‘The military were very surprised when I joined the revolution’ — Myanmar’s NUG Health and Education Minister Zaw Wai Soe

Subscribe to the Myanmar Now daily newsletter. It's free. Sign up > An internationally trained specialist, Zaw Wai Soe was a trusted physician to the highest echelons of Myanmar society before the 2021 military coup. Prior to becoming a minister in the National Unity Government (NUG), his patients included Aung San Suu Kyi and the family of former dictator Than Shwe. In 2005, Zaw Wai Soe was on duty when victims of three simultaneous bomb blasts inundated Yangon General Hospital with hundreds more emergency patients than it could handle. This led him to champion the establishment of Myanmar’s first emergency medicine system, which was supported by the military regime then in power in its bid to meet the requirements of hosting the 2013 Southeast Asian Games. Zaw Wai Soe is also a pioneer of spinal surgery in Myanmar. Having served as head of Yangon’s University of Medicine 1 and 2, Zaw Wai Soe took on a leading role in educational reform under the government led by the National League for Democracy (NLD). When the military seized power in 2021 he made the decision to join the Civil Disobedience Movement (CDM), leading thousands of medical professionals in opposition to the junta. In conversation with Myanmar Now, Zaw Wai Soe discusses why medical professionals have been at the forefront of the resistance movement and the current situation of CDM healthcare workers. Myanmar Now: How was it for you to work so closely with members of the military government and also with Aung San Suu Kyi? What was your impression of the top military officials? Zaw Wai Soe: In the UK I had trained in traumatology, joint replacement, and spinal surgery, very few doctors in Myanmar could manage these kinds of cases. That’s why I was very popular. In 2004 a family member of a senior general had a spinal injury in a serious accident. It could have caused paralysis. I took care of them and came to know the family and other groups of [military] generals. The patient recovered and the family donated around US $1 million to build a spinal surgery unit in Yangon Orthopaedic Hospital, including a three-story building. After that, I was very popular among the generals’ families. Aung San Suu Kyi was released from house arrest in 2011. In December 2013, I operated on her feet for minor orthopaedic surgery. I advised her to go and have surgery in England, but she wanted to have surgery in Myanmar with me. At that time [it was the] Thein Sein government. I had to inform them because I was government staff. After the surgery, I told her, please don’t do too much. But she went to the Chin hills for her campaign immediately after the stitches [were taken] out. Around that time, I had to see her every day. We discussed education, healthcare, and nutrition, and her meditation. She told me about her Mom, Daw Khin Kyi, and her family. In 2018, I was elected as the chair of the Rectors’ Committee for 164 universities for higher education reform during the Aung San Suu Kyi-led NLD government. I had to go almost every week to Naypyitaw. After the retirement of Than Shwe, I was a family doctor for them [his family]. Whenever I went to Naypyitaw, they organised my accommodation, transport, and food. I visited him almost weekly. [Than Shwe] would tell me about his experience, sometimes for two, three hours, about how he built Naypyitaw and how he developed the 2008 Constitution. He wanted me to be on the Union Election Commission in the future. He told me: because you are in the middle, you have to take that position. MN: Between the NLD and the military? ZWS: Yeah, I was in between. Of course, I’m a doctor, no colour, in the middle. MN: Did you have a positive view of the generals before the coup? ZWS: I am going to answer that question [by saying], it’s because of the system, [Myanmar’s situation is] not because of the people. Myanmar people are [all] the same. But because of the system they become dictators. That’s why we are fighting for system change, not for regime change. What we need in Myanmar is a constitution, a federal democracy system. They [the military generals] are human, some are bad, some are not that bad. But because of the system, because of corruption, because of power, they become dictators, their way of thinking is different. MN: Not many people get such a close-up view of both sides. ZWS: Yeah, I was very close to them [the military side]. Actually, they were very surprised when I joined the revolution. Healthcare workers participate in a protest against the coup in Yangon, 2021 (Myanmar Now) MN: So following the coup, why did you choose to join the CDM? ZWS: [During the NLD government time] I was involved in the reform of education and healthcare. [Before] 2009, health expenditure in Myanmar was $1 per person per year. $1 means you cannot buy medicine for the people. Our healthcare standard was one of the poorest in the world. As an orthopaedic surgeon, I want good equipment and operating theatres. We had to use second-hand equipment and implants donated from Western countries. We don’t want to go back to the dark ages. When the coup happened, I was the most senior person [looking after] Covid-19 control in Yangon. I was preparing for the third wave, thinking about what to do [in response to] the coup. On the third or fourth day, my juniors joined the CDM. They wanted my opinion regarding Covid-19 control and what would happen if they continued the CDM. That caused a dilemma and a lot of stress. But I knew that with the military we could not manage [the healthcare situation well]. [Under the military] our child mortality rate was one of the highest in the world, also the maternal mortality rate. I was taking these things into account. Because of the [period of] democratisation, our level of healthcare and standard of education was getting better. If we go back to military [rule], we go down again. I decided to join the CDM movement on the 8th of February. I announced my university as a CDM university. Since then I haven’t been able to go back to my house or my family. I’ve been in hiding. MN: When did you become NUG minister? ZWS: After joining the CDM I made contact with politicians who I knew, [including] Ko Jimmy, Daw Phyu Phyu Thin, and Min Ko Naing. We set up a Zoom meeting on 14th February. They taught me about politics. I remember Ko Jimmy saying, “You have to be resilient. Politics is a very tough job for you. Not like medicine, we are going to compete with the military who have the power to pressure [us].” When we formed an acting government on 2nd March [2021], I was appointed as a Minister for Health and Education, Immigration and Labour. When we formed the National Unity Consultative Council (NUCC) together with ethnic leaders, we divided into two groups, one group writing the Federal Democracy Charter, one group managing the strikes and the CDM. I was assigned to organise and promote the CDM. MN: How have you found it transitioning from being a doctor into this political role? ZWS: I think it’s not that different because medicine is problem solving. I have experience in disaster management like bomb blasts and floods. Now the NUG is managing the military-made national disaster. We also have clinical auditing in medicine. Each morning, we have to do an audit of what we did yesterday and make any corrections. We have to admit what we have done wrong. We are doing the same thing now in the NUG every day: PLAN – DO – CHECK – ACT. A doctor has to listen to his patients. Now, we are listening to the people’s voice. We are also managing time zone differences. [Sometimes] you have to get up in the early morning, 2am or 3am. For me, it’s no problem. In orthopaedics and traumatology, you have to work 24 hours. MN: Why do you think that medical doctors have been so much at the forefront of the protest and the CDM movement since the coup? ZWS: Medical personnel are very close to the people. And, from 2010, the partial democratisation opened the door to the international world. There was hope for the future. MN: Did you notice concrete improvements during that time? Of course, [the] $1 per person per year [healthcare spending] increased 20 or 30 times. Before 2010, in orthopaedic practice we used only second-hand materials, even to repair broken bones. During the democratisation [period] we [could] use brand new. The same thing with machines, imaging, MRI and CT. Before, in the whole country we had only one MRI, but after, we have about 15 MRIs. Our maternal mortality rate, and children’s mortality rate was coming down. We saw this [improvement] in only five to 10 years. We don’t want to go back to poor healthcare standards. We cannot accept that. MN: Do you think that the CDM movement has achieved success? ZWS: Yes. Our CDM roadmap and steps: 1. CDM (refuse any order from junta) 2. Total CDM to stop the junta’s administration 3. Take the administrative power from junta 4. Run the administration and services by CDMers Now we control 77 or 78 towns, and also rural areas. We are taking over and resuming the administrative mechanisms in the country. Now the military cannot rule the country. I think the CDM roadmap is moving forward and we are achieving our goal. Zaw Wai Soe addresses an audience in Melbourne, Australia, in September 2023 (Myanmar Now) MN: In the military-controlled areas now, how are people accessing healthcare? ZWS: Of course, they have non-CDM [staff] working there. But because of the military coup and the CDM, and the division between manpower, they [the government hospitals] don’t have enough manpower, and we also don’t have enough manpower. Healthcare coverage is down to 20–30 percent...we had 80-90 percent before. We are in a fragile position, fragile country, fragile health care, fragile education, fragile economy, not failed yet, but it’s going to. That is why we want to win the revolution as soon as possible. MN: Now it’s three years after the coup. What do you think most of the CDM doctors are doing now? ZWS: You can categorise medical professionals into five groups. One group are now working with the revolution. We have about 4,500 healthcare workers working with us practising medicine. We have 77 hospitals and 257 clinics, and mobile [clinics]. They are working together with the People’s Defence Forces in liberated areas, some in the jungle and in ethnic areas. The second group is the CDM who are in hiding, but they're [unofficially] giving their services. The third group are doing other things not related with health care like [working in] restaurants. The fourth group are those who have gone to Thailand, India or a third country. Number five is working with the military [in hospitals under the junta]. But most of the CDMers have continued the CDM. MN: How do you feel about the final category? Do you think it's a legitimate decision since many people need healthcare in military- controlled areas? ZWS: For the healthcare system and for the people, I’m not happy with that. But the cause is the military. I don’t want to blame healthcare providers, they have their freedom, they have their right, they can decide for themselves. But the junta survives because of non-CDMs. If they do not work for the junta, it will collapse within a short time. But I am happy that most of the people stay in the revolution. That’s why we are winning. But what I expect, I believe, if we win, all the people will come back and work for the country. For non-CDM doctors to come back and work, we need to verify how much they supported the junta. After verification and signing a commitment to the revolution, and keeping the promise that they will never work for the junta, they can be doctors/healthcare workers in the new Myanmar. But we cannot recognise/count the period they worked for the junta. Of course we have a non-CDM policy. Based on that policy, we are going to have a law, we are in the process of writing it. At the moment we have non-CDM management guidelines. They can work in the revolution areas. But we need to verify and screen them because some of them are very close to the military and military supporters. The non-CDM are not our enemies. They are our people. They have to work in the future country. We are not going to take action against them. But [for] senior people, or [those] people who committed a crime, we have to deal with [them according to] transitional justice and transitional law. In 2023 we came up with an agreement with approval from the NUCC. We discussed with different stakeholders and agreed on a CDM policy, [including] human rights. We also consulted with the [NUG’s] Justice Department and international [stakeholders]. MN: How have you integrated the ethnic health care systems with your NUG structures? ZWS: Ethnic healthcare systems were the same as ours, not well developed. After the coup they are relatively better because CDM [staff] moved to ethnic areas. [For example] before we didn’t have a medical school in Kachin State. Now we have Kachin Medical School and a nursing school. Before they couldn’t do head and neck neurosurgery. Now CDM neurosurgeons have moved there. Also, in the Karenni area, our CDM university doctors and medical students moved there. Karenni area healthcare is better than before. This may not be sustainable. Immediately after forming the NUG we formed a Covid-19 task force together with all the ethnic health organisations, including Wa, Rakhine, and Shan. Based on that, we developed the National Health Committee together with [various] ethnic groups. Before the military coup I had never met them before. Now we have been working together. I think this revolution made a lot [of difference to] our understanding. I have never seen that kind of unity in Myanmar before in my lifetime. This is a blessing in disguise. Of course, armed revolution is not good, but before the military coup, I had seen only the view from the centre, the Bamar. Now I’ve seen both sides of healthcare, the government side and the ethnic side. That is also one of the important factors to get international support. We meet together [to speak to] the international development partners. I think our unity can make more donors want to support us.

‘The military were very surprised when I joined the revolution’ — Myanmar’s NUG Health and Education Minister Zaw Wai Soe

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