Ma Naw, a resident of Palaw Township in southern Myanmar’s Tanintharyi Region, is worried about the health of her month-old daughter. Unlike her two older kids, her youngest daughter didn’t receive the vaccinations against serious diseases normally given to newborn children. And due to the conflict between the resistance and the junta, there is little chance of Ma Naw’s youngest getting the immunizations in the future, so she is naturally concerned about her daughter catching a serious disease.
“I had to give birth at home because of the fighting and my daughter hasn’t received any of the vaccinations that are supposed to be given to newborns,” Ma Naw told The Irrawaddy.
Newborn babies are supposed to be vaccinated against tuberculosis and hepatitis B, as well as receiving a vaccine that protects against diphtheria, tetanus and whopping cough. Other vaccines kids should receive include measles, polio, rubella, Japanese encephalitis and pneumonia.
Ma Naw said the closest vaccination point is in Palaw Town, but she is unable to travel there because of fighting between People’s Defense Forces and the Myanmar military.
Ma Soe, an internally displaced person (IDP) from Moebye Town in southern Shan State, is another mum unable to get her newborn vaccinated, even though she gave birth over 45 days ago.
“People are running away from the fighting. I can’t even inject the child with medicine. No one will come to our camp to administer the vaccines,” Ma Soe told The Irrawaddy.
The experiences of Ma Naw and Ma Soe are evidence of the collapse of the child healthcare system since the junta’s coup of February 2021.
Of the 4.4 million children under the age of five in Myanmar, almost one million had not been vaccinated in 2021, according to the United Nations Children’s Fund (UNICEF). Some 22 per cent of all children in Myanmar have not been vaccinated at all, added UNICEF, and have lost access to basic healthcare services since the military takeover. So millions of children are at risk of catching serious diseases.
Collapse of the child healthcare system
Under the now-ousted National League for Democracy (NLD) government, up to nine vaccines including pneumonia, polio and tuberculosis were routinely given to children nationwide. According to the civilian National Unity Government’s (NUG) Ministry of Health, the nine vaccines can protect against the 13 diseases that cause the most deaths among children in Southeast Asia.
Some 90 per cent of target children nationwide were vaccinated by the Ministry of Health under the NLD government, including kids in areas controlled by ethnic minorities such as Karen and Kayah states.
But soon after the coup, medical staff were some of the first government workers to join the Civil Disobedience Movement (CDM) and refuse to work for the regime. The junta has targeted striking medical workers, but many public hospitals and healthcare centers remain closed and support for the CDM is still strong.
At least 70 healthcare workers have been killed in the last two years and another 936 have been detained, according to the NUG’s health ministry.
Dr. Htar Htar Lin, the director of the expanded vaccination program under the NLD government, was among those arrested and was sentenced to seven years in prison by the junta. Many medical staff who joined the CDM remain in hiding out of fear of being arrested.
Now even children living in urban areas can no longer receive a complete set of vaccinations. The situation is far worse for children living in IDP camps, border areas and remote ethnic regions, according to healthcare workers.
During the NLD’s time in power not only regular vaccines, but also vaccines for severe diarrhea were given, according to a doctor who has joined the CDM. However, children haven’t been vaccinated since the coup, he added.
“This is a situation where the entire health system has completely collapsed,” the doctor told The Irrawaddy.
Nearly 500,000 children under the age of one have not been fully vaccinated and many children under five years old in all parts of Myanmar are now at risk of catching diseases that can be prevented by vaccines, said the NUG’s Ministry of Health.
“There is no way to get to the IDP camps and give vaccinations,” said Ko Nay, who is assisting IDPs from Khin-U Township in Sagaing Region.
Sagaing, which is one of the strongholds of resistance to the junta, has seen hundreds of thousands of people flee their homes as the Myanmar military raids and torches villages. Some 73 villages have been torched in Khin-U Township alone, with 20,000 people forced to flee including children under the age of five.
“If infectious diseases break out, they will be difficult to control,” Ko Nay told The Irrawaddy.
The threat from the lack of immunization coverage
As of March, over 1.7 million people in Myanmar had been displaced by conflict. They include many kids under the age of five who don’t have any access to vaccines, according to the NUG’s Ministry of Health.
“Consequently, vaccine-preventable diseases in children under five may become a mass epidemic. Among them, there may be deaths due to diseases such as measles, which is very contagious, and polio,” said an official from the vaccination program of the NUG’s health ministry.
Medical experts say that if children have not been vaccinated for more than three years and measles breaks out, there is a high probability that it will lead to an epidemic.
In addition to the lack of access to vaccines, IDP camps have a high population density, a lack of clean water, inadequate shelter and a shortage of basic food and medicine, all of which are factors that encourage the spread of epidemics and infectious diseases, according to the NUG’s Ministry of Health.
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A CDM doctor said that due to the lack of vaccines, diseases such as polio may reappear, while outbreaks of diphtheria, tetanus, and whooping cough may cause children to die.
“These diseases may appear in the next year or over the next five years” said the doctor.
UNICEF has also warned that thousands of Myanmar children remain at risk of preventable disease outbreaks due to low vaccination coverage, and said that there was an urgent need to immunize children.
However, the military regime is neither interested nor focused on children’s immunization coverage, according to the healthcare community.
An official from the NUG’s Ministry of Health said that the junta-controlled health ministry controls the transportation and distribution of medicines, including vaccines, throughout the country.
Furthermore, attacks on health workers and the targeting of hospitals in resistance areas has caused great difficulties for the NUG’s health ministry and the healthcare systems of ethnic revolutionary forces,” said the NUG.
“Despite these limitations and difficulties, the NUG’s health ministry is working with ethnic health groups and local social groups to develop regional programs that make it possible for children to receive vaccines,” said the NUG official.
Mothers in IDP camps and elsewhere hope that those programs will happen soon, so that the health of their children can be protected.
“This should not be ignored as it is very important for the future of our children,” said Ma Naw.