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OPINION
A medical student who left Yangon for Kayah State reflects on the last year of tumult as fighting intensified, prompting her team of medics to treat wounded civilians, resistance fighters and even junta troops while avoiding airstrikes and disease.
Read part one of Su’s diary here, and a separate account by her of two revolutionary lives here.
By SU | FRONTIER
We faced months of hardship after an airstrike destroyed our hospital in May last year. Some of our team members left for other conflict zones like neighbouring Kayin State, while the rest of us struggled to stay safe and secure food and water.
However, we kept looking for a new hospital location. By September we started construction on a small outpatient department and a 10-bed inpatient department in Hpruso Township, complemented by a minor dressing room and a labour room. Although rudimentary – made of brick, wood and thatch – these facilities provided a lifeline for both the local community and resistance fighters when opened in October.
Because the military regularly bombs healthcare facilities in resistance-held areas, this time we built our living quarters separate from the workplace, setting up makeshift huts amid the thick foliage of the forest.
But before we could finish our new facility, the war intensified.
In November last year the Karenni Nationalities Defence Force, one of many armed groups formed in response to the 2021 military coup, launched an offensive to seize the Kayah State capital Loikaw.
The post-coup crisis has turned sleepy Kayah – Myanmar’s smallest state, nestled in the mountains on the Thai border – into a fierce battleground. I was a final-year medical student in Yangon when the military seized power, but in 2022 dropped everything to come here to provide care to the local community and revolutionaries.
After the November offensive began, our team of healthcare workers was divided up and deployed to another hospital in western Demoso Township, where we treated patients who had been evacuated from the front lines in Loikaw, including resistance fighters and civilians.
We even treated wounded regime soldiers, which admittedly was difficult to stomach.
While I dressed the wound of one such soldier, I thought of the imprisoned youth activists and the dead bodies of innocent civilians. One of my friends, who had been injured in an airstrike in March last year that we are certain intentionally targeted his medical facility, even treated a captured air force pilot during that time in November. But we remembered our medical ethics and strove to treat all patients impartially.
This was made even more difficult in the face of a steady stream of resistance fighters and civilians wounded by the military. In one particularly distressing case, an older woman arrived with her 19-year-old grandson following an airstrike on their village in the dead of night. The grandson’s injuries were severe, requiring our team of surgeons to perform above-the-knee amputations on both of his legs to save his life.
I felt heartbroken thinking about this young man playing football or offering his shoulder to his grandmother to lean on while they walked together – things he’ll never be able to do again.
The surge in fighting strained our resources, but our team remained dedicated to providing care even as fighter jets screamed overhead. Events took a particularly terrifying turn on November 20, when the western Demoso hospital was struck with a 300-pound bomb.
Fortunately there was no one in the operating theatre at the time; the team had just finished a major surgery and was taking a break before the next operation. The bomb blast caused the ceiling to cave in, with rubble collapsing on the operating table.
I had briefly left the hospital to buy food but rushed back to find the medical team already in action, swiftly moving patients into bomb shelters. Miraculously, no one was injured, but I couldn’t help but wonder about the mental toll on the patients, many of whom had lost limbs in battle only to have the battle find them once again.
Our teammates in neighbouring Hpruso Township came to help us evacuate the patients to other hospitals in western Demoso. For most of us, it was the second time our hospital had been bombed; for some it was the third.
The logistics of care
With mobile internet cut off in western Demoso, we had to travel around two hours on muddy, bumpy roads every three or four days to contact our distressed families. Thankfully, in December, our own Starlink satellite internet device arrived, restoring a link to the outside world that we had sorely missed.
As the fighting raged to the north in Loikaw, it also began to intensify to the south, in Hpasawng Township. A doctor, nurse and two medical students from our team were deployed to the front lines there, where conditions were even harsher.
With scarce water and food supplies, some of them came back a month later nearly five kilogrammes lighter. The doctor, who was suffering from piles, saw his condition deteriorate due to the lack of clean water.
In June last year, an unexpected tragedy occurred when one of our team members’ pet dog contracted rabies. We were slow to diagnose Marfy’s illness, relying on tele-consultation with a veterinarian. By the time rabies was identified, four other dogs, as well as five members and a one-year-old baby, had been exposed through bites, licks or scratches.
It was then a race against time to secure rabies vaccines and immunoglobulin from Taungoo and Taunggyi, in Bago Region and Shan State. They were discreetly shipped inside trucks carrying groceries due to the regime’s tendency to block the delivery of medicines.
There were no further cases of rabies, but the incident taught us the importance of proactive measures. In Marfy’s memory, we committed to spreading awareness about the disease and the need for proper pet care.
Earlier in the year, our fundraising team had secured the necessary budget to establish a full fledged hospital, which we built one village over from the earlier makeshift clinic in Hpruso, which had been converted into a school. In February, construction began on a facility hidden in the mountains. While the rugged terrain provided a sense of security, it also posed challenges, with landslides and the dense forest complicating the construction process.
The road leading up to the hospital alone cost US$2,500 to pave, raised through various online campaigns and regular donors. Despite the hurdles, we not only completed the facility but also recruited 14 more team members to operate it, bringing our total staff to around 60. These included general and orthopaedic surgeons, ear, nose and throat specialists and a pathologist.
Some of them were former colleagues who had left Kayah to rest, while others were new recruits who had deserted their positions at regime-run health facilities elsewhere, and who were subjected to a thorough background check. The team was also joined by local volunteers known as patient care assistants, whom we trained to provide nursing support.
Our new hospital was fully equipped with essential tools – smuggled from Yangon or Chiang Mai, Thailand – including X-ray machines and a laboratory staffed by newly recruited technicians.
From the ashes
In May, we held the opening ceremony for our new hospital, reflecting on the challenges we had overcome to begin again.
But the challenges continued. In June and July heavy rains caused landslides and mud that made the road impassable for cars. We spent two to three weeks at a time living at the hospital, cut off from road transport, breaking our own rule about living apart from our workplace. Thankfully, village administrators with experience in public works from before the coup helped us repave the road to make it more water resistant.
Meanwhile, villagers suffered as nationwide flooding reached Kayah. Diseases such as flu, malaria, pneumonia and TB became more prevalent, as did malnutrition. We created an isolation ward to address the rise in patients.
At the same time, final-year medical students like myself were preparing for our exams, balancing our hospital duties with intense study sessions. Our exams will be administered at the end of October online via Zoom by the Interim University Council, accredited by the National Unity Government, a parallel administration appointed by elected lawmakers deposed in the coup.
Like the revolution itself, our degrees are aspirational. We know the government of Myanmar will only recognise them if the revolution succeeds, and we have no idea how foreign countries might view them. But we are driven by a desire to succeed and make our families proud.
Many of us have also found other ways to engage with and give back to the community. I’ve been teaching English to local children, while another, third-year medical student has been teaching knitting and handicrafts to adults – both as a means to earn a livelihood and as a way to explore their creative talents. Another team member has been teaching dance to children at local schools, uplifting their spirits and nurturing a sense of community.
In June, my boyfriend’s 21-year-old nephew arrived in Kayah. After his brother had been arrested for joining the armed resistance in Yangon, he left to undergo guerrilla training in Kayin.
But war isn’t for everyone. When he received news on the front lines that his mother had died of cancer he was overwhelmed by grief and knew he couldn’t fight anymore. So he joined us here, where he has enrolled in a political science programme run by the Nway Oo Guru Lay Myar education centre, believing that knowledge can also be a powerful tool in the fight for justice and freedom.
As for me, I will be 27 this month. I feel I am at the age where I should be taking responsibility for my parents, who are nearly 60. They invested a lot in my education, and I feel it’s time for me to give back, but for now we are all financially dependent on my older brother, who is a seaman.
I often think about my parents, living alone in Yangon and in constant fear of the regime coming to interrogate them about me. With the junta now carrying out a census that more closely resembles an intelligence gathering exercise, they have no good answer if asked where I am. Now I’m thinking that by 2026 I might try to move to Thailand and bring my parents there.
If I had no one to look after, I would stick with this revolution for as long as it takes. I believe that by fighting injustice and refusing to submit to military rule, in some way we have already won.