Myanmar’s pandemic coup: Health workers in the forefront of resistance

Four months after the military took power through a coup, Myanmar confronts a spike in COVID-19 cases. How are health workers dealing with the twin challenges of a pandemic and a repressive regime?

May 31, 2021 by Peoples Health Dispatch
Medics protest in Myanmar in March. Photo: The Irrawaddy

Four months after the Tatmadaw (Myanmarese military) took power in a coup, resistance continues, demanding the restoration of democracy. Health workers are on the frontlines of these movements that have seen the strong participation of workers and trade unions.

The coup took place shortly after the elections of November 2020 in which Aung San Suu Kyi’s  National League for Democracy (NLD) won an overwhelming majority. Continuing with its earlier response to the COVID-19 pandemic, the NLD government initiated a vaccination program in January. Abruptly, just a few days later, newly elected parliamentarians from the NLD were arrested and Myanmar was effectively back under the Tatmadaw after a six-year tryst with limited democracy.

Start of a new COVID wave? 

The Tatmadaw took over as Myanmar’s wave of Covid-19 infections was ebbing. From February till May, weekly averages of new daily cases remained below 30. On May 28, the country reported 96 new cases, the highest since early February. In response, the Tatmadaw imposed stay-at-home orders in two towns on the Indian border where the cases were concentrated.

This is worrisome as the vaccination program and the entire health system are struggling. Civilians are refusing to take the jab and thousands of health workers are on strike as part of the civil disobedience movement.

“The situation is hard, we want to work, but not under the junta. We are committed to the NLD government that won the elections. We will only work in public facilities run by them,” said a doctor who is part of the nationwide civil disobedience movement.

Resistance by workers

In a swift reaction to the Tatmadaw takeover in February, health workers stopped work in at least 70 hospitals. They declared that their commitment to save lives of the people of Myanmar also extended to opposing a military coup. Another statement followed from the Confederation of Trade Unions Myanmar (CTUM) that strongly opposed the coup and called for the release of arrested political leaders and the restoration of the parliament.

In a few weeks, Myanmar’s resistance movement expanded dramatically to include workers from many other fields: bankers, grocers, railway workers, teachers, textile workers and others. A massive civil disobedience movement emerged, with workers and trade unions at the center.

In response to workers’ leadership of the disobedience movement, the Tatmadaw declared some 16 labor unions to be “illegal organizations” and arrested or filed arrest orders for at least 71 individual union leaders. There have been 135 confirmed cases of workers being fired for participating in street protests, while thousands more have had their factory jobs threatened if they participate further in the disobedience movement.

Such has been the impact of the health workers’ defiance that, ahead of the 8 March nationwide strike for a “full-extended shutdown of Myanmar economy“, at least five hospitals were occupied by the military in Yangon and Mandalay. This was interpreted as a direct attempt to impede access to care for civilians and a warning to doctors against further treating injured protestors. The strike was called by 18 trade unions across industries, including agriculture, energy, mining, construction, food, and transportation.

Health workers on the frontlines

80% percent of Myanmar’s healthcare system is public and health workers hold 10% of government jobs. By late February, nearly one-third of Myanmar’s 1,262 public hospitals were closed. This industrial action has badly impacted the regime. Although the Tatmadaw opened military hospitals to the public in an attempt to save face, many civilians feared them or refused to go there out of principle.

Instead of providing care in their workplaces, doctors supporting the disobedience were instead providing free treatment at private and free clinics, or setting up charity clinics for those needing emergency treatment. Others went undercover to treat patients wounded during the crackdowns on anti-regime protests that intensified at the end of February.

Despite dismissals, threats and repression, health workers have remained on the frontlines. On 28 March, a 20-year-old nursing student was shot dead while attending to injured protesters in Monywa, the capital city of the Sagaing province in central Myanmar. Since then, at least another 11 health workers have been killed, 32 injured, and 157 arrested.

Since mid-April, the junta has been intimidating health workers through lawsuits under Section 505 (a) of the Penal Code. Following amendments made by the junta in mid-February, offenses under this provision are now non-bailable and subject to arrest without a warrant.

The Tatmadaw list of health workers charged under this law swelled to 139 by 19 April, and to 360 in early May, testament to how hard the regime has been hit by the defiance of health workers across the country.

Critics of the protests have hinted to the actions of health workers as irresponsible and contrary to their duty to serve. However, the health workers have challenged this narrative. “Limiting access to lifesaving interventions” is a “complex ethical challenge”, health workers wrote in a letter published in the Lancet on February 19: “Our duty as doctors is to prioritize care for our patients – but how can we do this under an unlawful, undemocratic, and oppressive military system?” The letter brings to the fore the deeply political nature of the role of a health worker who serves her community, which inspired workers in many other sectors to join them too.

Global solidarity

The workers’ actions have led to reactions of solidarity in the region and around the world. Labor and human rights groups have organized protests outside Myanmar embassies in Thailand, Japan, Cambodia, and the Philippines, among other places. Many have issued solidarity statements condemning the coup.

Public Services International, the global union representing health sector unions, called on governments and international institutions to condemn the military coup and arrests, cease any funding to the Tatmadaw regime and recognize elected representatives as the government of Myanmar. Together with other global unions, they have launched a Strike Fund to support the striking health workers, local government and other public service workers.

It is an uphill battle for the civil disobedience movement and  health workers. They have called on the international community to intervene on multiple occasions. There are grave and documented violations of the right to health and medical neutrality by the Tatmadaw. As the World Health Assembly convenes in Geneva from May 24 to June 1, it is an opportunity to shine a light on the tragedy unraveling in Myanmar in the context of the pandemic and with a lens of its implications for health.

Unfortunately, the WHA is likely to conclude without a word about the plight of health workers, patients’ safety and medical neutrality towards protestors, or about the effects of this illegitimate regime on the country’s public health system.