Participants demographic characteristics

The study involved the participation of seven camp leaders and ten internally displaced persons (IDPs) from the Chin, Karen, and Kachin states in Myanmar. All camp leaders were male, seven of the IDPs were female, and three were male. To ensure anonymity in direct quotations, the researcher used the identifiers “IDP L1, L2” for IDP camp leaders and “IDP F1, F2” or “IDP M1, M2” for female and male IDP participants, respectively, based on their gender identification.

Experiencing constant fears and anxieties

Since the military coup, armed conflict between ethnic groups and Myanmar’s military has escalated significantly. The military randomly raided several homes and interrogated innocent civilians, particularly at night. Several civilians were killed during the interrogation, and some of their bodies never returned to their families. Military forces use sexual violence against civilian populations as weapons. This poses a specific risk to the psychological health of women and children.

“Since the military has taken control of the state, we are in greater danger and are less secure wherever we go. The military forces have raped women and tortured them to death in many places”- IDP F1.

“At night, we are more afraid of what will happen to us. This is especially stressful if the dog is barked. No one can sleep or know what to do “- IDP F2.

Furthermore, the Myanmar military carried out indiscriminate attacks on unarmed civilians, including the IDP camps. They fear heavy weapons attacks because armed conflicts frequently occur near shelters. Because of this adversity, the mental health and well-being of the IDP population are negatively affected.

“During my wife’s child delivery in the IDP camp, I heard a military helicopter in the sky. I was terrified because I could not relocate my wife immediately to the bunker. I dug to protect myself from military airstrikes. Furthermore, the bunker was not constructed systematically, and as a result, cannot provide us with protection from an explosion if the military attacks us”- IDP M7.

“When we hear the sound of a military jet, we rush into the bunker, much like chickens fleeing into bushes when they see an eagle bird hovering above. Some children were discontent with this situation and cried inside the bunker. My feelings of upset and terror cannot be adequately expressed in the words “- IDP M3.

“Our lives were filled with uncertainty daily. Older adults and children are particularly vulnerable and insecure. There is never a state of calm or peace in my mind. I think about where we should repeatedly flee to safeguard our lives. We live every moment with terror and vigilance in our minds”- IDP F5.

This indicates that the military actions have significantly worsened the precarious living conditions and insecurity among IDPs in Myanmar and instilled a constant fear for their safety. Moreover, participants have expressed deep concerns regarding the heightened vulnerability of children and women in the aftermath of the military coup. The pervasive fear of being targeted and attacked persists among them. Tragically, the history of sexual abuse perpetrated by the military, such as the cases of rape and killings of women in different regions, including the Rohingya women in Rakhine State in 2017, further exacerbates their Challenges.

Precarious living and infectious disease

Many displaced persons were newly displaced, living in precarious conditions in the jungle because of armed conflicts after the military coup. A Chin State camp leader overseeing approximately 140 IDP houses reported that hazardous living conditions and unsanitary drinking water caused many health problems.

“Currently, we are experiencing many difficulties. Our camp is constructed from anything we can get in the jungle, such as banana leaves. When it rains, our tent does not protect us from downpours. Furthermore, forest steam was used as the drinking water. The water became dirty and muddy after the rain. However, we were unable to obtain clean drinking water” IDP L1.

Participants from different locations report similar circumstances and hygiene problems.

“Many of our people suffer from stomach problems and numerous illnesses due to the lack of a hygienic toilet along with unhygienic drinking conditions in the camps”- IDP L3.

Furthermore, near the Thai border, another IDP camp leader from Karen State stated that unsanitary water and unprotected shelters put people at a higher risk of contracting various diseases.

“Our location in the jungle is a breeding ground for disease transmission, particularly malaria and dengue fever, caused by mosquitoes. Many people here do not have mosquito nets and have been sick with malaria and dengue fever, including my wife and children. I recovered from malaria IDP L7.

The remaining participants reflected on this situation. Several IDPs took refuge in their local churches and farmlands, while others were trapped in the jungle and fled to neighbouring countries’ borders. They faced numerous challenges, as the military blocked all humanitarian aid distribution from local non-governmental organisations, international organisations, and United Nations agencies. Furthermore, they are not protected from monsoon rain, making them more susceptible to flooding during the rainy season.

Surge of infectious disease and COVID-19 cases among IDPs

The participants in this study reported that they had been living in fear since the military attacked them and had experienced an increase in infectious diseases and cases of COVID-19 in their camps. Old IDP participants in mentioned that they occasionally received health treatment from various non-governmental organisations (NGOs) before the military coup. The military, however, blocked and restricted all humanitarian supplies, including the medical workers of the NGO, from providing medical treatment, support, or protection equipment to IDP communities despite some suffering from COVID-19 symptoms. In addition, the military had arrested some philanthropic health workers who provide informal healthcare to IDPs. Therefore, the elderly population in camps are at a greater risk of contracting COVID-19 because they may have pre-existing health conditions such as paralysis, hypertension, and digestive problems.

“As an older adult living in an IDP camp, I am concerned about the welfare of elderly people. No assistance is available to older people in IDP camps, except for a monthly contribution of 15000 Kyats (9 USD) from the WFP. If patients become ill or test positive for COVID-19, 15000 kyats would not be sufficient to cover the cost of medical treatment. Since the coup, NGO workers have been unable to reach the IDP camps. This puts the elderly population in a more vulnerable condition because they are unable to receive monthly assistance owing to the failure of the banking system and roadblocks caused by the military”- IDP L5.

In particular, the participants in this study from Kachin State reported that many IDP camps had tested positive for COVID-19. They expressed their helplessness because they lacked personal protective equipment (PPE), medicine, healthcare workers, and access to healthcare facilities. This is how the camp in charge of an IDP expressed his concerns regarding a potential outbreak.

“I am afraid for the safety of everyone who tested positive for COVID-19 and the remaining camp members. We cannot perform social distancing and do not have proper handwashing facilities. There are no PPE suits, no medicine, and no vehicles to transport the patient to the hospital”- IDP L4.

With the military attack on healthcare facilities and workers after the military coup, other participants transported the patient to the nearest health centre on motorcycles and tricycles. However, they were denied hospital admission due to overcrowding and the limited number of healthcare workers during the COVID-19 outbreak in 2021. In addition, it was unaffordable for them to go to a private hospital because of higher costs and lack of financial resources. According to some participants, this forced them to rely on self-medication, resulting in numerous deaths owing to a lack of timely medical treatment.

Lack of food supply and substantial risk of hunger

According to the participants in this study, their living conditions have become more difficult since the military coup and the subsequent political turmoil during the COVID-19 pandemic. They face food insecurity and struggle to obtain essential meals on a daily basis. As a result, they are deprived of their daily meals, and their children are already malnourished.

“We were displaced from our homes to save our lives by abandoning everything of our belongings. We do not have anything to eat in the jungle. I cannot express how hopeless I feel now.“ –IDP F10.

“We feed our children anything we can get our hands on. Little bean and rice soup now and again. Life is tough. Our children are malnourished; everything has risen following military takeovers, especially rice prices. We cannot afford to eat rice since a sack costs (40000–50000) Kyats, equivalent to (19 - 23) $ USD. Cooking oil prices have also increased. We do not have a place to borrow money. We die from starvation. ‘IDP F9

On the other hand, some IPDs have lived in camps for over ten years. Before the military coup, they could find daily basic labour to sustain their lives. They received 1,5000 kyats (9 USD) from the World Food Program (WFP) for one household, as well as other support from a variety of donors and non-governmental organisations (NGOs). As the military restricted humanitarian assistance, they experienced food insecurity. However, none of the donors, including those in the WFP, could reach them. The following are examples of how IDPs described their living conditions and vulnerability before and after the military takeover.

“Before the military coup, we could find daily labour to support ourselves. In the current climate of gunfire, heavy weaponry, and deadly pandemics, finding food is exceedingly difficult “- IDP M3.

“Due to the military coup, we have been left with nothing to eat during the COVID-19 surge. We could not obtain a monthly subsidy of 15000 Kyat (9 USD) from the World Food Programme because the military restricted all humanitarian supplies. Every day is filled with agony, as there is no source of income”- IDP F8.

Longing peace to return home safely

The study participants reported that the military coup undermined the hope of the entire population of Myanmar. In particular, the escalating armed conflict following the military coup robbed them of their hope and dreams of returning home.

“If the military coup had not occurred, we might have been able to return to our homes and no longer be uncertain. However, we have lost everything, including our hopes and dreams. People are living in increasingly dangerous and challenging environments. Our current situation is that we do not know where to obtain food, in addition to a constant fear of being attacked “-IDP L5.

I wish to return to my native home. I have never been pleased by this. I am longing for the day when I will be able to return to my old house, even though it is old now”- IDP F5.

In addition, the participants in this study were concerned about returning to their homes due to military forces stationed in civilian schools, churches, and hospitals arbitrarily arresting and killing the villagers and civilians.

“The army has occupied our school and hospital buildings, so we are afraid to return home. Additionally, we learned that the military killed many civilians and arbitrarily arrested villagers. Our lives are in danger if we return home, although we go back home long.“–IDP L2.

“The military kills civilians, even in their homes, and arbitrarily arrests villagers. It is challenging for me to return home, and I am filled with anxiety beyond my word limits “-IDP F9.