3 years after the Myanmar military coup—the people are suffering

• Published in: The Lancet (British edition) Vol. 403; no. 10440; pp. 1966 - 1969
• Main Authors: Htet, Aung Soe, Soe, Zaw Wai, Aye, Win Thuzar, Maung, Cynthia, Lien, Lars, Ottersen, Ole Petter, Bjertness, Espen
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 18.05.2024; Elsevier Limited
• Subjects: Adolescents; Anxiety; Atrocities; Best practice; Civil society; Cooperation; Coups d'etat; COVID-19; Democracy; Diplomacy; Displaced persons; Ethnic factors; Funding; Health care; Health facilities; Health problems; Health services; Humanitarian aid; Humanitarianism; Infrastructure; Massacres; Medical personnel; Mental depression; Mental disorders; Mental health; Military psychology; Military service; Morality; Mortality; NGOs; Nongovernmental organizations; Pandemics; Post traumatic stress disorder; Psychological stress; Public health; Rohingya people; Signs and symptoms; Social interactions; Socioeconomic factors; Socioeconomics; Tuberculosis; Myanmar (Burma); Ukraine
• ISSN: 0140-6736; 1474-547X; 1474-547X
• DOI: 10.1016/S0140-6736(24)00584-1

In 2022, Myanmar reported the second-highest number of aid workers killed globally.15 In addition, the MMC introduced new registration requirements and procedures for NGOs that affected their zones of operation and the delivery of life-saving humanitarian assistance (mainly affecting the national and international NGOs who are main contributors to the humanitarian aid programme).14 Even before the coup Myanmar was already facing several challenges in the health sector. The parliamentary government in Myanmar that came to power in 2011 increased spending on health, but it was still only 3·7% of the total government budget in 2016.16 Out-of-pocket spending accounted for 75% of all health spending in 2016.16 The economic recession in 2022, which saw inflation reach 18%, affected health care as people continue to have less disposable income for medical expenses. [...]the prevalence of depression and anxiety has increased from 18% before the coup19 to 61% in 2021.20 The deterioration of health services and the high prevalence of mental distress are most likely attributed to the polycrisis of war and conflict, forced migration, the COVID-19 pandemic, and a weakened health-care system post-coup.21 Those affected directly by the coup's trauma, or indirectly by displacement or loss of protective factors (eg, family, financial protection, and socioeconomic factors) are at risk of developing post-traumatic stress disorder (PTSD), anxiety, depression, and other psychiatric disorders.22 Community mental health programmes, reaching displaced people in the border area and hard-to-reach areas, should be given priority. For children and adolescents, focused psychosocial interventions can help reduce symptoms of depression, anxiety, and PTSD and enhance hope, coping, and social support.23 For adults, WHO has developed the Self-Help Plus intervention to manage psychological distress and mental health problems in vulnerable populations, shown to have effects on symptoms up to 3 months after delivery.24 To help resolve the conflict and put the democratisation process back on track, we suggest using health as a bridge for peace through strengthening of health services and humanitarian aid delivery reaching displaced people in the border areas and hard-to-reach areas inside Myanmar.