Burma: doctors, military targets in full resurgence of Covid-19

Ryan no longer walks the long corridors of the General Hospital in Mandalay, Burma. For more than five months, his white coat has been put away. The 32-year-old internal medicine specialist is one of hundreds of caregivers who deserted public hospitals under the control of the Burmese army after the February 1 coup. “I categorically refuse to work for the military,” he insists to France 24.

Caregivers were the first to enter into resistance, just hours after the putsch that overthrew the civilian government of Aung San Suu Kyi. “I just took the time to send my patients home and then I went to protest,” recalls Ryan. Soon after, under their leadership, thousands of teachers, civil servants and students joined their ranks.

Five months later, faced with an incredibly violent crackdown, these large-scale demonstrations have become rare, giving way to clashes between resistance groups made up of armed civilians and the military. For their part, many caregivers were forced to flee. Others continue to try to work in the shadows, in makeshift hospitals.

Four hundred doctors threatened with arrest warrants

“The caregivers are the central figure of this movement of civil disobedience which still paralyzes the country today”, explains to France 24 Jennifer Leigh, epidemiologist in charge of monitoring the situation in Burma for the human rights NGO Physicians for humans rights. “But this aura has earned them today being one of the targets of the Tatmadaw, the Burmese army.”

“Medicine is certainly the most respected profession in the country and the junta is afraid of the influence that caregivers can have on the population,” she said. “Historically, they have always played a major role in popular uprisings and have often marked their opposition to the military.”

In total, nearly 900 people have died since February 1, according to the count made daily by Association for Aid to Political Prisoners (AAPP). About 5,100 people have been arrested and thousands remain missing. Among them, 157 doctors were imprisoned, officially for “disturbing public order”, between February 11 and May 11, according to the census carried out by Physicians for Human rights. Twelve were killed.

“Four hundred doctors and 180 nurses are still targeted by arrest warrants,” says Jennifer Leigh. “They are presented as ‘enemies of the state’. Their photos are circulating in the media, with rewards for anyone providing information on their whereabouts.”

“The military can arrive at any time”

In Mandalay, Ryan and several of his colleagues opened a makeshift health center in the days following the coup. Resourcefulness is the watchword: the address is circulated by word of mouth and the establishment operates mainly thanks to donations from citizens. Doctors offer basic and completely free care. “We know full well that the threat is constant. The military can arrive at any time to stop us, or even worse,” he testifies.

“For the moment, I have decided to stay here, but I am ready to flee if necessary,” he said. According to Physicians for Human Rights, 73 health centers have been stormed since the coup, the soldiers ransacking the premises in search of these dissident caregivers.

Like Ryan, Zin, a doctor at Yangon General Hospital, hung up his gown in early February to join the civil disobedience movement. After taking part in the demonstrations organized in the city, he decided to flee. Today, he no longer dares to work.

“The only thing I do is offer teleconsultations via social networks,” he told France 24. “It’s extremely frustrating. People are dying every day because we cannot treat them. the soldiers are ready to do anything to punish us. “

In recent weeks, however, the military has managed to reopen the general hospitals of Rangoon and Mandalay, the two largest establishments in the country, by mobilizing staff from their ranks. But faced with the absence of caregivers, the offer remains extremely limited.

“Anyway, the population is very suspicious of seeking treatment from the military. For many, it is only a solution of last resort,” says Ryan. “Some people try to go to private hospitals, but they are usually way too expensive. Others prefer to give up.”

Rise in Covid-19 contamination

Faced with this health system almost at a standstill, NGOs and associations are sounding the alarm. Especially since for several weeks, the Covid-19 pandemic has experienced a strong resurgence.

Thursday July 1, 1,500 cases of Covid-19 have been recorded in the country, while the pace was around 100 per day in early June. Burma officially has 3,347 deaths. A figure certainly largely underestimated.

“On our side, we manage to test some patients with material that is illegally collected. These data are not taken into account in the official figures but they show a sharp increase in the number of cases”, explains Ryan. “At the time of the coup, we already had a lot of Covid-19 cases. But we were in pretty good control of the situation. I had just received my first dose of the vaccine.”

“Today, I am afraid that we are heading towards an Indian scenario,” Zin worries. “The military do not have the human or material resources to cope with a new wave of contaminations. Some people have already rushed to buy oxygen and medicine. Now prices are skyrocketing and we are approaching ‘a shortage. “

The junta has put in place restrictions linked to Covid-19 in several cities in the country, notably in Mandalay but also in the region of Bago, in central Burma. It is thus forbidden to leave one’s home for non-medical reasons. But the situation is particularly worrying in the border areas. Several sources of contamination have been detected there, but conflicts between ethnic militias and the military drastically limit access to healthcare.

On immunization, state media reported that junta leader Min Aung Hlaing had agreed to buy two million vaccines from Russia. A spokeswoman for the Ministry of Health also said that the authorities are also negotiating with China to buy more doses. For the moment, only a shipment of 1.5 million vaccines had arrived from India at the start of the year, for a country of 54 million inhabitants.

“The Burmese health system was already structurally fragile. It had only been developing for about ten years,” recalls Jennifer Leigh. In 2018, according to data provided by the World Bank, the country had only 6.7 doctors per 10,000 people. Far from the 15.6 average in the world. And for the epidemiologist to conclude: “This political crisis is causing a health catastrophe.”