“In the majority of cases, we have to amputate limbs to save the patient.”

By Daniele Bellocchio
First published January 21, 2025 by The New Humanitarian

KAYAH STATE, Myanmar

Soon after Soe Kan Naing arrived in Kayah in May 2023, the eastern state became home to some of the fiercest fighting between Myanmar’s ruling junta and a collective of ethnic armed groups trying to wrest control from the military rulers. So he decided to put his medical degree to work at a local hospital built to assist civilians caught in the crossfire and fighters of the armed groups battling the junta.

“Most of the people we treat are victims of explosions, artillery shells, and landmines. In the majority of cases, we have to amputate limbs to save the patient,” the 31-year-old told The New Humanitarian at the hospital and rehab centre, which is located in Demoso district.

Some medical equipment has been smuggled through the porous border with Thailand, but the hospital staff said it’s never enough. And when the rainy season begins, the operating room often floods, making it extremely difficult, if not impossible, to carry out surgeries.

When Soe Kan Naing lifted his right arm to speak, his tattoos, which denote his affiliation with an opposition armed group, became clearly visible. Given the junta’s penchant for detaining and torturing people they suspect to be linked to the armed opposition or against their rule, they are a bold statement.

After requesting that no video footage be taken that could identify the hospital’s location, the young doctor took a group of visitors on a tour of the facility. Sheltered by tree branches and camouflage tarps were several huts. One was for victims of explosive devices and another for patients with infectious diseases. There was also a small laboratory for tests and an underground operating room.

“Secret location”

When The New Humanitarian visited in *June 2024, a team of volunteer nurses and doctors was assisting a fighter who had lost an eye due to a mortar shell explosion.

Soe Kan Naing said the hospital was built in a “secret location”, nestled in the mountains around Demoso, in March 2024. Hidden by thick vegetation to try to protect it from airstrikes, it is the city’s only hospital and provides medical support to over 150,000 people.

“The junta’s air force bombed the previous hospital several times,” Soe Kan Naing said. Since it took control of the country in a February 2021 coup, the junta, which receives support from Russia, India, and China, has faced repeated allegations that it targets civilians and civilian infrastructure, such as schools and hospitals, in its deadly air raids.

In November, the International Criminal Court issued an arrest warrant for Min Aung Hlaing, the military leader, accusing him of crimes against the nation’s long-persecuted Rohingya Muslim minority.

“We will do everything we can to save him”

A young man named Paing Paing was working in neighbouring Shan State when a drone dropped a bomb. His left leg and right arm were amputated. He also has numerous abdominal and facial wounds. 

“His condition is very serious, but we will do everything we can to save him. With what we have, it won’t be easy, but we will make it,” says Soe Kan Naing. 

There are women, men, and even children in the bamboo and raffia huts. They lie in silence, surrounded by a web of tubes and blood-stained bandages: the visual representation of the suffering and violence civilians are enduring in Kayah State due to the ongoing civil war.

Since the military took power, the country has plunged into an escalating civil war, with the junta forces on one side and the People’s Defense Force (PDF) – most of whom operate under the exiled National Unity Government – and ethnic militias fighting for autonomy and the rights of Indigenous minorities on the other.

According to ACLED, which collects data on fatalities, 76,445 people have been killed in the conflict since February 2021. Almost 3.5 million people are now internally displaced, and almost 20 million people need humanitarian assistance, including an estimated 6.4 million children.

Fiercely fought over

PDF soldiers prepare to reach the front lines near Loikaw, the capital of Kayah State and a key city for controlling the region. When The New Humanitarian visited, the capital – which is constantly being fought over – was abandoned by civilians.

In Kayah, which locals refer to as Karenni State, the situation for civilians is extremely dire. The state’s location – bordering Thailand, between resistance strongholds in the Dry Zone and the southeast, and just 150 kilometres from the capital, Naypyidaw – gives it strategic importance.

But the price has been steep. Human rights organisations have verified bombings and attacks on at least 174 schools, more than 300 hospitals and clinics, and numerous refugee camps – many in this state. 

Civilians wounded by the junta’s airstrikes are often among the patients in this hospital.

“His body was torn apart”

Nay Lin Aung was teaching maths at the Demoso Daw Saw Ei Baptist school when it was reduced to rubble by a junta airstrike on 5 February 2024.

“That morning, when I arrived at school, my students told me that planes were flying overhead,” the 26-year-old recalled. “I went out of the classroom to check and realised that the jets were headed straight for us.”

After the bombs struck, Nay Lin Aung ran back to check on the students.

“The first student I saw had no arm, his body was torn apart, his organs exposed. He was lifeless. The second child I saw was lying outside a bunker. I thought he was alive, but then I realised he was dead and had been hit in the head by a fragment.” 

The horrors continued as he made his way through what was the school. “The third student was bleeding, alive, so I ran to help him and handed him over to the first responders, but during the trip to the hospital, he passed away. The last student was in terrible condition: His head was completely destroyed, and his body was reduced to charred fragments.”

“Losing education means losing life”

At a school in the city of Demoso, students practise drills to be ready and able to take cover in case of airstrikes.

More than 13,700 public schools are closed in Myanmar, and almost all of them in areas affected by clashes between the junta and the armed groups.

“The worst part is that an entire generation in Myanmar has lost its education. Losing education means losing life,” Kan Yar Man, the 42-year-old pastor of the Demoso Baptist Church, told The New Humanitarian.

“In this area, the population suffers a lot because there are no international NGOs that can operate here. We are extremely isolated and try to help each other. Those who have more give and help those who have lost everything.”

(*An earlier version of this article incorrectly stated that The New Humanitarian visited in October 2024. The visit was in June 2024. This correction was published on 22 January 2025.)

Edited by Thin Lei Win and Ali M. Latifi.

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The New Humanitarian puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Find out more at www.thenewhumanitarian.org