At least 355 attacks and threats against health workers, facilities, and transports in Myanmar were perpetrated during the first ten months of the country’s coup and crackdown (February 1 to November 30, 2021), according to an analysis based on open-source reports compiled by Insecurity Insight, Physicians for Human Rights (PHR), and the Johns Hopkins University Center for Public Health and Human Rights (CPHHR).
Myanmar’s government forces, including the military (“Tatmadaw”), police forces, and other government aligned militias have perpetrated approximately 90 percent of documented attacks against health care since military takeover. In recent months, the military has escalated the same scorched earth tactics it used to devastating effect against the Rohingya minority in Myanmar in 2016-2017, including widespread burning and destruction of civilian homes and infrastructure like hospitals in ethnic minority regions of the country. November 2021 also saw the highest number of health workers detained (80 documented arrests) compared to any month since the onset of the coup, while government forces increasingly launched indiscriminate artillery and arson attacks against hospitals and clinics.
COVID-19 remains a threat to Myanmar’s debilitated health system, particularly with the emergence of new, highly transmissible variants. The daily number of COVID-19 infections and deaths has since declined significantly, which at its peak saw over 7000 confirmed cases and nearly 400 COVID-related deaths daily between July and September 2021, and vaccination efforts have resumed nationwide. Yet, vaccination coverage is variable given persistent civilian mistrust of the military government, inadequate access for displaced and incarcerated populations, and frequent disruptions to health service delivery in conflict zones.
Within the 355 total incidents that took place across Myanmar during the first 10 months of the military’s coup and crackdown (February 1 to November 30, 2021), Insecurity Insight, PHR, and CPHHR highlight reports of:
- 284 health workers arrested
- 31 health workers killed
- Hospitals raided at least 113 times
“What started as a coup in Myanmar is now approaching a civil war and health system collapse,” said Christina Wille, director of Insecurity Insight. “Our documentation shows that the military’s atrocities against civilians and health workers appear to be escalating. Recent months saw clinics firebombed, health workers detained in mass arrest events, and humanitarian NGOs’ supplies destroyed. Without immediate action by neighboring countries and the international community, 2022 could be an even more catastrophic year for Myanmar’s besieged civilians and the medics who care for them.”
The incidents referred to are based on the dataset 01 February – 30 November 2021 Violence Against Health Care in Myanmar Data, which is available on the Humanitarian Data Exchange (HDX). For the purposes of this research brief, one incident can comprise multiple types of violence or threats such as those above. The brief does not include incidents of violence against patients. Selected events can also be viewed on the global map on threats and violence against health care.
The new research brief highlights several new developments in the military’s ongoing crackdown on the medical profession and the anti-coup movement, including in its conflict with the National Unity Government (NUG) and its military wing, the People’s Defense Forces (PDF), which declared war against the State Administrative Council (SAC) – the military government – on September 7, 2021.
The military is increasingly using indiscriminate artillery and arson attacks against hospitals and clinics that provide health care to communities perceived to be sympathetic to pro-democracy groups. In October 2021, at least four facilities were reportedly destroyed and three additional facilities were damaged in fighting and indiscriminate attacks against civilians. For example, on October 29, a private clinic in Thantlang township, Chin state, was burned to the ground by SAC forces, along with at least 160 homes.
Military forces continue to raid and occupy health facilities. In October and November, military forces reportedly raided at least 13 health facilities in Ayeyarwady, Magway, Sagaing, and Yangon regions, and Chin, Kachin, and Kayah states, resulting in the arrest of 19 health workers. This represents an escalation from the three-month period of July to September, in which eight facilities were raided or occupied. For example, on November 16, approximately 40 SAC soldiers and aligned non-state security actors occupied two sub-rural health centers in Ngwe-twin village and Thit-kyin-gyi village, Sagaing region and were seen transporting boxes of weapons into the health clinic.
Mass arrests of health workers increased. In November, at least 80 health workers were reportedly arrested or detained, more than in any month since the start of the coup in February 2021. For example, on November 2, ten volunteers with a local NGO that delivered COVID-19 aid were arrested by SAC forces.
The military escalated its attacks on the local NGOs that provide humanitarian aid to displaced populations in ethnic minority regions such as Chin, Kachin, and Shan states and Sagaing region. For example, on November 15 an aid worker involved in supporting camps for internally displaced people was reportedly beaten and arrested by SAC forces in Pekon township, Shan state.
“The COVID-19 response in Myanmar is still riddled with barriers related to widespread government mistrust, ongoing conflict, and rising health costs,” Sandra Mon, a PHR expert and epidemiologist from Myanmar at the Johns Hopkins Center for Public Health and Human Rights. “Civilians seeking COVID-19 vaccines through non-governmental channels are forced to rely on ethnic health organizations who are constrained to their geographical jurisdictions, or on private health facilities which may charge up to US$200 for a two dose regimen.”
“Services through the NUG remain under-realized due to the violent targeting of PDF members and other NUG-affiliated civilian actors. The global rise of the Omicron variant should compel local and regional health bodies to exercise utmost vigilance and continue to support Myanmar’s COVID-19 control measures. Access, equity, and public health diplomacy will be key to avoiding yet another health catastrophe in Myanmar,” added Mon.
Insecurity Insight, PHR, and CPHHR used an open-source methodology to compile incidents noted in local, national, and international news outlets, online databases, and social media reports. The incidents reported are neither a complete nor a representative list of all incidents. Most incidents have not undergone verification by Insecurity Insight, PHR, and CPHHR. Data collection is ongoing and data may change as more information is made available. However, the data offers a snapshot of how Myanmar’s military is persecuting health workers and targeting facilities amid its broader crackdown on civilians.
“After 10 months of brutal repression and now with the expected onslaught of the Omicron variant, Myanmar’s military must immediately end hostilities and its obstruction of health care,” said Susannah Sirkin, director of policy at Physicians for Human Rights. “The Tatmadaw is violating human rights – including the right to health – every day through its assaults on civilians and widespread denial of health care during a pandemic. International actors must ratchet up the pressure on the regime to abide by international human rights law and its obligations to cease attacks on medical personnel.”
The research brief makes several recommendations to UN member states, urging the international community to ensure the full implementation of UN Security Council (UNSC) Resolution 2286, adopted in May 2016, which strongly condemns attacks on medical personnel in conflict situations, as well as UNSC Resolution 2565, which calls for a global ceasefire during the COVID-19 pandemic.
Insecurity Insight monitors open sources for information on incidents that interfere with the delivery of health care. This information is shared once a month in the Attacks on Health Care Monthly News Briefs, and with a wide range of stakeholders who campaign for change or work on the ground. Subscribe to updates here.
Physicians for Human Rights (PHR) is a New York-based advocacy organization that uses science and medicine to prevent mass atrocities and severe human rights violations. Learn more here.