In the poorly lit hallway of the RHI Hospital in Rikhawdar, a border town in western Myanmar’s Chin State, 20-year-old Chhanhim holds his bandaged head, grimacing from the pain. The only noise breaking the silence of the night is the buzz of a generator.
Chhanhim, who – like many people in Myanmar – uses only one name, is a fighter for an ethically aligned armed group that has been battling the nation’s military junta since the February 2021 coup.
He looks out of a tiny window facing the heavily guarded border with India. Once a key trading post, and a vital escape route for those seeking refuge from the war, the border is now completely sealed off.
Since his injury in a March 2024 ambush in Kale, a remote township in western Myanmar, Chhanhim’s health has deteriorated.
The closure of the border has made it impossible for him to get a crucial CT scan at a hospital in Aizawl, India. This is almost 200 kilometres away but there is nowhere in Myanmar he can reach that has a functioning hospital offering the advanced services he needs.
“We used to cross the border for treatment,” Chhanhim’s said the next day, when the pain had subsided a little. “Now, it's too dangerous. The border closure has trapped us here. We are unable to receive the treatment we desperately need.”
The sudden termination of the Free Movement Regime (FMR), which allowed for cross-border access to essential services between Mizoram in India and the border areas of Myanmar, has plunged his home township of Kale into a healthcare crisis.
The decision was made by the Indian government in February, in the lead-up to national elections, allegedly to address security concerns. But it has stranded thousands of people and left them in urgent need of medical attention.
“The closure of the border has dealt a heavy blow to our community,” said Dr. Lalaramzaua, the only doctor at the RHI Hospital. “We're struggling to handle numerous cases with very limited resources. We rely on our neighbours in Mizoram for supplies and medication. With the border now closed, our ability to provide the care we need is severely compromised.”
A countrywide crisis
It’s not just Kale, though. Intensified fighting between armed groups, who have also been accused of abuse and violence against civilians, and the junta, which has come under repeated scrutiny for tactics that place civilians in harm's way, have had a major impact on healthcare across Myanmar.
Earlier this month, Médecins Sans Frontières reported a notable increase in the number of war-wounded crossing from Myanmar into neighbouring Bangladesh.
Rohingya Muslims, who say they have come under attack both by the anti-junta armed group, the Arakan Army, and by the military leadership, made up the majority of the arrivals. From 3-7 August, MSF treated 39 people — 40% of them women — in the Cox’s Bazar refugee camps in Bangladesh.
Recent unrest in Bangladesh, where the former prime minister, Sheikh Hasina, fled the country on 5 August, is also affecting healthcare access to those people who do manage to make it out of Myanmar.
The International Rescue Committee said four weeks of protests and communications cutoffs in Bangladesh forced the organisation to suspend all its operations apart from one 24/7 health clinic in Cox’s Bazar. That clinic treated primarily Rohingya Muslims, who have faced persecution from successive governments and ethically aligned armed groups in Myanmar over several decades.
‘A death sentence’
Among those severely impacted is Malsawm Puia, a 28-year-old from Kale township battling blood cancer.
Before the border closure, Malsawm Puia received treatment in Mizoram. With the end of the free movement agreement, he now faces an uncertain future as he is unable to access the necessary medical care. “The decision by the Indian government could be a death sentence for many of us,” said Malsawm Puia's mother, who accompanied him to the hospital.
Lalremtluanga, a 28-year-old rebel fighter, was injured in January during a mission.
Initially treated in Aizawl's Greenwood Hospital, he had to leave due to worsening conditions and was then treated at the RHI Hospital. His condition, worsened by a broken leg and concerns about infection, makes it even more urgent to receive cross-border medical support.
“We have pregnant women and cancer patients here. The lack of facilities means I can only treat basic conditions. The situation is heartbreaking, and we are doing everything we can with the limited resources available.”
“The situation is dire,” said Lalremtluanga. “We lack proper healthcare and medication here. The border closure has put us in a difficult position.”
The sudden end of the FMR and the ongoing construction of border fences have left nearly 100,000 residents of Kale township struggling with a failing healthcare system.
The only hospital, already stretched thin by the ongoing conflict and injuries from the unrest, now faces an unprecedented challenge in providing care with a severe shortage of medical supplies and facilities.
“We have pregnant women and cancer patients here,” Dr. Lalaramzaua said. “The lack of facilities means I can only treat basic conditions. The situation is heartbreaking, and we are doing everything we can with the limited resources available.”
Women face perilous childbirths in Myanmar.
Enok, a 38-year-old farmer in Kale township, gave birth to her fourth child at home with the help of a midwife. She considers herself lucky for managing a safe delivery amid the raging conflict in the region. Unable to travel to the hospital for a medical check-up, Enok still can’t obtain postnatal supplements and has to subsist on plain rice.
“I can’t get enough sleep,” Enok, who used a pseudonym for security reasons, told The New Humanitarian. “People are so tired because they can’t sleep.”
Flick through the slideshow below for more on the healthcare crisis facing civilians and opposition fighters in western Myanmar:
