for specialised treatment. These challenges leave many people struggling to access healthcare.

 

If a wave of new COVID-19 infections grips Myanmar, it will be a public health disaster given the country’s capacity to test, treat and vaccinate is a fraction of what it was before the military seized power.

 

An estimated 60,000 people in Myanmar have been displaced within the country and 10,000 more in neighbouring nations since the 1 February seizure of power, according to data from UNHCR. This is largely due to a resurgence of conflict in Myanmar’s borderlands, particularly in Chin, Kachin and Kayin states, predominantly between the military and ethnic armed groups, but also increasingly pro-democracy people’s defence forces. Airstrikes and shelling are forcing people to flee their homes and have caused an unknown number of civilian casualties. 

MSF is scaling up its operations in anticipation of receiving more patients, including emergency treatment. Where medical facilities are open, MSF is providing supplies to treat trauma patients.

 

MSF teams are witnessing the impact of the escalation in violence via the rapid deterioration of peoples’ ability to access healthcare. The public health system is on the verge of collapse. Some facilities have been occupied by the military, and volunteer medics are being attacked for treating protesters. There are cases where protesters are reluctant to seek care because they fear arrest, particularly at the military hospitals where, due to government hospitals being closed, people are being directed.

 

Patients in Myanmar are forced to travel farther to get care at a time when risks are much greater. For patients with conditions requiring regular and long-term care, such as HIV, tuberculosis and hepatitis C, the on-going insecurity and delays in accessing medicines could be life threatening.

An MSF-supported clinic was told by security forces it could not treat protesters. The security forces visited the facility, ordered the emergency beds removed and insisted all injured people be taken to the military or military-controlled hospitals. Police also arrested one of its volunteers for being involved in protests and demanded names and addresses of others working there. The facility was forced to temporarily close and is now barely functioning operated by a skeleton staff.

 

Doctors and nurses continue to be targets of violence. Staff working in medical facilities MSF has provided support to shared reports of medical staff being arrested and detained.

 

There have been 179 attacks on health staff and facilities since the start of the military takeover, and 13 people killed in these attacks, according to the WHO's Surveillance System of Attacks on Healthcare.

As the public health system in Myanmar deteriorates, its economy is also collapsing. Cash is increasingly difficult to obtain, with people facing huge queues at sporadically filled ATMs. The kyat has fallen 17 per cent against the dollar, pushing up the cost of imports and goods like cooking oil, rice and fuel.

 

Humanitarian agencies are not immune to this liquidity crisis. Facing shortfalls in cash and increased costs can prevent organisations, including MSF, from buying supplies and medications, paying staff salaries and moving goods around. In Rakhine state, water and sanitation has long been a problem in Rohingya camps, where people rely on humanitarian aid for access to clean water. Now that many organisations are scaling back their activities as they struggle to access cash and get supplies into the camps, we are seeing a spike in people seeking treatment for acute watery diarrhoea.

 

MSF fears for the people of Myanmar in this worsening crisis. All obstacles preventing sick and wounded people from seeking healthcare, including the violence, detainment and intimidation of health workers, must be dismantled.