A crisis within a crisis

The major earthquake that struck central Myanmar created a crisis within a crisis. It comes as a prolonged armed conflict and political crisis has eroded a health system, making access to care more difficult.

A natural disaster knows no bounds. All people negatively impacted by the earthquake, no matter their leanings, need access to lifesaving humanitarian care.

Médecins Sans Frontières/Doctors Without Borders (MSF) is contributing to this care by providing water, sanitation, shelter, relief items, mental health support and medical assistance.

The current situation

As of April 2025

According to the United Nations Office for the Coordination of Humanitarian Affairs, the earthquake has killed about 3,800 people, injured about 5,100 and forced about 207,000 from what is left of their homes.

Some 55,000 homes are damaged or destroyed, along with 2,600 schools, 400 roads or bridges and 304 hospitals or clinics.

In Mandalay, the second-largest city, displaced people seek shelter wherever they find open space, such as along roads, under trees, in a football stadium. Hospitals have even moved patients to temporary shelters outside.

The United Nations estimates more than 17.2 million people are living in affected areas, with more than 9.1 million exposed to the strongest tremors across 58 of the country’s 330 towns. Two million need urgent assistance, adding to the 4.3 million already in need.

Water, electricity and telecommunications remain disrupted in the hardest-hit areas, hampering relief efforts.

A state of emergency has been declared in the capital, Naypyidaw, and in five other areas. With a significant reduction in functional hospital beds—the city’s jewellery museum has been repurposed as a hospital—capacity to provide essential medical services is limited, complicating relief efforts. As in Mandalay, people are living outside often close to their damaged homes, where they are at risk of being buried under rubble in an aftershock. Some whose homes are still standing live in camps because they are worried about going back inside.

“People are quite anxious and fearful,” says Mark Maxwell, MSF mental health activity manager in Myanmar. He finds it hard to comprehend how, within a few minutes, “people’s lives were just destroyed, all their possessions, their work—escaping with only the clothes on their back.”

One of the other areas declared a state of emergency is Shan State, where an estimated 80 per cent of houses around Inle Lake in the south are destroyed. Communities here, while smaller in number, are more vulnerable than those in other regions. This is because the people have nowhere to go—they live in lake dwellings on patches of dry land—and response efforts are limited.

How MSF is responding

We sent assessment teams to Shan State and to Mandalay and Sagaing Regions, also declared a state of emergency, after the earthquake. The teams, comprising medical, logistics, water and sanitation experts, distributed relief items and supported the general hospital in the city of Mandalay.

Our objective now is to support the ongoing response by providing safe drinking water, sanitation, shelter, relief items, mental health support and medical assistance.

Where MSF is responding

Our history in Myanmar

We have worked in Myanmar since 1992. Our focus: providing HIV and tuberculosis care, emergency responses to national disasters and conflict and support for vulnerable people, including the persecuted Rohingya in Rakhine.

We pioneered HIV treatment in Myanmar and steadily grew a large patient cohort—with more than 35,000 patients on antiretroviral treatment by 2015, we became the largest provider of antiretrovirals. After 2015, we began working with the Ministry of Health to transfer patients to the decentralised National AIDS Programme, so people could receive care closer to home.

Escalating conflict and prohibited delivery of medical humanitarian assistance has, since 2023, forced us to indefinitely suspend clinics in Kachin, Rakhine and in the north of Shan. For example, we evacuated teams from the capital of northern Shan in 2024 after fighting heavily damaged our clinic. We had provided HIV and tuberculosis services, sexual and reproductive health and basic healthcare to the people of Lashio for 23 years.

Our medical humanitarian care is now fragmented across the country and focused on where we can still get people and supplies to our clinics. As the frontlines shift, so does our ability to access patients and provide care. We remain flexible and responsive, providing emergency responses wherever possible.