In Myanmar’s Kayah, medics treat war wounded in hidden hospitals

Kayah State, Myanmar – When the military seized power in February 2021, Dr Ye was living a life many young people in Myanmar only dream of – working as a doctor in London. Hailing from a military-supporting family, he had given little thought to politics before then.

“Before the coup, I was brainwashed by them,” the 32-year-old told Al Jazeera during an interview in southern Shan State in December. “The coup enlightened me.”

But it also left him reeling with survivors’ guilt. He watched from afar as hundreds of people his age and younger were gunned down in the streets during peaceful pro-democracy protests. Soon, those protests morphed into an armed uprising, with the military deploying mass reprisals against the civilian population.

“For a while, I was donating money, but I wasn’t happy with that. Every morning when I woke up, I was depressed seeing news about the killings, the bombings, the burned down villages,” he said.

At his lowest point, Dr Ye even attempted suicide.

“I decided I had to come back and participate in the revolution physically,” he said.

In April 2022, he travelled to Kayah State, which shares a mountainous border with Thailand. A coalition of anti-coup armed groups has carved out significant territory there and in neighbouring southern Shan.

Dr Ye’s decision to move to this “liberated area” caused a rift in his family because his father is an official in the regime’s prison department in the nation’s capital of Naypyidaw.

“We totally split up, we don’t talk at all any more,” he said, adding that his father had even threatened him with arrest. “I don’t think he’ll ever change his mind.”

His background as a paediatrician made Dr Ye valuable in treating the many children displaced by the conflict, but like all healthcare professionals in Kayah, he is also a temporary war medic.

“I have to stabilise the vital signs, check the blood pressure and heart rate,” he said, of patients brought in after being injured in the conflict.

Raining down bombs

When a resistance fighter was rushed into her clinic in east Demoso with a serious injury to his right leg from an air attack, Dr May got to work despite the buzz of warplanes overhead.

“We could hear the sound of a fighter jet flying over us, but we couldn’t run anywhere because we had to resuscitate the soldier. So, we just had to stay there and accept whatever might come,” said the 33-year-old, who worked as a general practitioner at a private hospital in Mawlamyine before the coup.

“I could work in a private hospital again or go abroad, but if I did that I’d feel like I wasn’t doing my duty for my country, for my people,” she said.

In the first half of 2023, east Demoso was one of the worst conflict zones in the country, and Dr May took to sleeping in a bomb shelter.

“Every day when I woke up, I heard the sound of artillery, and sometimes at 2 or 3am, we’d hear a fighter jet flying over our heads,” she said. “We literally lived beneath the soil in the bunker. We had to sleep there, we had to eat there because we didn’t feel safe on the surface any more.”

When Al Jazeera visited east Demoso on January 4, it was eerily quiet. Fighting had since shifted to Loikaw, the state capital, but few civilians had returned home, leaving the area largely devoid of people.

Dr May said the military targets healthcare facilities because it knows resistance fighters receive treatment there, even though common civilians also rely on them for life-saving care.

“Because we’ve been taking care of our comrades, including war injuries, and that’s not good for these …,” she pauses thinking of the right word. “These dogs.”

Since the coup, people in Myanmar have taken to referring to regime soldiers as sit-kway, or “military dogs”.

The Geneva Convention says that health facilities and mobile health units “may in no circumstances be attacked”.

After months of near-misses, Dr May’s hospital was hit by an air raid in May 2023.

“It felt like I’m suddenly on a battlefield, I’m inside my own coffin, everything flashed before my eyes,” she said. Luckily, nobody was killed, but the inpatient buildings were destroyed.

Dr May’s hospital has since moved to a more stable area in the state and Dr Ye said his facility has also relocated three or four times. Dr Oak, who did autopsies of the victims of the Christmas Eve massacre, said he has had to move twice as well. Once, a missile landed next to his hospital in Nanmekhon in Demoso township. The second time, an air raid hit his facility in northern Loikaw township. Dr Oak was taking a break, using the internet in town, but four of his medics were killed.

For this reason, most hospitals in Kayah are not only hidden but also come equipped with bomb shelters.

On the front lines

When Al Jazeera visited one of these clandestine hospitals in late December, a member of the Demoso People’s Defence Force (PDF) was groaning in his bed.

“It hurts so much I can’t sleep,” he said. The PDF is a pro-democracy armed group with units spread out across the country. The fighter’s legs had been badly injured by an air attack in Loikaw; doctors had already amputated one of his feet.

Half of the 12 patients in the hospital had been injured by landmines in Moebye, a town in southern Shan that is mostly controlled by the resistance. The military seemingly rigged it with explosives before retreating in September 2022.

A 20-year-old woman working as a nurse at the clinic was a trainee nurse at Loikaw Hospital before the coup. She spent six months as a front-line medic for the Karenni Nationalities Defence Force (KNDF), another post-coup armed group, before coming to the hospital.

“I want to help any way I can,” she said, declining to share her name for fear of reprisals. “Nothing is too hard for me to help people, to save people.

Another 20-year-old KNDF medic, who was a high school student when the military seized power, said he must rush into the battlefield unarmed to extract wounded soldiers.

“Our rule is medic, no gun. I see the military shoot my comrades and I want to shoot them so badly, but I can’t,” he said.

In Loikaw town, the KNDF battalion commander overseeing the medical response told Al Jazeera three of his medics had been killed since the resistance launched an offensive to seize the capital in the closing months of last year.

“They send aerial drones to survey the area and if they find us, they send in an air strike, so we have to move around every few days,” he said.

He continues to pray for a peaceful resolution to the crisis but is prepared to fight till the end.

“We always pray for their compassion, that they will see the truth and turn to us and surrender, but they never do,” he said. “So, we have to wipe them out once and for all.”

Despite the hostile and terrifying environment, Dr Ye says he has found unexpected fulfilment and understanding in Kayah.

“I didn’t know much about all the difficulties going on in the border areas because I chose not to, I think,” Dr Ye said. “Before the coup, I wasn’t the only one. Most of the Bamars, we chose not to think about the conflict.”

For decades, Myanmar’s ethnic minorities have struggled under military occupation and oppression, while Bamar-majority areas rarely saw armed conflict. But today, the uprising against military rule has taken root in the central Bamar heartland as well, and many Bamar youths have joined ethnic armed groups in the borderlands.

Dr Ye said it was his “adamant hope” that there would be greater ethnic unity after the revolution. When asked about his plans after the war, he says he will need to help with the “rehabilitation” of Myanmar.

“I used to have so many dreams in London, but I don’t want to think about that because this is my life now,” he said. “My country needs me. Even if the revolution was over tomorrow, I couldn’t go back to London right away because my people will still need me for a while.”