SEATTLE, Washington — Myanmar’s impressive ethnic diversity, consisting of 135 different ethnic groups, comes along with decades of civil war and unrest. In particular, the government’s persecution of the Rohingya ethnic population has long escalated into devastating armed conflict, widely regarded as genocide and an attempt at ethnic cleansing. Myanmar’s Rohingya population, a Muslim ethnic group in the majority-Buddhist country, have suffered communal violence, forced displacement and deadly attacks from the Myanmar army since an escalation of conflict in 2018. The minority group also does not receive equal access to healthcare in Myanmar.
Fragile Healthcare System
Healthcare in Myanmar is regarded as one of the world’s most fragile systems. Total health expenditure occupied only 2.0 to 2.4% of the nation’s GDP from 2001 to 2011 which is the lowest among Southeast Asian and Western Pacific countries for that time period. In northern Rakhine townships, where more than 90% of the population are identified as Rohingya, there was only one physician per 158,000 people, compared with one physician per 681 people in the Buddhist-majority state capital of Sittwe, according to a study in 2013. Myanmar’s Rohingya population faces a number of barriers in accessing health care due to movement restrictions and squalid living conditions in displacement camps that significantly increase their vulnerability to the COVID-19 pandemic.
Armed Conflict and Displacement
In 2018, Myanmar military began launching a series of deadly attacks at northern Rakhine regions to suppress insurgent militant groups, the largest amongst which is the Arakan Army. Army troops had burned villages and attacked civilians, forcing approximately 30,000 people out of their homes. About 140,000 people, mostly Rohingya, currently live in displacement camps with little access to medical care and sanitation.
Although Myanmar’s military had declared a national ceasefire to assist with COVID-19 response efforts, the truce excludes Rakhine and southern Chin states, locales currently controlled by the Arakan Army. The fighting continues amid the pandemic, putting health workers at risk and inhibiting disease preparedness, as continued conflict also means there are no health coordination between the government, military and ethnic armed groups. This lack of coordination endangers medical personnel and humanitarian workers and reduces their access to displaced populations, thus harming disease prevention, surveillance and testing efforts.
Potential Health Disaster
The COVID-19 pandemic threatens to exacerbate existing conditions in the Rakhine State. Although Myanmar has so far averted a major outbreak with less than 200 confirmed cases and only six deaths as of July 2020, the nation remains vulnerable due to its fragile health infrastructure. Myanmar’s Rohingya population, in particular, faces an increased risk of transmission in crowded displacement camps. If cases of COVID-19 were to begin to spread, there could be disastrous consequences given crowded, unsanitary conditions and an internet ban in ethnic townships, which limits disease surveillance and residents’ access to information about the pandemic.
Even prior to the spread of COVID-19, studies had shown that health indicators for members of the Rohingya population across Myanmar, Bangladesh and Malaysia were consistently worse compared to other populations living in the same areas. For instance, Rohingya populations have high morbidity and mortality rate, as well as a high prevalence of waterborne illnesses. According to a 2013 government report, diarrheal illness affected 40% of Rohingya children under 5 years old in displacement camps, five times the rate of other children living in the Rahkine State. The mortality rate for children younger than 5 in Maungdaw and Butheetaung, both Rakhine townships, was 135 and 224 deaths per 1,000 live births, respectively.
International organizations have long placed pressure on the Myanmar government to resolve the humanitarian crisis in the Rakhine State. According to a 2019 WHO report, local civil society organizations, the Red Cross Movement and other humanitarian partners have mobilized in Myanmar to execute an emergency response plan. An allocation of $5 million from the Central Emergency Response Fund and the Myanmar Humanitarian Fund currently assists life-saving efforts in six key sectors including healthcare.
Since the outbreak of violence in 2018, the United States has contributed nearly $820 million in humanitarian assistance for the Rohingya minority in the Rakhine State and Bangladesh. This funding provides life-saving assistance in key sectors including education, coordination, food security, health, shelter and sanitation. In December of 2019, the European Commission announced a release of €10 million in humanitarian aid for the Rohingya crisis, on top of the €33 million already issued in the same year. This funding aims to provide quality healthcare in Myanmar, address undernutrition and supply food and protection for afflicted populations.
With sufficient cooperation from the government and sustained aid from international organizations, slowly but surely, Myanmar’s healthcare crisis can be overcome and there may be light at the end of the tunnel for Myanmar’s Rohingya population.
– Alice Nguyen