(Bangkok) – The Myanmar military junta’s years of unlawful attacks on healthcare facilities and health workers have severely hindered the emergency response to the devastating earthquake on March 28, 2025, Human Rights Watch and Physicians for Human Rights said today. A month after the earthquake, the junta has continued to obstruct access to lifesaving services in opposition-held areas and during military operations.
The junta’s arrests and prosecutions of over 872 health workers affiliated with the anti-coup movement and the closing of private hospitals that hire them has drastically reduced healthcare operations in quake-affected areas. The military and associated forces have attacked at least 263 healthcare facilities and killed at least 74 health workers since the coup, according to Insecurity Insight, a Swiss nongovernmental organization.
“Since the 2021 coup, the Myanmar military has been attacking the healthcare system in opposition areas, exacerbating an already serious public health crisis,” said Lindsey Green, deputy director of research at Physicians for Human Rights. “Governments supporting the earthquake response should call on the junta to cease airstrikes and other unlawful attacks targeting healthcare facilities and health workers and release all those wrongfully detained.”
Media reports tally over 5,350 deaths from the 7.7 magnitude earthquake, although US Geological Survey estimates suggest that the final count could reach 10,000 or higher. The United Nations estimates that 2 million people need assistance, in addition to the nearly 20 million who already needed aid.
Human Rights Watch and Physicians for Human Rights spoke with five health workers providing emergency relief in Mandalay and Sagaing regions, in addition to health workers who had fled Myanmar and other humanitarian actors. They described an emergency response effort severely hampered by years of military attacks on health care.
The worst affected regions, Mandalay, Sagaing, Naypyidaw, Shan, and Bago, have long been subject to abusive military crackdowns. In just these areas, Myanmar armed forces had carried out at least 125 attacks on hospitals, arrested at least 258 health workers, and killed at least 32 since the coup, according to Insecurity Insight.
Myanmar’s healthcare system is severely under capacity, with many health workers having fled the country to escape the military’s campaign of arbitrary arrests and attacks on anti-coup health workers. A health worker who has remained outside the country since the coup due to safety concerns told Physicians for Human Rights that many who participated in emergency response training have since fled the country because of the junta’s assault on health care. Losing these colleagues has “drastically limited the effectiveness and timeliness of response,” the health worker said.
In Sagaing, more than 70 percent of health workers had fled since the coup. One doctor working in a mobile clinic said that the junta’s crackdown had left some areas without any staff, making it impossible to assess post-quake healthcare needs. Several health workers reported medicine shortages, which they said stemmed from restrictions on pharmaceutical imports that the junta has refused to lift since the earthquake. The junta has long imposed internet blackouts that are limiting information and emergency response, particularly in opposition and contested areas.
Remaining public hospitals have been unable to provide the care needed, the organizations said. A doctor in an emergency response team in Mandalay described multiple cases in which patients developed rotting wounds due to delays in treatment at the public hospitals.
Several health workers said they were afraid to operate in junta-held areas. A doctor in Sagaing said that he and other doctors affiliated with the anti-coup movement cannot safely pass through junta checkpoints to provide care where it was needed most because they fear being arrested. “It is heartbreaking,” he said. “It is unimaginable even to think that I cannot go help. Many of my friends lost their family members, and I can’t go help.” Another doctor in Sagaing said that he and others cancelled plans to visit a district because they considered it too risky since they had an anti-coup doctor on their team.
Since the coup, Myanmar’s junta has been responsible for numerous war crimes in conflict areas and crimes against humanity against anti-junta protesters. Military operations have continued, with the junta launching at least 160 aerial attacks since the quake, without facilitating relief efforts or access for aid workers. One doctor said he and his colleagues had turned back from a quake-affected area because of ongoing hostilities.
Response teams from donors and humanitarian organizations said the junta has restricted their access by delaying visas or limiting their work to major cities and junta-controlled areas. An April 2, 2025, internal UN document says that the junta is restricting access in areas outside its control, leaving them “largely devoid of external assistance.”
A doctor in Sagaing said that junta authorities have confiscated medicine being transported to opposition-held territories. The UN special rapporteur on Myanmar, Tom Andrews, said he “received reports of humanitarian workers being stopped, interrogated and extorted at military checkpoints.”
Following an April 5 junta announcement that “rescue teams must request prior authorization and cannot independently act without approval from the relevant authorities,” support from local aid groups in some areas dwindled, given the risks of registering personal information with junta authorities that have criminalized local aid. Junta-affiliated militia reportedly blocked local rescue teams from recovering bodies.
Humanitarian agencies have warned that landmines dislodged by the quake pose a serious risk, with at least 32 of the 58 worst-hit townships contaminated.
Prior to the earthquake, aid blockages and a lack of access to medical care had already exacerbated malnutrition, waterborne illness, and preventable deaths, with over one million children missing vital vaccines. Hostilities and conscription by the Myanmar military has also led to mass displacement of over 3.2 million people and a rise in communicable diseases like tuberculosis and cholera.
Tens of thousands of people have been sleeping outdoors, exposed to extreme heat reaching 44 degrees Celsius and without access to clean water. This increases the risk of heat-related illness and waterborne diseases, especially for older people, people with disabilities, pregnant people, and children. Women and girls have reported increased sexual and gender-based violence.
Foreign funding has fallen drastically. The UN is appealing for US$241.6 million in additional aid, but the broader $1.14 billion response plan is only 7.5 percent funded. The sharp decline stems in part from the US government’s abrupt dismantling of foreign aid, reducing its share of support from 30 percent in 2024 to 3 percent in 2025.The three USAID workers sent to Myanmar to assess the earthquake were fired days after arriving.
China, Russia, India, Turkey, and ASEAN member states have sent response teams. Other countries have pledged aid, including a promised $137 million from China. These funds should be channeled through independent humanitarian actors to ensure aid reaches those most in need, the groups said.
The junta is obligated under international human rights law to uphold the rights to life, health, and shelter. Under international humanitarian law applicable in armed conflict areas, Myanmar’s military and opposition armed groups are prohibited from deliberately attacking civilians and civilian objects, including medical facilities and health workers. They are obligated to facilitate rapid and unimpeded impartial humanitarian assistance to all civilians in need and cannot withhold consent for relief operations on arbitrary grounds.
The UN Security Council should hold an open meeting on Myanmar and pass a resolution calling on the junta to immediately facilitate humanitarian relief efforts without obstruction and cease attacks on healthcare facilities, transportation, and health workers, the organizations said.
“Myanmar’s junta has spent four years destroying the country’s healthcare system and chasing away healthcare professionals,” said Julia Bleckner, senior health researcher at Human Rights Watch. “Concerned governments should urgently increase humanitarian assistance and engagement with local partners and networks to ensure that aid reaches everyone who needs it.”
