Written By Khine Zaw
In the Arakan final decisive war, the Arakan Army (AA) has completely taken control of Paletwa Township, along with Maungdaw, Buthidaung, Rathetaung, Ponnakyun, Kyauktaw, Mrauk-U, Minbrar, Myaybon, Pauktaw, Rambre, Thandwe, Taunggoke, Ann, and Gwa Townships.
In the territories under the control of the Arakan Army, the Arakan People’s Revolutionary Government is implementing administrative mechanisms and providing public services to the Arakan people, according to local residents.
The Arakan People’s Health Department is also involved in providing public services, offering healthcare to the Arakan people. However, residents report facing challenges such as shortages of medical supplies and an insufficient number of healthcare workers.
Before the Myanmar junta takeover in the Arakan region, healthcare services were provided at an average ratio of one doctor per over 20,000 people. After the military coup, the number of doctors decreased to nearly half, according to healthcare workers.
The Arakan region has a population of over three million, with high mortality rates among pregnant women and children under five. However, even with the participation of retired doctors running private clinics, there were only around 160 doctors available, according to healthcare professionals.
Due to the long-standing shortage of healthcare workers, many people already lacked access to medical treatment. The further decline in the number of healthcare professionals has made medical services even more inaccessible for the Arakan people, leading to an increase in preventable deaths, residents say.
In addition to the shortage of healthcare workers, the Myanmar junta has cut off communication routes and blocked the transportation of medical supplies. As a result, obtaining medicine has become extremely difficult, and prices have surged by three to ten times, according to Arakan residents.
Due to the lack of doctors in the region, many people are unable to receive timely medical treatment. Others cannot afford to travel long distances to reach healthcare facilities. As a result, the number of deaths has reached the hundreds, residents report.
Why has the number of healthcare workers decreased?
According to a statement from the General Administration Department, the Arakan region has a total of 19 district hospitals, 54 township hospitals, 131 rural health centers (RHCs), and 559 sub-health centers (SCs).
However, many of these hospitals and clinics lack doctors and nurses. In some hospitals, only general physicians are available, while there are no surgeons or anesthesiologists. As a result, a significant number of patients requiring surgery cannot receive the necessary treatment, healthcare professionals say.
After the military takeover, many medical students and nursing trainees either dropped out of school or left the country. As a result, the healthcare sector was unable to recruit new staff, worsening the shortage of medical personnel, according to healthcare professionals.
During this period of increasing staff shortages, some healthcare workers also resigned because they refused to work under the Myanmar junta, medical staff report.
After the Arakan final decisive war began, the Myanmar junta reportedly forced and threatened healthcare workers under its control to relocate to junta-held areas, according to medical professionals.
Additionally, some healthcare workers fled the conflict and ended up outside the Arakan region. Due to difficulties in returning, many have not been able to come back, healthcare workers say.
Due to these factors, the number of doctors, nurses, and midwives in the Arakan region has further declined, Arakan residents say.
Arakan People’s Health Department
The Arakan People’s Revolutionary Government has established the Arakan People’s Health Department and is providing healthcare services to the people of Arakan, according to local residents.
However, staff from the Arakan People’s Health Department stated that in areas under the control of the Arakan Army, the number of healthcare workers, including doctors, is no longer as full as it was before.
In areas controlled by the Myanmar junta, some healthcare workers have moved to hospitals and clinics there, while others have left the country. However, some healthcare workers have remained in the Arakan region, according to local residents.
Meanwhile, in areas under the control of the Arakan Army, healthcare workers who have stayed behind have not fully joined the Arakan People’s Revolutionary Government, as it has not yet been able to provide full salaries for its staff, locals say.
As a result, with a limited workforce, the Arakan People’s Revolutionary Government has been integrating military doctors, medical staff, and pharmacists into its healthcare services to fill the gaps, according to some officials from the government.
However, locals say there is still a significant gap between the number of doctors available and the needs of the people.
“There isn’t a single doctor in our entire region. We are only operating with pharmacists and those who have attended medical training,” a local resident told Border News Agency.
The Hardships Faced by the People of Arakan
In those areas, not only are there no doctors, but there are also only a few clinics available, according to local residents.
As a result, for common illnesses and general health issues, people have to rely on traditional healers in nearby villages, locals say.
“For illnesses that require a doctor’s consultation, we have to travel far. The travel expenses alone cost hundreds of thousands of kyats,” a local resident told Border News Agency.
Locals say that when they travel long distances—sometimes over ten miles by both water and land routes—to reach external clinics, they have to pay between 50,000 to 100,000 kyats per visit.
“A single visit to the clinic costs at least 50,000 kyats. The total expense increases depending on the amount of medicine needed,” a displaced woman from Ponnakyun Township told Border News Agency.
In clinics under the Arakan People’s Revolutionary Government, patients do not have to pay for consultations or treatment fees—only the cost of medicine, according to local residents.
In areas controlled by the Arakan Army, some civil society organizations are providing free medical clinics and healthcare support. However, healthcare workers from the Arakan People’s Health Department say that these clinics lack both sufficient medical supplies and skilled healthcare professionals.
Additionally, due to the threat of airstrikes by the Myanmar junta, which frequently target non-military areas, including hospitals and clinics, the healthcare facilities under the Arakan People’s Revolutionary Government have to relocate regularly.
As a result, some officials from the Arakan People’s Revolutionary Government say that accessing healthcare has become even more difficult for the people of Arakan, as they now have to travel farther to receive treatment.
In the Arakan region, there are specialists in general medicine, surgery, obstetrics, and dentistry, but due to a lack of medicines and medical equipment, major surgeries and treatments cannot be performed, according to healthcare workers from the Arakan People’s Revolutionary Government.
As a result, people have to travel to neighboring countries like India and Bangladesh for medical treatment through border crossings. However, locals say they continue to face many difficulties and challenges during this process.
“The healthcare situation is quite difficult. The hospitals are not yet fully operational, so we rely on the support and cooperation of nearby healthcare workers. For serious illnesses, people often have to go to Bangladesh,” said a former member of parliament from Maungdaw Township in an interview with Border News Agency.
Residents from minority villages in the Arakan region say that due to their remote locations and poor communication infrastructure, they face significant challenges in accessing medical treatment.
As a result, people with chronic or severe illnesses, as well as those needing major surgeries, must travel through Kyaukphru, which is still under junta control, and take a flight to Yangon for treatment, according to residents of Arakan.
However, traveling to Yangon for medical treatment is not accessible to everyone. The cost of travel alone exceeds 1000,000 kyats, and there is the added risk of being arrested by the junta, which makes many people hesitant to make the journey, locals say.
“If you get seriously ill, it’s not easy. The travel cost to Yangon alone is between 2000,000 to 3000,000 kyats. Even when you return, the doctor-prescribed medicines are not fully allowed Myanmar junta checkpoints confiscate them,” said a woman from Pauktaw Township who traveled to Yangon for medical treatment, in an interview with Border News Agency.
Residents of Arakan also say that there are people who have been arrested by the junta during their journey to Yangon for medical treatment.
The Difficulties Related to Access to Medicine
Since the start of the Arakan war, the Myanmar junta’s forces have blocked all land and water routes in the Arakan region and have also prevented international humanitarian aid organizations from providing assistance.
As a result, people, including internally displaced persons (IDPs), are facing significant challenges in accessing healthcare services, including medicine and other medical assistance.
Additionally, healthcare facilities operated by the Arakan People’s Revolutionary Government, which are currently open with a limited number of staff due to the threat of airstrikes by the Myanmar junta, face significant challenges in providing adequate medical supplies.
Healthcare workers in the region report that the high cost and difficulty in importing medicines have made it difficult to obtain the necessary supplies, and as a result, essential medicines are not always available. This shortage continues to create major challenges in providing adequate healthcare services.
Due to the blockade of all land routes connecting the Arakan region to the rest of the country by the Myanmar junta, the necessary medicines are being imported through alternative routes, including Bangladesh, India, and other smuggling paths.
However, those involved in bringing in the medicines report that if they are arrested or detained during transit, the imported medicines are often confiscated or lost, adding to the already significant challenges of ensuring a steady supply of essential medical supplies to the region.
“A route exists, but if you’re caught, everything is lost,” said one person involved in smuggling medicines into the Arakan region, speaking to the Border News Agency.
When the supplies finally arrive in the region, locals report that the journey is difficult, and due to the greed of business owners, prices for goods have skyrocketed, making the cost of essential medicines unaffordable for many.
“Compared to the prices in central Myanmar, the prices in Rakhine have at least tripled. In the southern regions, they’ve increased by six to ten times,” said someone helping to provide medicines to displaced persons, speaking to the Border News Agency.
Despite purchasing medicines at these inflated prices, those supplying the medicines report that it’s still impossible to buy all the necessary medicines.
Pregnant women and children under the age of two are in urgent need of vaccinations, but they are unable to purchase the necessary vaccines that need to be kept refrigerated, according to Rakhine health workers.
As a result, children and pregnant women in the Rakhine region have not been able to receive vaccinations since the beginning of the conflict, and it’s now been about two years, as reported by the local Rakhine community.
Since the military coup and during the COVID-19 pandemic, pregnant women and children in the Rakhine region have not been able to receive all necessary vaccinations, as reported by the local Rakhine community.
Pregnant women are supposed to receive the necessary vaccinations for diseases like tetanus, while children should receive vaccines for diseases such as polio, measles, mumps, rubella, chickenpox, and pneumonia. However, these essential vaccines have been inaccessible for them.
According to the general disease specialist, if these vaccines are not administered, pregnant women could contract tetanus and even die, and children could develop diseases that cannot be treated. This is a very concerning situation.”
A specialist in general diseases mentioned to Border News Agency: “Diseases can spread rapidly. Don’t let children get cold. Stay away from those suffering from runny noses and sore throats. Be cautious not to touch contaminated surfaces. If children are unwell, seek systematic medical treatment as soon as possible.”
Pregnant women also need to be extra cautious as they haven’t received the necessary vaccinations, according to general health specialists.
“If the required vaccines are not given, the risk of contracting tetanus during and after childbirth increases. The mother must ensure the cleanliness of the environment during delivery and after birth to prevent the spread of the disease. After delivery, careful attention should be given to prevent any infection from occurring,” said a general disease specialist to Border News Agency.
Pregnant women and children are not only unable to receive the necessary vaccines but also lack access to emergency medications, such as snakebite antivenom and rabies vaccines, in the Arakan region, according to health workers and local residents.
“If bitten by a snake, there is no vaccine available. Even if there is one, it is too far away, making it difficult to receive it in time. It’s similar to the past when people had to rely on traditional healers,” said a victim of a snakebite from Pauktaw Township to Border News Agency.
Furthermore, in many of the displaced persons camps and some villages in the Arakan region, people are facing difficulties in purchasing medicine for skin diseases, according to those assisting displaced persons.
Although skin diseases (such as eczema) are occurring among displaced persons in the Arakan region, there are no specialized dermatologists in the area. As a result, those suffering from these skin conditions are not recovering within a reasonable time frame, according to those providing aid to displaced persons.
“With guidance from external dermatologists, we are forced to buy the medicine. There are no specialists available locally,” said a relief worker from Thandwe Township, speaking to Border News Agency.
International Assistance is Needed
Humanitarian aid organizations have been providing support to the people of Arakan, including displaced persons, who are facing difficulties in accessing medical supplies and healthcare services due to the lack of doctors and other essential resources. Civil society organizations have called for international assistance to help those in need.
In the Arakan region, home to over three million people, thousands have been displaced and are living as refugees due to the ongoing conflict.
International aid is urgently needed. We are struggling. If diseases worsen, death is the only outcome. We cannot afford treatment,” said a displaced woman from Pauktaw Township to Border News Agency.
Due to the lack of healthcare services, international assistance is crucial, and the people of Arakan believe that the international humanitarian aid organizations should be invited to support them, as stated by the Arakan People’s Government.
The people of Arakan believe that the Arakan People’s Revolutionary Government should provide guarantees for the safety and security of international humanitarian aid organizations. They argue that such collaboration will help address the healthcare challenges faced by the people of Arakan.
A Thet community leader from Maungdaw Township told Border News Agency, “Healthcare is not about ethnicity; it is a challenge for everyone. The reason is that medicines are not available for purchase, and there are no pharmacies. Therefore, we are relying on natural remedies to address the issue.”
The people of Arakan said, “Although the Arakan People’s Revolutionary Government is assisting in addressing these challenges, there are still many unmet needs on the ground.” They emphasized that international humanitarian aid, including healthcare support for the people of Arakan, is urgently needed.
A displaced pregnant woman from Maungdaw Township told Border News Agency, “That’s the difficulty. Since I’m giving birth, I need to go to the hospital, but I can’t go. Since I’m about to give birth, I need international assistance.”
Despite the establishment of humanitarian assistance and development cooperation offices (HDCOs) and the ongoing reconstruction efforts in areas controlled by the Arakan Army, the people of Arakan still require significant international humanitarian aid, according to the residents of the region.
According to the people of Arakan, the Head of the Humanitarian and Development Cooperation Offices (HDCO), Twan Morn Naing, who is the brother of Arakan Army (AA) Commander-in-Chief General Twan Mrat Naing, is leading efforts in cooperation with international humanitarian aid organizations, foreign embassies, and civil society groups.
The Department of Health of the Arakan People’s Revolutionary Government announced on August 16th last year that, in addition to essential medicines, urgent medical supplies are critically needed for general diseases. As a result, neighboring countries, international organizations, civil society groups, and humanitarian workers have been urgently requested to provide assistance with these vital medicines.
Healthcare Worker Needs
The Arakan Army (AA) announced on November 13th last year that, during the one-year-long conflict with the Myanmar junta, the junta’s forces targeted and destroyed 12 hospitals and schools, leaving them severely damaged.
Officials from the Arakan People’s Revolutionary Government have stated that there is a significant shortage of healthcare workers, including doctors, within the Arakan People’s Health Department.
In addition to attacking healthcare facilities, the junta’s forces also arrested some healthcare workers, carried out interrogations, opened cases, and executed or disposed of their bodies, according to reports from healthcare workers.
The Arakan people believe that the Arakan People’s Revolutionary Government should ensure cooperation with international humanitarian organizations by offering necessary protection and support, as these organizations are vital for addressing the needs of the Arakan community.
The Arakan people believe that if international humanitarian aid organizations establish offices and provide healthcare services to the Arakan community, it will be beneficial for the Arakan People’s Revolutionary Government as well, helping them to address the pressing needs of their people.
A displaced person from the Rathetaung Township stated to Border News Agency, “This is a revolutionary period, so it’s not fully settled yet. We understand everything, but we hope to make things more efficient and ask for that.”
Former healthcare workers and medical professionals from the Arakan region have also emphasized the importance of collaborating with the Arakan People’s Revolutionary Government to provide essential healthcare services to the people.
A female activist assisting displaced persons in Kyaukphru Township told Border News Agency, “During the final phase of the struggle for independence and nation-building, it is important that everyone participates, without looking out for personal gain.”
Specialist doctors have suggested that with the assistance of international humanitarian aid organizations, the Arakan People’s Revolutionary Government should establish basic healthcare training programs, including setting up nursing schools and medical universities, to train healthcare professionals and provide better medical services to the people.
The people of Arakan are urging international humanitarian aid organizations to collaborate with the governments of India and Bangladesh to assist in providing cross-border support and cooperation.
However, due to the ongoing challenges in the Arakan region, including the significant shortages of healthcare professionals, medicines, medical supplies, and health facilities, the people acknowledge that there are still many pressing needs in healthcare. They also recognize that, together with the Arakan People’s Revolutionary Government, they must face and overcome these difficulties.
