Introduction
From the start of the COVID-19 pandemic, there were concerns about what would happen in Myanmar, given its extremely weak health infrastructure, its long history of conflict and political instability, and its large impoverished and at-risk population. The low spread of the virus in Myanmar through the first half of 2020 however led some to believe that the Myanmar government was getting it right. The World Health Organisations country representative in Myanmar boasted in July 2020 that Myanmar has done extraordinarily well so far. He cited Myanmars whole-of-government approach, adding: So the country has really gone all out to strengthen the public health side and preparedness and response, which has been critically important to try and make sure we have as few cases as possible in Myanmar.
Although the Myanmar governments COVID-19 Economic Relief Plan (entitled Overcoming as One) made claims about being a coordinated action leaving no-one behind, many of the positive actions of the government have not reached the entire population. Aid and support have remained insufficient in most rural areas, like that of Southeast Myanmar, which is largely populated by ethnic minorities who are already vulnerable due to protracted and on-going conflict, displacement, and ethnic oppression by the central government. Thus Myanmars success should and can only be gauged through a closer look at COVID-19 response and impact in rural ethnic areas.
Very early on in the pandemic, despite the relatively slow spread of the virus, political fractures and infrastructure weaknesses due to Myanmars long and on-going history of conflict could be seen not simply in the governments response, but that of other stakeholders, like Ethnic Armed Organisations (EAOs), locally based civil society organisations, and NGO/INGOs. In a brief report on the situation in Southeast Myanmar during the first wave of the pandemic, KHRG noted the poor coordination and collaboration between stakeholders and the delayed and uneven response to the crisis. KHRG argued that the lack of coordination between political stakeholders has meant that villagers and local leaders have struggled to obtain information and consistent training and regulations, and has left too much of the responsibility of figuring out what to do in the hands of those who lack information and resources to effectively organise awareness and prevention. Not only did this poor coordination result in the forced removal of screening checkpoints by the Tatmadaw, KHRG also found the rise of conflict and tension between villages, increasingly critical challenges to livelihood, as well as the breakdown of local systems of mutual aid.
Given the early indications that COVID-19 response and support were failing in some of the most vulnerable areas in Southeast Myanmar, KHRG continued to monitor the situation to more fully assess the structural weaknesses and barriers that might lead to crisis as the pandemic entered a second wave of outbreaks beginning in August 2020. Increased threats of infection in rural areas did in some cases lead to new efforts at awareness and prevention, but in general sparked heightened restrictions by both the Myanmar government and the Karen National Union (KNU). Thus rather than working to increase individual knowledge and responsibility on the part of villagers, most measures ended up being in the form of broad restrictions like travel bans and school closures that have had significant negative impact on villagers lives. These restrictions also seemed to be matched by a reduction in the range of stakeholders providing services and aid. Although the government has provided small amounts of financial and material assistance to households in need, villagers living in KNU-controlled and some mixed control areas have been excluded, leaving local authorities and CSO/CBOs to figure out solutions to support these communities.
Most rural areas in Southeast Myanmar have not (yet) experienced widespread local transmission of the virus, and thus impacts have been more clearly tied to restrictions and prevention measures as opposed to the full-on health crisis seen elsewhere. But because of the already extremely vulnerable situation of many rural communities, the livelihood impacts are themselves at risk of creating a humanitarian crisis. The poor handling thus far of information and prevention, as well as of testing and treatment, may also have wider implications if outbreaks start occurring in the more remote areas.
On February 1st 2021, the Myanmar military seized power by staging a coup against the newly elected government. Although this report focuses on the situation prior to the coup, the infrastructure and services (albeit insufficient) that the central government, EAOs and other stakeholders have put in place over the past year are in the process of being dismantled. Public healthcare services in some areas have come to a halt, and there have been major disruptions to communication, transportation, supply chains, and banking services. COVID-19 testing has been largely reduced, with little reporting now taking place. Any plans for widespread vaccination seem to have been entirely interrupted.
If rural areas of Southeast Myanmar have not yet faced widespread problems of infection, all of this is likely to change. As local doctors have pointed out: Since the military takeover, the COVID-19 response has stalled. Mass public rallies and protests are both serving a critical function for resistance and unity, but also as likely superspreader events for virus transmission. Without adequate testing, public compliance and goodwill for isolation, access to acute clinical care, and continued immunisations, the implications for COVID-19 spread, morbidity, and mortality are substantial. Thus, there is need more than ever to find solutions to bring support and aid to rural villagers, whose situation has already deteriorated and become more precarious over the past year. With the military now in control, there is even less likelihood that support and services will reach rural ethnic communities.
Although this report covers the period prior to the coup, and describes an infrastructure that may now barely exist, the problems created by COVID-19 and the governments response have not disappeared, and will need to be addressed. Furthermore, the underlying political dynamics that impede the development of a support infrastructure capable of addressing the needs of rural ethnic minorities continue to play out. The report thus begins by providing a brief overview of the political dynamics that have shaped access to services and COVID-19 response. Followed by that is a discussion of COVID-19 reporting and testing, and the prevention measures that have been put in place to address the rise in COVID-19 cases. The discussion then turns to impacts on livelihood, access to different forms of support, and the situation of healthcare and education.
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