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On a remote Indian border, Myanmar’s refugee doctors battle growing needs

‘I loved my job but didn’t want to work under the military regime.’

Lalruatpiang, a refugee from Myanmar, shows a photo of his baby, Vanlaldika, who died aged three months after struggling to find diagnosis and treatment for his pneumonia in India.
Lalruatpiang, a refugee from Myanmar, shows a photo of his baby, Vanlaldika, who died aged three months after struggling to find diagnosis and treatment for his pneumonia in India. (Makepeace Sitlhou/TNH)

When his parents escaped across the border from Myanmar in May 2021, a whole new world awaited Vanlaldika in India's remote and marginalised northeastern state of Mizoram.

 

Born in Myanmar’s Chin state, his mother, a teacher at a government-run school, was among the millions who joined the civil disobedience movement against the military junta after the February 2021 coup. When their protests were met with brutal violence, despite being pregnant at the time, she fled with her four-year-old son and husband, giving birth to Vanlaldika in India in September.

 

In the bitter cold month of January, the newborn took ill. His father, 27-year-old Lalruatpiang, recalled how the family first went to the district hospital in the main town of Champhai. The physician couldn’t diagnose any specific illness. “They gave us some medicines, but the cold and fever didn’t get any better. He cried all night,” Lalruatpiang told The New Humanitarian. 

 

With no sign of improvement in three days, they rushed back to the border village of Zokhawthar, where refugee doctors from Myanmar running private clinics offer free treatment for refugees. One of these doctors diagnosed Vanlaldika with pneumonia but said he had no facilities in place to admit him for treatment. Before his parents could get back to the district hospital in Champhai, about 15 miles away, the infant died. 

 

In the wake of the February 2021 coup, a large-scale civil disobedience movement has been met by brutal military crackdowns. Chin state and the neighbouring Sagaing region in particular – both home to strong resistance from the People’s Defence Force and ethnic armed groups – have seen vast military operations and violence that have displaced tens of thousands of civilians. Many have taken refuge in India, which shares a land border spanning over 1,600 kilometres with Myanmar, most of it porous.

Among the northeastern states, Mizoram is playing host to the most refugees. However, medical infrastructure and resources have been woefully inadequate; government hospitals were already severely understaffed before the influx. Refugee doctors try to fill the gap by offering free services to refugees as well as public healthcare alternatives to local residents.

Zokhawthar’s Mercy Health Centre, the only fully functioning medical facility in the border village, has taken some of the load. But with the number of refugees soaring in recent months, refugee physicians and makeshift clinics are scrambling to meet the needs of a village whose population of 3,000 has doubled. 

The refugee doctors of Mizoram straddle an uneasy position. India lacks a refugee law, meaning they cannot receive asylum and find formal work. Without Indian medical licences, the doctors can provide only basic care in an unofficial capacity. Like their patients, they bear the scars of conflict. Still, they hold a critical role in a community desperately lacking adequate medical care.

 

In Zokhawthar, Mint is one of five doctors who started to work at the Myanmar Refugees Clinic, which opened in May courtesy of funds raised by civil society organisations. He asked that his real name not be used for security reasons.

 

“It is more of an emergency first aid centre and a mobile clinic,” said Mint, who treated Lalruatpiang’s son. “We have only general medicine.” 

 

Mint’s life in Cikha, a small town in Chin state near the border of India’s Manipur state, was disrupted after arrest warrants were issued last year against all those who protested with the civil disobedience movement. Days after the military declared a coup in Myanmar, hospitals transformed from a place of care and healing to sites of brutal crackdowns by the junta. 

 

At least 284 healthcare workers were arrested, and hospitals have been raided 113 times since the coup, according to Physicians for Human Rights (PHR), a US-based NGO. Healthcare personnel have also been caught in the crossfire between armed resistance fighters and the regime. PHR said military-backed forces have committed 90 percent of the attacks, including the shelling and burning of hospitals, and indiscriminate attacks on health workers. 

 

“Even after we started protesting, we worked until April [2021] without a salary,” Mint said. “The military repeatedly warned us against participating in the civil disobedience movement. So the staff left one by one, and I came here by June last year.” 

 

Mint told The New Humanitarian the junta has all their documents and identity records, “even their photographs”.

 

Water shortages and growing health problems

 

Lalruatpiang and his family are among some 50,000 refugees who have fled from Chin state and Sagaing region to Mizoram since the coup. Champhai district alone now hosts over 10,000 refugees. Despite the absence of a refugee law, the Mizoram state government has been helping those displaced — though they cannot legally recognise them as refugees. 

Along the Tiau river, which separates Myanmar from India, refugee camps hosting thousands have spread — along with disease. Unseasonably heavy rains this year have led to a rise in waterborne illnesses, while extreme heat, dust, and cold nights have seen other conditions spread. 

“A lot of fights have broken out over water,” said Moite, a 40-year-old mother of five who fled Chin state last year. ““Whenever it rains, the river turns yellow and red… Otherwise, it is cleaner than the pipe water that comes from the four tanks shared among 240 residents.”

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Myanmar refugees share a joke in their camp in the Indian border village of Zokhawthar. Some 50,000 people have fled across the border into India in recent months.
Ninglun Hanghal/TNH
Myanmar refugees share a joke in their camp in the Indian border village of Zokhawthar. Some 50,000 people have fled across the border into India in recent months.

Moite had come to the Mercy clinic with her six-month-old son, who suffered from a cold and chest congestion. In the waiting room, women with sick children in tow sat listlessly, sweating amid the scorching heat. 

 

Clean drinking water, said Moite, was sold at prices as high as 2,000 Myanmar kyats, or almost $2 for a 10-litre bottle. Aside from colds and fever, diarrhoea and other stomach infections were rampant among both children and adults in the camp, she added.

 

Dangers on both sides of the border

 

Rita, another doctor from Myanmar who also asked to be identified by a pseudonym, fled from Chin state, where she was working in the government health department. 

 

“I was three years old when the last military coup happened in 1988 and suffered a lot growing up under the military regime,” said Rita. “The education system was badly hit and we got a chance to freely express ourselves only recently,” she said, referring to Myanmar’s relatively democratic opening in the 2010s. 

 

Read more →Communities defy bombs to keep schools running in Myanmar

 

Rita didn’t want to see future generations live the horrors and trauma of her own childhood. “I loved my job but didn’t want to work under the military regime,” she explained. “So we started to show our support for the civil disobedience movement, along with 445 members of the [health department] staff.” 

 

Following the arrest and killing of several health workers, many others have escaped persecution in Myanmar, leaving an already struggling healthcare system devastated.

 

The situation has been made worse by the junta redirecting medical resources to their own military personnel. For example, at the height of the Delta wave of COVID-19, which killed over 19,000 people last year, oxygen supplies were reserved for the military.

Many of these emergency patients couldn’t accurately express their health problems, nor could they understand what the doctors prescribed. We started this clinic to bridge the language barrier.”

In February, Rita started volunteering in the lone refugee health clinic in Aizawl, Mizoram’s state capital, which plays host to thousands of refugees living in rental homes, with their relatives, or in camps outside the city. Started with the collaboration of the Mizo Students Union and the BN Hospital and Research Centre, the clinic has a barebones staff with just two doctors and a handful of nurses to attend to patients.

 

It is only accessible through a steep flight of stairs going down the hill at the edge of the hospital’s emergency unit. And, much like the Zokhawthar clinic, it is only meant as a referral point to the main hospital.

 

The need for doctors from Myanmar became acute during the Delta wave, when Mizoram was one of India’s worst affected states in terms of infection rates and continued lockdowns. Although most refugees from Myanmar’s Chin state are familiar with the local Mizo dialect, not being fluent in the language created hurdles during the pandemic.

 

“There were a lot of COVID cases among refugees, especially those living in the camps,” Rita told The New Humanitarian. “Many of these emergency patients couldn’t accurately express their health problems, nor could they understand what the doctors prescribed. We started this clinic to bridge the language barrier.” 

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Women wait to be seen at Zokhawthar's Mercy Health Centre.
Makepeace Sitlhou/TNH
Women wait to be seen at Zokhawthar's Mercy Health Centre.

Most refugees come from the Chin Mizo Kuki Indigenous tribes, which are spread across northeast India, Bangladesh, and Myanmar — and those who come from the same ethnicity have been greeted more warmly than other refugee populations. Still, refugees spoke of profiling and housing discrimination.

 

Rita – who came to Aizawl with her husband, her sister, and her sister’s family – said they were turned away by five houses before they were accepted by a local landlord who treated them well. 

 

“They rejected us because we’re from Burma,” she said, using Myanmar’s former name. “The [false] stereotype is that we’re involved in illegal businesses and trade.” 

 

This prejudice became especially acute during the strict lockdown periods, some of which lasted for months, when the refugee communities were seen as superspreaders. 

 

Unlike in most states in India, civil society organisations in Mizoram, like the Young Mizo Association, ran a tight ship: organising community service and volunteer work, including enforcing strict lockdowns; rigorously testing locals; and providing food and medical services to the needy. This, in turn, led to stigmatisation for those who tested positive. 

 

“The Mizo community sees us differently. Those refugees were perceived to have gotten COVID because they didn’t obey the rules,” Rita said, adding that some refugees have been struggling with depression as a result. 

 

Although her skills and Masters degree in medicine are being woefully underutilised in the refugee clinic, without a licence to practise in India, doctors like Rita must tread lightly and can’t afford to risk their precarious positions. 

 

The Indian government hasn’t deported any refugees so far, but roughly 100 have been detained in recent months in the neighbouring states of Assam and Manipur. Those living in Mizoram say they don’t feel threatened by local law enforcement, but many are still constantly looking over their shoulders.

 

Though they live in limbo, returning home is not an option.

 

“I was issued an arrest warrant because of supporting the civil defence movement and raising funds for them,” Rita explained. “This is why it’s not good for me to be exposed.” 

 

Reporting for this article was supported by the International Women's Media Foundation's Howard G. Buffett Fund for Women Journalists.

 

Edited by Abby Seiff.

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