In the first weeks of the pandemic, there were encouraging signs that Myanmar was being proactive in its COVID-19 response. On 30 January 2020, ahead of most countries in the world, the government created a ‘National-Level Central Committee for COVID-19 Prevention, Control and Treatment’ in an effort to get ahead of the virus.
Despite these early efforts, the national-level body which came to have ultimate responsibility for Myanmar’s COVID-19 response — the ‘Coronavirus Disease 2019 Containment and Emergency Response Committee’ — was heavily stacked with military representatives and had a mandate in many ways more focused on security than public health.
The reality of the country’s decades-long civil wars and patchwork of health system governance has meant simultaneously that the central government does not have the capacity to provide adequate health services across the entire country — notably in many border regions, important during a pandemic — and that long-standing mistrust makes cooperation even harder. While authorities in Myanmar announced a ‘no one left behind’ approach to their COVID-19 response, for many citizens access to the central government’s health system was limited or non-existent long before the pandemic began.
Historically, Myanmar’s highly centralized health system has often neglected the diverse needs of ethnic minority populations: health staff from majority areas are typically posted to far-away territories with little understanding of the local needs, cultures and languages. Health infrastructure in ethnic minority areas is underfunded and people living in areas controlled by ethnic armed organizations, especially those fleeing armed conflict, rely on the health services provided by these groups and ethnic health organizations. For hundreds of thousands of internally displaced people (IDPs) stranded in camps in Karen, Rakhine, southern Chin, Kachin and northern Shan states, these are the sole providers of health care.
Ethnic armed groups and health care organizations have implemented a wide range of COVID-19 interventions in conflict areas and territories outside of government control. These local-level responses include community-managed checkpoints and health checks, quarantine centres for travellers, health referrals for those potentially infected, local needs assessments, distribution of personal protective equipment and dissemination of public health information in minority languages. At this time of shared crisis, the importance of this work should be recognized and supported by the Myanmar government and by international donors — yet in practice, these groups have received little support from international donors and have been overlooked by authorities in Myanmar itself. Indeed, in some cases the central government and military have actively disrupted their response efforts.
For the Myanmar military, it seemed that the outbreak was viewed as a strategic opportunity rather than a collective threat. While the number of confirmed COVID-19 cases steadily rose through late March and April 2020, the Myanmar military continued offensives in Rakhine, southern Chin, Karen and northern Shan states. At a time when all focus should have been on addressing the pandemic, people living in ethnic minority areas have had to deal with troop movements, unwanted military road-building projects and fighting that has displaced thousands of people.
To make matters worse, government soldiers were also actively disrupting local COVID-19 response activities in ethnic states, especially those delivered by armed groups. In Shan state, for example, the Restoration Council of Shan State (RCSS) implemented numerous COVID-19 prevention efforts in their territory, including establishing health checkpoints staffed with medics and distributing public health information in Shan language. Yet in April 2020, despite it being a recognized signatory to the Nationwide Ceasefire Agreement, the Myanmar military attacked RCSS soldiers accompanying medics on COVID-19 work and warned local Shan villagers not to accept medical treatment from them. Though the government subsequently promised in June 2020 that it would support RCSS’s COVID-19 response, tensions and military disruption continued on the ground.
While authorities have pursued similar policies elsewhere — in Karen State, for example, the military physically destroyed a number of COVID-19 screening checkpoints established by the Karen National Union and ordered the closure of others — these issues are most pronounced in Rakhine and southern Chin states, where armed conflict has raged throughout the pandemic. The fighting between the Myanmar military and Arakan Army (AA) has in fact intensified in parallel to the unfolding pandemic: on the same day Myanmar announced its first confirmed COVID-19 case the AA was designated a terrorist organization, presaging an increase in the frequency and severity of offensives against it. The expansion of armed conflict in Rakhine state at the same time as the virus was spreading significantly impeded the ability of civil society organizations and international humanitarian agencies to provide a comprehensive response to local people, including many IDPs. Meanwhile, the military’s tactical mobile internet shutdown disrupted people’s access to information on the pandemic. The very real threat of violence — a World Health Organization (WHO) driver was shot and killed while delivering test samples in the first phase of the pandemic, for instance — further obstructed health workers. The pandemic was also used as a pretext for soldiers and police to harass, extort from and assault Rohingya people living in IDP camps.
The emergence of COVID-19 could have been an opportune moment for the Myanmar government to expand cooperation with the existing parallel health systems in ethnic minority areas and build a more effective decentralized health structure to address the pandemic. It could even, perhaps, have offered the possibility of at least a temporary cessation of hostilities as the country rallied to contain the virus. Instead, the military has used the pandemic as a pretext to escalate its use of force, a process that arguably culminated in its February 2021 coup. With the arrest of State Counsellor Aung San Suu Kyi, the killings of hundreds of protesters and the detentions of thousands of others, maintaining power rather than protecting public health appears to be the main priority.
Photo: Members of the Rohingya community gather at the Thet Kel Pyin internally displaced persons (IDP) camp in Sittwe, Rakhine State, Myanmar. Myanmar’s military seized power and declared a state of emergency for one year after arresting State Counselor Aung San Suu Kyi and Myanmar President Win Myint in an early morning raid on 01 February 2021. Credit: EPA-EFE/NYUNT WIN.