While Myanmar’s crippled health system is a major obstacle in responding to COVID-19, the ongoing civil wars further exacerbate the impacts of the pandemic. Another characteristic that would push Myanmar to become a failed state, as it currently bears many of the characteristics of a weak state, is an outbreak of disease or the occurrence of a natural disaster. The authors point out that due to ongoing domestic conflicts and the feeble health system, refugees, internally displaced persons (IDPs), and especially women and children within these populations, would likely be the most vulnerable and that the current situation in Rakhine State and Paletwa township of Chin State resembled that of a failed state.

The authors also refer to an assessment provided by the International Rescue Committee (IRC), which compares the situation in the refugee camps and areas of displacement to the densely populated conditions and a high risk of transmission on the Diamond Princess cruise ship. On that cruise ship, the transmission of the virus was four times faster than that of Wuhan and if an outbreak of the disease occurs in the refugee camps in Bangladesh, the disease transmission rate is projected to be more than 600,000 people.

Myanmar’s health system bears significant shortcomings in terms of human resources and basic infrastructure. The healthcare system in conflict-affected areas was noted as being much worse. Currently, among the total number of more than 300,000 IDPs in Myanmar, more than 180,000 IDPs are in Rakhine State and Paletwa township of Chin State. The number of IDPs in these areas has risen by a few thousand due to escalating conflict during the early period of the COVID-19 outbreak in Myanmar in March and April.

The authors posit that despite the assistance given to IDPs in these areas by the Ministry of Social Welfare, Relief and Resettlement, international organizations, and civil society organizations, given the pre-existing weak healthcare system, the assistance will not be adequate in case of an outbreak of disease.

Furthermore, in terms of COVID-19 prevention and control efforts, regardless of some degree of cooperation brought about by the government’s establishment of the coordination committee with the ethnic armed organizations and the Tatmadaw’s announcement of a unilateral ceasefire, some limitations, including the exclusion of major conflict areas from this ceasefire, will likely result in hardships in fully engaging in necessary cooperation efforts on the ground.

Although cooperation between the government and ethnic armed organizations has been agreed to in principle, and is conducive finding ways towards peace, the authors further urge the major stakeholders to consider the situation of IDPs.

The authors suggest that if a disease outbreak occurs in these conflict affected areas, that failing to meet the needs of the IDPs amidst the pandemic will likely lead to major hurdles in nation-building, the peace process, and national reconciliation.