Myanmar coup: Doctors and nurses resist the military

Jonathan Head
South East Asia correspondent

Image source, Getty Images
Image caption

Hospital workers led street protests against the coup on February 1.

Medical workers from Myanmar told BBC that a large portion of Myanmar’s healthcare now comes outside government hospitals. These nurses and doctors are opponents to the military, and they support the National Unity Government which is challenging the legitimacy of the junta.

For their safety, most interviewees have had their names changed.

Healthcare workers announced that they would boycott state-run hospitals to organize resistance against the coup of 1 February in Myanmar. The “white coat revolution” was their first demonstration on the streets.

It put the medics in conflict with the military and led to much of Myanmar’s healthcare system being underground.

Many health professionals are said to have quit their jobs, abandoned hospitals and patients in some areas. Senior doctors defended the difficult decision in a letter to The Lancet, a medical journal.

“Our obligation as doctors is prioritize care for patients. But how do we achieve this in an illegal, oppressive, and undemocratic military system?”

“Fifty-years of military rule in the past failed to build our health system. Instead, they enshrined poverty and inequality and provided inadequate medical care. “We cannot go back to the same situation.”

Grace, who is a Yangon Nursing University teacher, said that they “choosed” to all join the CDM. [civil disobedience movement]”.

Every evening we used to bang on pots, sing songs of revolutionaries and dance in front the school at 8 p.m. After losing an election, we were outraged. How could they arrest our leader?

Grace, one of the thousands of medical professionals who quit their jobs and lost her place of residence as a consequence of it all joined protests for the sake of the injured.

We arranged for ambulances to transport victims in the event of a shooting. We were most concerned about how they would be moved to safer areas.

“For minor injuries, we would transport them to the ambulance so they could be treated there. To treat gunshot wounds, it was necessary to create safe routes from temples or monastery compound clinics.

These desperate and improvised beginnings led to the creation of a shadow system for health, which is thought to have been under the National Unity Government’s (NUG). This was declared by the ousted parliamentarians in an attempt at challenging the junta.

The system actually runs by thousands of volunteers from across the country. They work in charities or private hospitals that are willing to take on the risk.

These doctors are providing care that’s not available at the state hospital, which is often very small.

As the NUG’s minister of health, Dr Zaw Wai Soe is an orthopaedic surgeon who was a leader in the fight against Covid-19.

Following the coup, he declined an offer to become their deputy health secretary and fled into hiding. Military authorities charged him with treason.

The NUG is a charity that raises money for Burmese who live overseas. It has also set up an online page where patients can get medical advice and telemedicine from doctors hiding in the shadows.

Zaw Wai Soe said to me that they don’t have sufficient money, saying this from an unknown location. We do have the support of locals and international diaspora. We are working hard to ensure that proper healthcare is provided, even though it’s not enough.

A dangerous job

It is still dangerous to work underground and defy the military.

In July 2015, the World Health Organisation reported that half of all 500 global attacks against health workers had taken place in Myanmar.

Manchester University conducted a similar study and reported that 25 doctors were killed, 190 had been arrested and 55 of the hospitals had been occupied.

Luke worked as an ICU nurse at a Mandalay private hospital. According to Luke, he was an ICU nurse in a private Mandalay hospital. The owner of that hospital had close ties the military and he decided to quit immediately.

“They took me to Mandalay Palace (where is the city’s military command) on 5 April. While they promised that they wouldn’t harm us after we arrived at Mandalay Palace, however, they beat and questioned us.

They sent us to Obo prison. The 50 of them were put in one single room. All of us shared a single bathroom and could only wash once per day. Summer was the hottest month of the year and water was scarce.

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Luke was held in prison for 87 consecutive days before being granted amnesty. He is now working as a mobile surgeon in Mandalay, hidden in a shipping container.

The lighting conditions are not ideal. We do our best. I was able to see some of the gunshot wounds in prison that were not treated correctly at government hospitals. Several people died as a result of these wounds.

These hospitals have more equipment but less skilled nurses and specialists. Many times, they won’t take patients who require critical care. Because we have so many specialists, I believe our medical care has improved. The problem with our system is the inability to work together.

I was told by nurses that they work in secret charity clinics in Yangon or Mandalay. These are Covid testing centers disguised to avoid military raids. Many have fled their homes fearing for their lives.

For the event of detention, they must wear normal clothes and not uniforms when leaving for work. It is important that they avoid being caught by the military traps. Many medics were arrested in this manner.

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Nway Oo, who is a Shan State nurse has said that nurses must be on the alert for patients when they are summoned to their homes. She was originally from Yangon but returned to Shan State to take care of her family. To confirm that the patient is truly ill, we check in with locals. To be certain that the patient’s authenticity, we wait at least one day.

One nurse that I talked with said that she was afraid that the security forces would conduct house inspections on her street. She hasn’t left Yangon since May.

Coping With Covid

The underground health system relies heavily on telemedicine and has struggled to provide treatment for patients who were infected by Covid in August.

The promising Myanmar vaccine program had been in place before the coup. But that was stopped after the military overtook the government. The doctor responsible for the vaccination rollout was one of the people they detained.

While the junta had promised to accelerate vaccination rates, they have been held back because of a dearth of qualified staff, lack of vaccines and lack of trust in the military-run medical system. Although the NUG initiated its own vaccination programme in July but it has been limited to areas bordering territories under control by sympathetic ethnic insurgent forces.

Mi April is a nurse instructor and is now helping former students use telemedicine to reach their local patients.

“I used work up to 2 a.m. responding to messages from sick relatives, saying that my father would die and my mother would die. Please respond.

“I couldn’t give them medicine or oxygen, so I was powerless.” There were people queuing up at oxygen-supplying places, but they were blocked by the military.

In July and August, the Delta version of Covid seems to have gone unnoticed in Myanmar. Hard to find the actual casualties. We spoke with nurses and doctors who said that seriously ill patients were not allowed to stay in government hospitals and they had to return home to recuperate or die.

Although Covids had dropped sharply by September, Myanmar is still vulnerable to new outbreaks. Vaccinations rates are far lower than those in neighbouring countries.

“During the worst Covid pandemic, we attempted to procure medicines, oxygen concentrators as well as cylinders. “It is very challenging, but it is possible to have human resources, as I think 70-80% of healthcare workers work with us,” Zaw Wai Soe said.

‘We lost our future’

He explained to me why the health workers of Myanmar played such an important role in opposing the coup. It is an ethical response from a profession that was severely neglected under military rule when Myanmar experienced one of the lowest healthcare expenditures in the world.

This started to change with the civil government of Aung San Suu Kyi. They also launched a massive recruitment campaign to recruit new personnel.

Comparing with other countries we do not get high salaries. We could all easily work abroad and get more money, such as in Singapore, Brunei, Malaysia and Singapore. After Covid’s arrival last year, however, many of us gave our best efforts for the country. All of us hoped that we’d have a better tomorrow with the elected government.

“The coup suddenly happened. This is the reason we couldn’t accept it. We worked for the people, despite our low salaries and poor living conditions.

“We had hope for the future and then suddenly lost it.”


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