“Our Health Workers Are Working in Fear”: After Myanmar’s Military Coup, One Year of Targeted Violence against Health Care

Introduction

On February 1, 2021, the Myanmar military (Tatmadaw) took control of the country in a coup d’état.^[1] Hundreds of thousands of people took to the streets in protest.^[2] The military regime not only imprisoned political rivals and dissenters,^[3] but quickly proceeded to wage war against the people of Myanmar at large with excessive force against protesters,^[4] arbitrary arrests of civil servants and other civilians, and indiscriminate attacks on entire communities across the country.^[5] The Civil Disobedience Movement (CDM), led by civil servants, grew into nationwide strikes across government and private sectors. For their early leadership and broad participation in CDM, health care workers have been targeted by the military with hundreds of arrest warrants for doctors and nurses as well as arrests of health care workers at their jobs and homes.^[6] Attacks on health care workers and health care itself has become a prominent feature of the coup d’état.^[7] Today, Myanmar is one of the most dangerous places in the world to be a health care worker.^[8]

Attacks on health care workers and health care itself has become a prominent feature of the coup d’état. Today, Myanmar is one of the most dangerous places in the world to be a health care worker.

Hospitals and other health care facilities have been occupied,^[9] raided, and shot at by Myanmar security forces;^[10] health care workers have been arbitrarily beaten and arrested while providing care;^[11] and patients have been arrested while receiving treatment in facilities. Myanmar military have occupied hospitals and used them as military bases, in direct violation of international humanitarian law.^[12] Myanmar security forces have raided and taken medical supplies from private clinics and charity organizations focused on providing voluntary medical and social assistance, including those associated with religious organizations,^[13] and have warned them not to provide care to civilian protesters.^[14] Humanitarian aid, including medical supplies, to displaced populations has been blocked by the Myanmar military.^[15] The country was devastated by a disastrous third wave of COVID-19 from July to September 2021.^[16] Thousands of people died – mostly at home, without access to any health care facility or provider – due to the collapse of the public health care system and obstruction of health care access.^[17]Act Now to Restore Rights in MyanmarIt’s time for Congress to pass the BURMA Act nowTake Action

Hospitals and other health care facilities have been occupied, raided, and shot at by Myanmar security forces; health care workers have been arbitrarily beaten and arrested while providing care; and patients have been arrested while receiving treatment in facilities.

The country’s conflict landscape has changed dramatically with widespread opposition to the coup d’état, including from long-established ethnic armed organizations and newly formed armed forces.^[18] The Myanmar military has shelled residential neighborhoods with artillery, burning down homes, cutting off internet access and food supplies, and indiscriminately shooting civilians. This heavy-handed retaliation against opposition to the coup has displaced more than 296,000 women, men, and children since February 1, adding to already significant numbers of internally displaced people across the country and expanding the geographical areas of displacement (e.g. northern Chin state, Magway region, and Sagaing region).^[19] Thousands of people have fled across borders to India and Thailand, including almost an entire community of 12,000 people from Thantlang township, Chin state.^[20] With indiscriminate attacks on communities and blocking of humanitarian aid by the Myanmar military, humanitarian organizations face safety challenges in accessing  conflict areas and displaced populations, including across affected areas that have not seen conflict in recent years or needs on this scale before. ^[21]

Under international human rights and humanitarian law, states are obligated to ensure effective protection for health care workers at all times, and to provide unencumbered access to emergency health care for all.^[22] The people of Myanmar are facing gravely diminished access to routine and emergency health care services, with ongoing and egregious deliberate targeting of health care by the Myanmar military and other armed actors opposing the coup d’état.

Political Context

On February 1, 2021, the Myanmar military (Tatmadaw), led by Senior General Min Aung Hlaing, contested the results of the November 2020 general elections, where the National League for Democracy, the party led by Aung San Suu Kyi, won by a large margin. The Myanmar military arrested leaders of the newly elected government and declared a state of emergency in which the military would control the country under a caretaker government for at least a year.^[23] Widespread peaceful protests quickly erupted throughout the country and military security forces responded to the protests with brutal crackdowns and excessive force, using rubber bullets, live ammunition, tear gas, and water cannons against non-violent demonstrators, and shooting both medical aid volunteers and children.^[24]

“Our healthcare workers are working in fear. We are being oppressed, we are forcefully arrested – as are our family members if we cannot be found – and are being prevented from providing proper medical care, resulting in permanent damage to patients and the loss of many lives.”
Mandalay Medical Cover (Partner Statement to UN Human Rights Council)

Newly organized militias formed in opposition to the coup d’état and attacks on communities, mostly notably as part of the People’s Defence Force (PDF) under the National Unity Government (NUG), which was created by a group of elected lawmakers and members of parliament who oppose the coup d’état and military-led State Administration Council (SAC)’s self-declared caretaker government.^[25] The NUG has declared its intention to form a Federal Union Army, which would include ethnic armed organizations that have fought against the Myanmar military for decades.^[26] In a speech on September 7, the NUG’s acting president called on all citizens to “revolt against the rule of military terrorists” and declared Myanmar to be under a state of emergency until “the resumption of civilian rule in the country.”^[27] Some ethnic armed organizations and PDFs have begun to collaborate against the Myanmar military, but the extent of formal alliances and coordinated chains of command that have been or will be developed are uncertain.^[28] In the context of escalating armed resistance that has increasingly harmed civilians, the chair of the Kachin Independence Organisation called on civilian resistance groups to stop all attacks on civilians and public facilities, including schools and hospitals.^[29]

Methodology

Since February 2021, researchers from the Center for Public Health and Human Rights at Johns Hopkins University, Insecurity Insight, and Physicians for Human Rights, as part of the Safeguarding Health in Conflict Coalition, have monitored open-source digital materials, including local, national, and international news outlets, social media reports, and communications from partners to identify reports of incidents of violence against health workers, facilities, and transport as well as obstruction of health care in Myanmar. This open-source methodology follows a protocol informed by the Berkley Protocol on Digital Open Source Investigations. Incidents are categorized under commonly reported concerns such as: health workers arrested, raids on hospitals, military occupations of hospitals, health workers injured, health workers killed, and incidents impacting COVID-19 response measures. The incidents reported are neither a complete nor a representative list of all incidents. Data collection is ongoing and data may change as more information is made available. Incidents have not undergone verification, but available information is reviewed for evidence of credibility.

Download“Our Health Workers Are Working in Fear”: After Myanmar’s Military Coup, One Year of Targeted Violence against Health Care