Healthcare workers in Myanmar are under attack. The world cannot afford to be silent.

 

On April 12th, Dr. Maw Maw Oo, a senior Emergency Medicine doctor was forcibly abducted by armed soldiers at his office in Yangon General Hospital. Dr Oo, who was coordinating his hospital’s COVID vaccination and treatment efforts, is just one of dozens of physicians to have been arrested by Myanmar security forces since widespread protests began in the country two months ago.

The violence began when the Myanmar military, the Tatmadaw, staged a coup d’etat by arresting Aung San Suu Kyi and other democratically elected leaders of the civilian government. This provoked a wave of nonviolent protests throughout the country in defense of Myanmar’s young democracy. Led by doctors and other leaders of civil society, the “Civil Disobedience Movement” (CDM) has spread throughout the nation. “Our duty as doctors is to prioritise care for our patients—but how can we do this under an unlawful, undemocratic, and oppressive military system?”, Myanmar’s health leaders write in the Lancet.

The Tatmadaw has responded to the peaceful protest movement with violence and stunning cruelty.

Since February 11, Insecurity Insight, in collaboration with Physicians for Human Rights (PHR) and the Johns Hopkins University Center for Public Health and Human Rights (CPHHR) has documented at least 109 attacks and threats against health workers, facilities, and transports by the Myanmar military.  At least 97 healthcare workers have been arrested and 10 killed. Doctors are routinely detained for treating injured protesters and ambulances are targeted and shot as they respond to injured protesters. Hospitals throughout the country have been violently raided and occupied by the military, seeking to arrest healthcare workers affiliated with the CDM movement. In the past month, the Tatmadaw has issued arrest warrants for almost 400 physicians for their participation in the Civil Disobedience Movement, accusing them of “threatening the stability of the government”.

In the midst of a global pandemic, this systematic targeting and abuse of Myanmar’s healthcare workers have driven them into hiding, operating clandestine clinics so as to continue to fulfill their duties to their patients. This assault on healthcare has upended Myanmar’s COVID response. Nearly all testing and treatment has ceased, and it is unclear how the country will vaccinate its population when its healthcare workers are in hiding and targets of violence.

An attack on healthcare workers, especially those delivering aid, is a grave violation of international law. Traditional protections afforded to healthcare workers are faltering. The past several decades has seen the continued erosion of medical neutrality across the world. In Syria alone, Physicians for Human Rights reports that over 900 medical personnel were killed in Russian and Syrian-regime attacks.  In response to these attacks, the United Nations passed Resolution 2286 in 2016. This resolution urges the Secretary-General to take proactive steps to prevent attacks, including the potential deployment of United Nations Peacekeeping Forces to ensure the protection of healthcare.

The continued erosion of medical neutrality can only exist within the context of the international community’s deafening silence and failure to act. The longer the international community fails to enforce international law, the greater the risk that these attacks on healthcare become normalized in conflict. When that happens, healthcare workers everywhere will be at risk.

In the past several weeks, medical organizations across the world have issued statements in solidarity with Myanmar healthcare workers, including the International Federation of Emergency Medicine, the Norwegian Medical Association, and the British Medical Association. Notably absent among these are the American Medical Association—an organization that carries significant clout and political weight in its country.

These bold statements are a positive step and should be lauded. In response to these statements, a Myanmar physician in hiding told the Telegraph, “If we don’t get any help from the international community, I feel helpless…We need more action than statements.”

Insecurity Insight recently announced they had documented over 4,000 attacks on healthcare workers in the five years since the passage of UN Resolution 2286, in which the United Nations reaffirmed their commitment to protect medical neutrality. Insecurity Insight writes, “the persistently high numbers of acts of violence against health care – almost all carried out with impunity – cry out for action.”

Action is needed. If medical neutrality is to be preserved for future generations, then the United Nations must finally embrace a full implementation of Security Council Resolution 2286 and commit to an impartial investigation into attacks on healthcare in Myanmar. States like Myanmar must be held responsible for their attacks on healthcare professionals, and the United Nations must prove itself willing to intervene to ensure the delivery of healthcare.

 

About the author: Brian Elmore is a researcher at Insecurity Insight and medical student at the Medical University of South Carolina. Insecurity Insight monitors open sources for information on incidents that interfere with the delivery of health care. Read our report detailing attacks against healthcare in Myanmar here.

Conflict of interest: I hereby declare the following interests, according to the BMJ Group policy: I am paid by Insecurity Insight for part-time work researching attacks on healthcare. My research contributed to the report cited in this article. I have had complete editorial independence in writing this article. The thoughts contained within are my own and have not been paid for it.

Handling Editor: Neha Faruqui

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