Shortages and hesitancy driven by distrust of authorities and China hobble vaccination campaigns in Southeast Asia.
Van Thawng Thawng’s phone buzzed as a series of notifications lit up the screen.
“Has anyone spoken to Ezekiel?” someone was asking in the Chin Student Union Facebook group, an organisation representing students from Myanmar’s northwestern Chin state. But no one had heard from the 20-year-old union leader.
A week later, on April 14, a friend called Van Thawng Thawng to tell him that Ezekiel’s body had been found.
They believed he had been beaten to death by security forces. Van Thawng Thawng was devastated.
“I just feel really stressed and angry, especially towards the military. Because Ezekiel is not the only one,” said Van Thawng Thawng, a former Chin student who serves as the general secretary of the same union. “One of my classmates was detained and another was killed trying to save his sister at a protest, and my mom, uncle and grandmother have all died in the last few months.”
While Van Thawng Thawng’s mom passed away from a long battle with cancer, he believes his uncle and grandmother both had COVID-19 given their symptoms but with limited testing he doesn’t know for certain.
“Everyone is dying and everyone is feeling depressed. It’s hard to comfort people and make them feel better.”
Across Myanmar, young people are reporting feelings of anger, sadness and helplessness following the military’s power grab on February 1 and its brutal suppression of anti-coup protests. They say these feelings have only increased since July when COVID-19 cases exploded in the country.
Today, many are struggling with the grief of losing loved ones to disease and violence.
Yet, forced to grapple with more immediate dangers like basic safety and access to medicine, attention to mental health has taken a back seat. But experts say the psychological toll is becoming impossible to ignore as rates of depression and suicide rise.
‘Hopeless and helpless’
Mental health in Myanmar has long since been a taboo topic, with depression and anxiety believed to be signs of weakness that should be handled privately. But with mental illness on the rise, counsellors are worried about the consequences if mental health continues to be pushed aside.
Cherry Soe Myint is a freelance counsellor in Myanmar’s largest city, Yangon, working in collaboration with the Applied Mental Health Research Group at Johns Hopkins University. Having recently lost her father and aunt, she has experienced first-hand the mental health impact that the coup, and now COVID-19, has had in Myanmar.
Recognising the severity of the crisis, she has been offering counselling services free of charge to those who cannot afford to pay for professional help.
“When I talk with my clients, I notice their suicidal rates because they are hopeless and helpless. They are thinking that they have no future, that they can’t overcome this really troubling situation, so they think about killing themselves,” said Cherry Soe Myint.
“One young woman, her aunt and grandmother passed away at the end of July and she thought they died because she didn’t do enough to save them. She hung herself. And this kind of event is increasing – the suicide risk is increasing.”
She noted that since the coup, seven out of every 10 patients she treats express suicidal intent, whereas, before the coup, there were only two or three cases every three months.
Only last week, in an incident that was shared widely online, five young people, four men and one woman jumped off a building in Yangon to escape a raid by security forces. It was later confirmed that two of the five had died.
For many Myanmar people, deep-seated fear of the military stems from experiences that they have either had or heard about under the previous military regime that controlled the country for nearly 60 years until 2010. Even for today’s Generation Z that grew up in a more democratic Myanmar, the fear of another decades-long fight against the same military forces looms large and has triggered an onslaught of mental health challenges.
“Our grandparents and parents already fought this and spent years in prison or passed away. If this isn’t over yet, is it going to be the same for us with decades more of military rule?” asked Phyu Pannu Khin, a member of the Myanmar diaspora in the United States and a PhD candidate in clinical psychology who has been offering mental health services online to those in Myanmar since the coup.
“There’s an intergenerational trauma and a loss of future and hope. For our [younger] generation, we have experienced relative freedom under the civilian government – we have tasted freedom and we had dreams, so it’s especially devastating now that this has all been taken away.”
COVID-19 and a lack of resources
The return to military rule is not the only source of depression and anxiety in the country.
While Myanmar managed to keep COVID-19 at bay during the first year of the pandemic, cases quickly began rising in July when a third wave hit. To date, 14,499 COVID-19 related deaths have been recorded but the real number is believed to be much higher.
Given the lack of resources, with hospitals closed and the military hoarding medicine and oxygen, a sense of helplessness has triggered an uptick in survivors’ guilt as the population struggles to save loved ones who are injured or sick.
“With COVID-19 people are asking for oxygen and medical treatment but are not receiving these essential things. We are seeing our family members dying in front of us and most people are self-blaming and feeling guilty,” said Cherry Soe Myint.
“Even though I am a mental health specialist and I know how to cope, I am also feeling survivors’ guilt, but I try and change my thinking. Why do I need to live? Why did my father pass away? It wasn’t because of me but the situation in the country.”
Cherry Soe Myint, along with other mental health professionals, has been trying to instil this kind of thinking among their patients through virtual therapy sessions, but she said there is only so much that can be done amidst security risks, unreliable internet, and COVID-19 restrictions.
While grief from the violence and COVID-19 are felt by all, experiences among different groups are distinct.
For young women, the fear of being stopped by a soldier and taken to a detention centre triggers particular waves of anxiety due to extensive reports of sexual violence, particularly against women from ethnic and religious minority groups.
“I am afraid of what soldiers might do to me. I think about that when I interact with soldiers all the time, especially at checkpoints,” said Thet, a young, ethnic activist in Yangon, holding back tears as she spoke. She asked to use only her first name for fear of retribution.
“During the day when I’m keeping myself busy I don’t feel it as much, but it’s in the quiet moments, especially at night, when things can get very difficult for me. I have very bad insomnia now. I can only sleep three hours at a time before I wake up.”
Thet is not alone. With regular evening raids and internet blackouts, nightfall has become an especially scary time of day for most people across Myanmar, with many experiencing similar anxiety and insomnia.
As a collective understanding has arisen from this shared grief and trauma, some have noted a greater openness towards discussions on mental health and more support for those who seek out help. Resources shared on social media as well as webinar training and therapy sessions have expanded in the last six months, allowing those in need to receive assistance.
However, for the vast majority, especially those like Van Thawng Thawng in rural and ethnic areas, the prevailing traditional views on mental health continue to prevent those struggling with mental illness to get help.
“If there were mental health resources in Chin state, it would be very nice, but in the entire country, Myanmar people, even now, are still not used to opening up and going to a therapist like in Western countries,” explained Van Thawng Thawng.
“Things are getting better with more people offering to help lift depression. But people are still not aware of it, not used to it. It will take time.”