I made my first visit to Myanmar in January 2018 for the start of an RCGP-Myanmar GP Society quality improvement project. The aim was to support progress towards the recognition of general practice as a specialty that would meet the challenges of developing universal healthcare for the entire population of Myanmar by 2030.
Work on this was already underway by the Myanmar GP Society and the Myanmar Medical Association and we worked in close liaison with these groups.
Volunteer RCGP trainers, in teams of four including UK GPs originally from Myanmar, undertook four visits to Myanmar. The teams visited GP practices to discuss and advise on quality indicators, professional/practice development and to provide encouragement and moral support. Six Myanmar GPs won scholarships to visit the UK to observe quality improvement in our GP surgeries.
When the pandemic arrived in March 2020, the programme was adapted to remote to ensure achievement of the long-term project objectives of improving quality in Myanmar general practice, alongside the short-term objectives of managing COVID-19.
Myanmar military coup
We have come to know many of the doctors well and have obviously been very concerned to see the situation that has unfolded in Myanmar since the coup on 1 February. As a result of what is happening we have formed a support group of GPs from Myanmar and UK who meet remotely, called Myanmar UK GP Health Action.
So, what is the situation like for doctors in Myanmar?
Doctors, who are clearly distinguishable by the red cross on their clothes, have not been immune to the violence that sweeps Myanmar. They have been beaten, arrested, shot at in the street while splinting broken bones and stopped at gunpoint in the middle of suturing wounds.
Many GPs do not return to their homes at night for fear of arrest – it is at night that people are taken by the security forces. Doctors have witnessed the military entering hospitals and taking away ventilators, ECG machines and vandalising the facilities.
Doctors are showing considerable courage, leadership, and resilience, in continuing to provide medical care to their communities in defiance of the military crackdown in Myanmar. The healthcare system is literally now at a standstill, in the middle of the COVID-19 pandemic.
Supporting doctors in Myanmar
Myanmar doctors tell us they need help to learn how to manage the trauma and emergency care they have no prior experience of. First aid videos for Myanmar in Burmese have been written by UK specialists to support this. Webinars are also being developed on the management of ballistics and tear gas injuries, fractures and pain control.
Doctors also need help and support for general healthcare. Other educational materials developed by UK doctors for use by colleagues in Mynamar have included COVID-19 guidelines, including home management for GPs, a website of paediatric and adult clinical guidelines and a webinar is planned on mental health resilience in a time of crisis.
The BMA has said that it would be willing to take action concerning oppression involving doctors and other healthcare professionals for which there is internationally-verified evidence and we are currently working with Amnesty International to collate such evidence.
BMA action could include expressing grave concern about the human rights abuses in Myanmar and the deliberate targeting of healthcare professionals and facilities in correspondence to the UK foreign secretary and others, examples of such correspondence can be found on the BMA website.
Meanwhile, doctors in Myanmar also tell us they want public condemnation of the violation of medical neutrality that has been experienced in their country.
Myanmar UK GP Health Action has agreed a statement, which has been endorsed by The Academy of Medical Royal Colleges and adopted by the Tropical Health Education Trust. We are demanding that the military and police forces stop the violation of medical neutrality and enable doctors and healthcare workers to deliver medical help to those who need it.
GPs who would like to help raise awareness of the situation in Myanmar could write to their MP about the issue.
The full statement can be found below.
Myanmar UK GP Health Action statement
United Kingdom and Myanmar GP Group Statement
Since the military coup in Myanmar on 1st of February 2021, Myanmar military and police forces have indiscriminately attacked crowds of peaceful demonstrators and health care workers with tear gas, rubber bullets and military grade weapons.
We demand that the Myanmar military and police forces stop their violations of medical neutrality and comply fully with their obligations under international humanitarian law especially the Fourth Geneva Conventions of 1949.
All medical professionals including general practitioners and other health care workers in Myanmar should be able to deliver medical care to anyone in need of their help, without fear of intimidation, attack or arrest.
The United Nation Security Council Resolution 2286 'strongly condemned attacks and threats against the wounded and sick, medical personnel and humanitarian personnel exclusively engaged in medical duties, their means of transport and equipment, as well as hospitals and other medical facilities'.
We strongly condemn the brutal attacks by Myanmar military and police forces on healthcare workers and medical transport who are treating the injured during peaceful demonstration.
We call for the immediate cessation and insist that the Myanmar military and police forces facilitate safe and unimpeded passage for medical and healthcare personnel so that they are able to carry out their work effectively.
All medical professionals must have access to use existing emergency healthcare facilities across the country. We urge the military and police forces not to occupy these facilities as their bases to threaten healthcare professionals and to prevent treatment of the injured.
- Dr Jim Brockbank is a retired GP. He continues in his role as a GP appraiser and as an international RCGP trainer for Myanmar. He also works with the human rights organisation The Helen Bamber Foundation