Editor’s note: This is the address delivered by Dr. Cynthia Maung at the 2022 Asean Civil Society Conference/Asean Peoples’ Forum held in Phnom Penh, Cambodia, last Nov. 3-5. The author is a Karen medical doctor and founder of Mae Tao Clinic at the Myanmar-Thailand border, which has been providing free healthcare services for internally displaced persons and migrant workers for three decades. She is the 2002 Ramon Magsaysay awardee for community leadership and the 2022 Gwangju Prize awardee for Human Rights.

The people of Myanmar have endured more than 70 years of military dictatorship, armed conflict, economic dysfunction, political repression, and oppression toward ethnic minorities. A meaningful transformation into a peaceful society that enjoys economic development, functions democratically and equality for all people represents the dream of all people in the country. The military dictator’s decadeslong oppressions and human rights violations toward the civilians have caused and exacerbated the humanitarian crisis in the country.

The resilient ethnic armed resistance against the military, the 1962 students uprising, the 1988 uprising, the objection of government to the 1990 election, the 2007 Saffron Revolution, and the 2021 Spring Revolution are proof that the people of Myanmar have been tirelessly fighting for a fair and just country which is based on the values of democracy and the guarantee of human rights for all. 

As a member of civil societies with our values based on human rights, our utmost responsibility is to insist on a return of the elected government to power, release of political prisoners, and safe return of the displaced to a safe and peaceful existence.

Health and humanitarian crises

Currently, Myanmar faces multiple dire humanitarian crises whose roots are deeply political, manifesting through widespread oppression and human rights violations against civilians, particularly the ethnic peoples and other minorities of the country. Longstanding impunity and decades of unchecked abuses have already resulted in extensive displacement, poverty, and food insecurity, along with a protracted public health emergency. 

The United Nations’ Office for the Coordination of Humanitarian Affairs reported that approximately 1.4 million people (as of Oct. 31, 2022) have been internally displaced across the country, of whom more than 1.1 million were displaced by clashes and insecurity since the coup. 

According to documentation by the Assistance Association for Political Prisoners (AAPP), 2,408 people, including prodemocracy activists and other civilians, have been killed in a military crackdown following prodemocracy movements; among them, around 250 are children. And 16,040 people have been arrested and 12,830 are currently under detention. These are the numbers verified by the AAPP only, and the actual numbers are likely much higher especially in ethnic administrative areas. 

A military coup dramatically affected the Myanmar effort to prevent and control the spread of Covid-19. The difficulties of access to resources for healthcare is more commonly felt by the communities in the peripheries of the countries and the ethnic areas. A network of ethnic health systems with over 200 health centers has already been established in Eastern Burma and served approximately 700,000 people. Before Covid, the ethnic health organization had been tackling communicable diseases such as malaria and acute diarrhea.  We also had a strong malaria elimination task force which was ensuring that drug-resistant malaria would not spread out of the region even with limited resources. 

The health system, which was overwhelmed by Covid-19, was further weakened after the coup due to the civil disobedience movement and the arrests of health workers. In the conflict-affected areas, the health system was further worsened by the airstrikes and intensified offensive attacks by the military. 

Economic impact

The economic impact of the pandemic and the military offensive was felt strongly by the poor and vulnerable. Many lost their jobs as businesses were shut down. The borders were tightly closed and many migrant workers were forced to return to their villages. The job insecurity and loss of jobs had a hard impact on the whole family. We are seeing more and more children dropping out of school and forced into child labor. Additionally, the flow of humanitarian aid to the conflict-affected areas was severely restricted by the State Administration Council. 

Pursuing alternative ways of delivering aid based on the basic premises of humanity, impartiality, independence, and neutrality has become crucial in these circumstances. One such approach would be to leverage existing channels, community networks and local aid structures, many of which have been operating for over three decades, to deliver humanitarian assistance to the most vulnerable communities of Myanmar.

Local structures are able to adapt their programs to different contexts and cultures, responding to specific needs of each community in a culturally competent, trusted fashion. This includes not only helping address the consequences of conflict, abuse, and displacement but also adopting to new realities, such as controlling Covid-19 clusters and instituting preventive measures. To support these initiatives, flexibility is key. 

There is a strong movement by health professionals to provide care. We are seeing many mobile clinics and a strong movement of health professionals who refuse to work in the military system and serve the community through their own clinics and networks. 

In ethnic and conflict-affected areas, a new network and collaboration was formed together with existing local health providers and the health professionals who fled to these areas. We can see the continuation of service provisions with a strong sense of community to rebuild the system, including health workers’ capacity building, discussion on federal health policy and advocacy for humanitarian aid to be delivered through the cross-border network. The networks are continually being strengthened. There are deliveries of food, maternity and hygiene kits, and ambulance services have been mobilized. We are now extending psychosocial support services to displaced and vulnerable people affected by the pandemic and the military coup in the region.

Cross-border options

In the case of Myanmar, this includes pursuing cross-border options when needed and working with ethnic health groups and civil society organizations to most efficiently save the lives of the most vulnerable populations and also help protect the public health of Burma’s neighbors and the region from the uncontrolled spread of Covid-19 and potential variants. 

In the conflict-affected areas, there is access to life-saving essential services. We are very focused on the safety of children and we are training the community in protecting women and children from trafficking. 

We still need to highlight the plight of the displaced and the refugees, as well as the women and children who need protection. They have fled their homes and are living in dire conditions. 

In a democratic country we should be able to provide life-saving medical assistance, vaccination, safe housing, essential food and clean water. A democratic country would be able to ensure that the whole population has access to essential health education welfare and protection.

Addressing these issues and bringing them into sharp focus for higher level discussions is still very difficult.

Solutions and way forward 

After the 2021 coup, the National Unity Government was formed with most of the democratically elected parliamentarians and with support from the majority of the citizens. They should be seen as the legitimate government. 

The stalled peace process needs to be reinstated and active engagement by the stakeholders should be encouraged. Discussions on the constitution and reform of the political system should be a priority. It should be inclusive and representative of all ethnics and civil societies. Negotiations on the peace process should be based on the values of federal democracy and equity. 

The international community has to support these processes by listening to and working together with the citizens of Myanmar, people affected by the conflicts, and the key actors in the societies who have been trying to promote democracy in the country and address the issues of human rights.

The rebuilding of community engagement structures, health, education, protection and livelihood infrastructures should be commenced as a matter of priority. 

During a time of crisis, humanitarian assistance needs to be provided unrestricted by any military. The needs of refugees and those internally displaced by conflicts and threats of life and security should increasingly be addressed. 

In every corner of Asia, the erosion of democratic values is becoming more common. This is not something to be encouraged; everyone must learn that democracy is fragile and that it needs to be nurtured by great efforts in building and strengthening civil society and social institutions that can promote and fight for these values. 

Empowering and educating young people to promote inclusiveness, equality, peace, and democracy will ensure that the future is shaped according to these values. 

As a community, the Association of Southeast Asian Nations should focus its efforts on strengthening civil society and social institutions, and empowering and educating young people to hold and preserve democratic values and human rights.