Travelling clinics serve as rare source of aid in war-torn Rakhine State

Aung Lin lay awake all night, unable to sleep from the influenza wearing down his body, wracking his joints and muscles with aches. The medicine he had taken earlier did not seem to be offering any relief or comfort, and it was not the illness alone that kept him awake. In the distance, he could hear the thud of heavy artillery shells falling through the darkness. “We have no options anymore. There is no good medicine left for us,” said Aung Lin, a social welfare volunteer in his 50s, living in Rakhine State’s Kyaukphyu Township. To ease his symptoms, he could only find some paracetamol tablets that had expired last year. It was the only practical choice available in his hometown of Kyaukphyu, which has been under siege by anti-regime forces led by Arakan Army (AA) since early 2025. The hospital in Kyaukphyu, he said, is grappling with major challenges due to the shortage of healthcare workers, constant power outages, and a paucity of essential supplies as well as medicines. While they have neither the resources nor numbers sufficient to compensate fully for the grievous deficiency in medical supplies and services, healthcare volunteers in Rakhine State have not given up on helping where they can. The volunteers have established mobile clinics, facilities they can set up in makeshift tents in areas where the health ministry run by the AA’s political wing—the United League of Arakan (ULA)—has yet to reach. Volunteers can also pack up the makeshift clinics for efficient travel, then follow or go to the displaced people in the state who are most urgently in need of care. Even these small efforts can make a vital difference where no help would be available otherwise, and under conditions that show little sign of improving in the near term, with infrastructural failures making even some lifesaving emergency treatments impossible. “There’s no blood stored in the clinic because of power outages,” Aung Lin said, referring to the clinics’ incapacity to control the storage temperature. “So we always have to get it on short notice in an emergency.” Patients often had to bring solar-powered lamps with them because of the constant blackouts, he added, noting that the township’s residents had also endured considerable hardship due to persistent food shortages that had even produced famine conditions in some cases. “Junta administrators said a vessel carrying rice sacks is sailing to us. But it has been over two months and we’ve seen no sign of the ship,” Aung Lin said, before adding, “No help is in sight and the war is drawing closer.” Aung Lin is not alone. No matter where he goes in war-torn Rakhine State, he says, thousands of people face similar challenges and uncertainties aggravated by the collapse of an already fragile healthcare system. Kyaukphyu is on the northern tip of Ramree Island, a 520-square mile tract between the brackish waters off the Rakhine State coast and the Bay of Bengal. Around 50 miles southeast of Kyaukphyu by road, also on the island, is the town of Ramree (Yanbye), which has suffered wholesale destruction amid incessant battles, with nearly every house sustaining significant damage. Although Ramree has been under the control of the AA for more than a year, residents’ lives are full of uncertainty as they try to rebuild what had been shattered by the ongoing war in Rakhine State. “Everything is incredibly difficult right now. We are barely still breathing,” a displaced woman from Ramree Township in her early 20s said. “Some families can’t even afford to buy a packet of paracetamol tablets when they fall ill.” War in Rakhine State Rakhine State’s humanitarian crisis is chiefly the result of the ongoing war in the state, which began when the AA launched a sweeping offensive in November 2023 aiming to take full control of the state from Myanmar’s brutal military dictatorship. The state, which comprises 14,000 square miles on Myanmar’s Bay of Bengal coast, shares borders with Bangladesh and India. Much of this territory is now under the control of the AA, which has seized 14 out of 17 townships from the military regime in the 19 months since the offensive began. The AA has even managed to take over the military’s Western Regional Military Command—one of fourteen such headquarters throughout Myanmar—in the town of Ann. However, battles are still raging near areas under the military regime’s control, including the state capital, Sittwe, and Kyaukphyu Township, the site of multibillion-dollar development projects backed by Chinese investment on the north end of Ramree Island. Since the present conflict between the military and AA escalated in late 2023, all healthcare services—including access to vaccinations for infants and pregnant women—have been disrupted by a regime blockade on the flow of medicines and other necessities to areas controlled by the AA. Displaced people served by medical volunteers at a makeshift clinic in Rakhine State’s Ponnagyun Township (Photo: Supplied ) Local volunteers attributed the healthcare crisis in war-torn Rakhine State to several causes, including the scarcity of healthcare workers, medicines, and other necessities for improving the physical and mental wellbeing of displaced, impoverished, and malnourished civilians. “There are no medicines for people with tuberculosis, thyroid disease, or HIV. And every kind of shot, including antivenom and the tetanus vaccine, is unavailable,” a displaced man from Taungup said. The crisis of inaccessible treatment is acute enough that its effects are not limited to the poor and displaced. Volunteers attributed the death of Hla Soe, an official in the AA/ULA and former member of parliament of the Rakhine National Party, to the inadequacy of medical facilities in Rakhine State. Hla Soe died after travelling to India to seek treatment that he could not access at home. The AA has reopened hospitals in certain areas and resumed basic medical services, allowing providers to offer free consultations and treatment. However, the patients themselves are still required to cover the cost of medicines at their facilities, a burden most can no longer afford. The difficulty is not only the result of the conflict, but also of its disruptive effects on work opportunities in the state, which have left many families without the budget to afford treatments, according to a volunteer who visits displaced people’s camps in Kyaukphyu and Ramree townships. “Emotionally, they’re drained. Their mental strength has been wearing down over the years,” he said of the displaced people. “Most of them are living hand to mouth, working in fields or cutting down trees for firewood.” Even with the AA trying to restore services, demand for care in the territories under the ethnic armed group’s control is outpacing capacity, locals said. Displaced people in AA-held areas say medical services are very limited. One or two hospitals at most, serving a population of tens of thousands, are equipped with essential medical devices. “There is only one hospital offering CT scan services, and two facilities providing eye and dental care,” the man from Myebon Township said. Moreover, travel to these ill-equipped medical facilities, many of which may not even have the capacity to provide the needed treatment, is usually arduous and risky. Clinics and hospitals are not only scarce, but are often only accessible by boat, requiring patients to brave storms and turbulent seas to reach them. “It takes a day to reach the hospital from Ramree Township,” said the volunteer, who is in his 30s. “Some people from Pauktaw Township have to stay in the boat for six hours to get there.” “Elderly patients and those who cannot visit clinics without the help of caregivers are unable to access AA-run hospitals,” he added. In addition, patients with chronic illnesses who require long-term hospital care said they no longer feel safe under the constant threat of military airstrikes and have become reluctant to seek that kind of treatment far from their homes. “Some say they would rather die from their illness than be killed in an airstrike,” a woman from Ramree Township said. The hope offered by mobile clinics, and its limits Aware of the urgent deficit of health facilities in medicines in neighbouring townships, local volunteers in Ponnagyun Township—some 10 miles northeast of Sittwe—and southern Rakhine State’s Thandwe Township have started providing health services to the displaced far from AA-operated facilities. Volunteers from Ponnagyun have set up a community clinic in a makeshift hut, where they treat patients and share basic medical knowledge with young people in need of care. “Some have had to sell everything they own just to afford treatment. It is difficult for them to even treat minor health problems,” said Zin Myo, a spokesperson for the mobile clinic in Ponnagyun Township. Once a month, the Ponnagyun volunteer team travels to areas where the AA’s health department has yet to establish a permanent presence, services that are especially in demand in the communities of displaced people uprooted by the constant clashes. The team is also working to open its second essential services clinic in Kyaukphyu Township with support and donations from both Rakhine people still in Myanmar and the diaspora. “We are planning to open a new clinic, since right now we can only visit displaced camps once a month due to limited supplies,” said R Gree, a local musician and co-founder of the mobile clinic. According to the team, some 20,000 displaced people are in urgent need of medical care in Kyaukphyu Township. Outbreaks of skin disease and diarrhea due to a scarcity of clean water have also created an especially acute need for basic treatments in Mrauk-U, Buthedaung and Sittwe townships, they said. The volunteer group in Thandwe Township offers both food and medical supplies to a relatively new displaced population, forced to flee their homes amid especially fierce fighting in Rakhine State’s south in recent months. However, their efforts have been limited by harsh weather conditions during the monsoon season. “We’ve halted our mobile clinic service at the moment due to the heavy rain,” a volunteer from Thandwe Township said. While waiting for the weather to improve, the team is using the donations it has already received to stock up on medicine, a task made difficult by the limited flow of supplies from the state line. Blockades have left many in Rakhine State with little choice but to buy necessary goods like medicines on the black market. Even then, the black market supply—mostly brought by boat from India and Bangladesh—is nowhere near enough to meet the needs of the wider population. “Some medicines for treating minor illnesses are allowed to pass through the restricted border route from Paletwa,” said a man from Taungup Township, referring to an AA-controlled town in Chin State on the Bangladeshi border. These limited supplies, however, have done little to remedy the deepening healthcare crisis in the state, where treatment and basic preventive care remain out of reach to thousands of struggling, displaced people.

Travelling clinics serve as rare source of aid in war-torn Rakhine State

In a state where clashes, blockades, and mass displacement have put essential health services and medicines out of reach for thousands, mobile health facilities are providing a modicum of relief

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