Aye Nyein Thu finished medical school in Myanmar’s central city of Mandalay less than a year before the military seized power in a coup on February 1.
Now, the 25-year-old is providing emergency medical assistance as state forces crack down on mass protests.
“Most [victims] had head injuries because police are using batons to beat protesters. Some people were shot as well,” said Aye Nyein Thu, who estimated she had responded to 10 emergency cases as of March 1. “We are facing the most terrible situation.”
Since the military arrested civilian leader Aung San Suu Kyi and more than 40 elected officials and declared a year-long state of emergency, millions have taken to the streets across the country, while approximately three-quarters of government workers are estimated to have gone on strike as part of a nationwide Civil Disobedience Movement.
With the demonstrations showing little sign of abating, authorities have turned increasingly to force.
They have fired live and rubber bullets, deployed water cannon and used tear gas and stun grenades on the crowds. The crackdowns have so far killed about 30 people and injured at least 200 more, according to the Assistance Association of Political Prisoners (AAPP), a monitoring group. At least 18 people lost their lives on February 28, a day the demonstrators have now dubbed “Bloody Sunday”.
The Civil Disobedience Movement has hampered the formal health system across the country – one official from the Yangon General Hospital told Radio Free Asia on February 9 that as many as 80 percent of government hospitals had shut down.
To meet the public’s medical needs, healthcare providers are now offering services voluntarily outside of government facilities, but the increasingly violent crackdowns mean many healthcare workers are risking their own lives to deliver life-saving treatment to those joining the protests.
“The biggest challenge is not to get shot when we help on the ground,” said Ze Nan,* a volunteer nurse in the Kachin State capital, Myitkyina. “The bullets can hit us, too; we can also die anytime.”
In Mandalay, which has seen some of the worst violence since the coup, Aye Nyein Thu is part of a team of about 30 volunteer healthcare professionals providing emergency response throughout the city. She has been walking among demonstrators with a backpack containing some basic supplies to stop bleeding and disinfect wounds.
So far, she has offered emergency first aid, to approximately 10 people and arranged for a volunteer ambulance service to transport victims to a clinic, also run by volunteers, for further treatment.
Medical team attacked
Her group is one of at least six medical teams that are operating mobile or stationary healthcare services across the city, according to Kaung Khant Tin, a doctor who is volunteering on another medical team, which focuses on primary care.
He said that only one team has the facilities and human resources to offer stitches and critical care for those with serious injuries, while military-enforced road closures have hindered the emergency response.
On the morning of February 28, state forces fired at medical support cars, injuring one volunteer from the team which had been treating the most serious cases, a local journalist familiar with the situation told Al Jazeera. The team has since ceased its operations. “If the violence continues, we don’t know where we should send our patients,” said Kaung Khant Tin.
In the Kachin State capital Myitkyina, approximately 100 striking government nurses are providing first aid and basic services through mobile teams and are running a referral network to volunteer ambulances and doctors.
Ze Nan, leads a nursing team of approximately 40 volunteers, who walk along with the demonstrators – wearing white wristbands and stickers so they can be easily identified – and are followed by motorbikes carrying medical kits.
On February 28, as protest numbers swelled, Ze Nan’s group bought its own phones and SIM cards and began distributing pamphlets around the city with their contact information in case of any emergency. Within hours, the team was treating head injuries from baton-wielding police beatings.
Along with the three other first responders interviewed by Al Jazeera, Ze Nan expressed concern about the high risk of physical danger. “They don’t discriminate when shooting people. We can be shot to death whether we wear our badges or not,” she said. “All the protesters can be injured or killed at any time, including me.”
Pyae Zaw Hein, who runs a volunteer ambulance and first responder team in the southern city of Dawei, also worries he and his team members could be caught in the crossfire. With a supply of five vehicles, they maintain contact with the various medical volunteer groups to transport patients to facilities around the city where they can receive treatment.
On February 28, authorities shot and killed three protesters in the city, and one person remains in critical condition. Paye Zaw Hein and his group have continued to work, but he said they face a minefield of dangers and dilemmas, including whether to respond to emergencies during the night when the military has imposed a nationwide curfew.
“We don’t know how to continue doing our jobs. If there is an emergency at night, we are so confused about whether we should go out to help or not,” he said.
In the Mon State capital of Mawlamyine, Nai Aung,* a private-practice doctor, helped establish a makeshift health facility as strikes picked up the week after the coup.
But within days, he and other participating volunteers heard that authorities had obtained a list of their names and were monitoring their movements and activities. The volunteers immediately closed the facility and began moving from place to place, providing services at vacated medical facilities across the city, while volunteer ambulances began running between the protests and the temporary clinics.
“We are fine with all necessary facilities and equipment. The only difficulty is our safety. We could not find a base to treat patients. If we were able to build a base, [authorities] could destroy it any time,” said Nai Aung.
He also fears that he could be arrested from his home at night or caught during the day. “We can’t treat patients publicly; we have to move around and hide. There is no guarantee for our safety as our names were disclosed and we are being watched by the police.”
On February 28, authorities started firing live rounds in the city, killing one 21-year-old man. As of March 1, Nai Aung estimated that his team had treated approximately 50 patients with injuries sustained during the protests, including two police officers.
“We are treating everyone without any grudges or personal biases,” he said.
Without access to proper medical facilities, however, Nai Aung says his team cannot effectively respond to patients shot in the head or neck, and is currently trying to coordinate referrals to hospitals in Yangon.
Crackdowns on protesters began escalating in Yangon on February 25, and on February 28, the Yangon General Hospital, which had been closed since February 8 due to the continuing strikes, announced it had opened its emergency department “out of necessity” to treat the wounded.
Doctors at the hospital treated 16 people, most with gunshot wounds, that day, while three people were pronounced dead on arrival.
In Mandalay, doctor Kaung Khant Tin said he planned to continue to provide medical services in whatever circumstances.
“We feel unsafe while treating patients. We worry about when [authorities] might threaten us or a gun may be pointed at us,” he said. “Although police are getting more violent, we are still going to the demonstration sites with the mindset that we have to treat patients whatever happens.”
“The fight is not over yet. The protests will continue and we will always support the protesters with the medical knowledge that we have,” he added.
“I haven’t seen any unity like this before. With this unity, we will definitely win.”
*Nai Aung and Ze Nan are pseudonyms for those who felt unsafe to speak to Al Jazeera using their real names due to the military’s targeting of those expressing dissent. All other interviewees have requested their real names be used.