Coronavirus: Asia
Myanmar's battered health system faces new threat
A system that has been near collapse since coup has to deal with variants sweeping through neighbouring countries
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Covid-19 patients at a hospital in Cikha, Myanmar, on Friday. Patients with Covid-19 symptoms started showing up at the hospital in the middle of this month. As it is only 6km from India, health workers fear the illness could be due to the highly infectious B16172 strain - though they lack the means to test for it.
PHOTO: REUTERS
YANGON • Breathless, fighting a fever and without the extra oxygen that could help keep them alive, new coronavirus patients at a hospital near Myanmar's border with India highlight the threat to a health system that has been near collapse since February's coup.
To help tend her seven Covid-19 patients at Cikha hospital, day and night, chief nurse Lun Za En has a lab technician and a pharmacist's assistant. Mostly, they offer kind words and paracetamol.
"We don't have enough oxygen, enough medical equipment, enough electricity, enough doctors or enough ambulances," Ms Lun Za En, 45, told Reuters from the town of just over 10,000.
"We are operating with three staff instead of 11."
Myanmar's anti-Covid-19 campaign foundered along with the rest of the health system after the military seized power on Feb 1 and overthrew elected leader Aung San Suu Kyi, whose government had stepped up testing, quarantine and treatment.
Services at public hospitals collapsed after many doctors and nurses joined strikes in a civil disobedience movement in the forefront of opposition to military rule - and sometimes on the front line of protests that have been bloodily suppressed.
Thirteen medics have been killed, according to World Health Organisation (WHO) data that shows there were 179 attacks on health workers, facilities and transport.
Some 150 health workers have been arrested. Hundreds more doctors and nurses are wanted on incitement charges.
Neither a junta spokesman nor the Health Ministry responded to requests for comment. The junta, which initially set fighting the pandemic as one of its priorities, has repeatedly urged medics to return to work. Few have responded.
A worker at one Covid-19 quarantine centre in Yangon said all the specialist health workers there had joined the strikes.
"Then again, we don't receive new patients any more as Covid-19 test centres don't have staff to test," said the man, who declined to be named for fear of retribution.
In the week before the coup, tests nationally averaged more than 17,000 a day. That had fallen to below 1,200 a day in the seven days through last Wednesday.
Myanmar has reported more than 3,200 deaths from over 140,000 coronavirus cases, although the slump in testing has raised doubts over data that shows new cases and deaths have plateaued since the coup.
Now, a health system in crisis is raising concerns about the likely impact on the country from the wave of infections with variants that is sweeping through India, Thailand and other neighbours.
Patients with Covid-19 symptoms started showing up at Cikha hospital in the middle of this month. It is only 6km from India, and health workers fear the illness could be the highly infectious B16172 strain - though they lack the means to test for it.
"It's very concerning that Covid-19 testing, treatment and vaccinations are extremely limited in Myanmar as more lives are at risk with new, more dangerous variants spreading," said Mr Luis Sfeir-Younis, Myanmar Covid-19 operations manager for the International Federation of Red Cross and Red Crescent Societies.
A total of 24 cases have been identified in Cikha, said Ms Lun Za En. Seven were so serious that they needed hospitalisation - a sign of how few cases had likely been detected.
WHO said it was trying to reach authorities and groups in the area who could provide help, while recognising the difficulties in a health system that was precipitously reversing years of impressive gains.
Ms Lun Za En said her hospital was doing the best it could with nebulisers - machines that turn liquid to mist - to relieve breathlessness. Some patients have oxygen concentrators, but they work for only the two hours a day that the town gets electricity.
Refusing to abandon the sick, Ms Lun Za En said she decided not to join the strikes. "The junta will not take care of our patients," she said.
Across Myanmar, some doctors on strike have set up underground clinics to help patients. When Myanmar Red Cross volunteers established three clinics in Yangon neighbourhoods, they quickly had dozens of patients. At best, such options can provide basic care.
Although military hospitals have been opened to the public, many people fear them or refuse to go on principle - including for coronavirus vaccinations in a campaign the ousted government had launched days before the coup.
Said Ms Lun Za En: "If the infection spreads to the crowded cities, it could be uncontrollable."
REUTERS