Editorial: A Medical Morass Afflicts Arakan State

By DMG 10 Oct 2022

Myanmar is a country grappling with shortages of both medicines and healthcare workers. Faced with a lack of access to modern medicine and medical care, local people in some remote areas still have to be treated with herbs and roots. Even when there are traditional medicine centres in Myanmar’s hard-to-reach areas, medicines often do not reach these areas. 

Despite the presence of international aid operations such as the International Committee of the Red Cross (ICRC) and Doctors Without Borders (MSF), the activities of these organisations have been limited since the military seized power in February 2021. Many people are facing health problems due to insufficient healthcare services, with people who live in rural areas feeling these difficulties especially acutely. 

About 75 percent of the medicines used in Myanmar are imported from India, with the remaining 25 percent or so from Thailand, China, Malaysia, Pakistan and Turkey. Due to the instability of Myanmar’s currency, the kyat, the prices of medicines have doubled, tripled and even quadrupled in some cases of late. According to the 2014 census, 70% of Myanmar’s people live in rural areas. 

While people living in urban areas can still generally afford to buy and use basic medicines as needed, it is difficult for people living in rural areas to receive medical treatment even if they can afford it due to the military junta’s restrictions on the transportation of medicines. 

Rural residents in Arakan State are thus experiencing more health problems since the military junta cut off supply routes amid renewed fighting between its troops and the Arakan Army (AA) over recent months. 

Even if rural patients are able to visit a hospital or clinic in their closest proper town, they are not allowed to take back with them more than the amount of medicine prescribed by the doctor. It is difficult for rural people to regularly return to see doctors at medical facilities in towns, but old methods of stocking up on medicines are no longer being tolerated, and extra purchased medicines are being confiscated at security checkpoints. 

What’s more, multiple doctors and other healthcare personnel in Arakan State have been detained by the regime in recent weeks, making a bad situation worse.  

On the other hand, drugs needed for public health are being smuggled in by paying bribes at security checkpoints. Whether under civilian or military rule, one thing is clear: When laws or regulations are promulgated but their implementation is weak, those laws and regulations become channels for bribery. 

There is abundant speculation as to why the junta might have restricted the ability to carry medicines. Is it due to the fact that AA troops may have been injured in airstrikes by regime jet fighters and helicopters during recent, intense battles with the Arakan Army, and are logically expected to have added medical needs as a result? Is it part of the “four cuts” strategy that has been employed by successive Myanmar military regimes? Or is it simple ignorance as to the enduring medical needs of civilian populations, whether in times of war or peace?  

If the answer is the latter, DMG would like to state plainly: Given the prevailing conditions, we are facing an unacceptable situation in which ailments are on the rise at the same time that medicines are increasingly in short supply.  

There should be no distinction between friends and enemies when it comes to healthcare workers and medicines. It is the responsibility of health workers to treat the injured, regardless of socioeconomic status or political affiliation. But these patients’ lives can only be saved if their caregivers have enough medicine.