The Tatmadaw’s Assault on Healthcare Reform in Myanmar

In downtown Yangon, a red brick colonial building erected by the British in 1899 still serves as the Yangon General Hospital. Despite multiple renovations over the past century, the building remains nearly derelict, with cracks in the walls and fading paint.

The hospital has a dark history, having witnessed the brutal suppression of nationwide uprisings by the military, also known as the Tatmadaw, in 1988. During the uprising, pro-democracy activists were massacred in the wards of the hospital as they sought refuge and treatment at the height of the junta’s crackdown.

In contrast with previous uprisings, the same wards today remain empty, and chains block off the main entrance. Since the Tatmadaw again seized power on February 1, the hospital has been closed to the public in solidarity with the nationwide strikes coordinated by the Civil Disobedience Movement (CDM).

Health workers all across Myanmar are taking part in the CDM, which has helped grind the state’s gears to a near-halt with sweeping public sector strikes. The movement was initially launched by health professionals who, struggling to contain the COVID-19 pandemic, rejected the legitimacy of the military. Indeed, the staff of Yangon General Hospital have played a prominent role in leading the dissident movement.

Up until the coup, Myanmar had been under strict stay at home orders to prevent further outbreaks of COVID-19. The yearlong restrictions were lifted immediately after the civilian government was ousted. In February, the United Nations’ country coordinator announced via video conference that “public healthcare has collapsed with nearly all COVID-19 testing and treatment halted.”

Dr. Min, a senior doctor, has worked at Yangon General Hospital for over 30 years. In his time working there, he has seen advances in the healthcare system interrupted by its stagnation under military rule. For Dr. Min, who asked to use a pseudonym due to concerns for his safety, a familiar sense of dread consumes his outlook as he contemplates once again working directly under the Tatmadaw.

“The military kept us in the dark ages for decades,” he told The Diplomat. “We were always denied access from working alongside international agencies to address the failures of the current system. Following democratization, our hospitals have not only received greater funding and support, we can voice our concerns without fearing repercussions.”

For generations, Myanmar has had one of the poorest healthcare systems in Southeast Asia. In 2000, the World Health Organization (WHO) conducted a comprehensive study of the world’s public health systems around the world in which it ranked Myanmar dead last: 190th out of 190 countries. Consequently, the nation has exceptionally high rates of infant mortality and infectious diseases, alongside low life expectancy.

Following its election in 2015, the National League for Democracy (NLD) government announced a number of crucial reforms to the public health system that elicited a newfound hope among healthcare practitioners like Dr. Min.

In 2017, the NLD government launched a National Health Plan (NHP), which aimed to establish basic packages of healthcare services across the country by 2020. The plan’s immediate goals were to invest in the accreditation, training, and support of health workers, as well as developing immunization programs and health clinics in every corner of the country.

Dr. Min said that the NHP came as a “relief” to him and many other medical practitioners. “We’ve not asked for better salaries or working hours,” he said. “Our goal was to be given the support from government institutions to allow doctors to carry out their basic duties. The National League of Democracy has shown a political commitment to this which has already led to a direct increase in the efficiency and effectiveness of our departments.”

Dr. Min lamented the fact that despite the changes introduced, the current healthcare system still fails to provide basic levels of care to the nation’s 54 million citizens.