Since the violent coup d’état in 2021, Myanmar’s healthcare system has nearly collapsed under the weight of political repression, worker exodus, and escalating conflict. The result is that what was once a robust public service has been transformed into fragmented emergency care provided largely by NGOs such as Médecins Sans Frontières (MSF). Field reports from MSF starkly document what international bodies like the Office of the United Nations High Commissioner for Human Rights, UN Special Rapporteur, and Associated Press have confirmed: hospitals shuttered, key disease programs disrupted, and millions left without reliable care. 

On the other hand, in forcibly returning vulnerable individuals to Myanmar without healthcare safeguards and under the shadow of rape accusations, Indian authorities violate international non-refoulement obligations while also inflicting profound harm on those already under physical and psychological duress. Amnesty warns that this practice “threatens to intensify the health crisis” for Burmese refugees, who find themselves trapped between persecution at home and denial of asylum with healthcare in India.

A quiet yet complex world unfolds in the lush hills and deep valleys where Mizoram, in India, meets Chin State, Myanmar. 

While the official border stretches for 510KM, the boundary feels more like a line on a map than a real division in practice: villages often straddle both sides, and families share bloodlines across nations. The military-led coup of February 2021 brought with it the migration of thousands of people from Chin State, who sought refuge from violence and persecution in Mizoram. The people on both sides are predominantly from the Zo ethnic group, which includes Mizos in India and Chin in Myanmar. They speak related languages, share customs, and follow similar Christian beliefs. This has created a strong cultural bond, even in the face of political borders. Marriages, festivals, and trade are conducted informally across the border. Despite the Indian federal government’s cautious stance, the Mizoram state government and its people have welcomed the refugees on humanitarian grounds, housing them in makeshift camps and local homes. This has created a quiet tension between the Indian central government and the Mizoram state leadership.

In Rikhawdar, a border town in western Myanmar, 52-year-old Thangi experiences first-hand the repercussions of disrupted healthcare and movement. Each month, she embarks on a grueling journey from her home in Rikhawdar to Zokhtwar, a distance of nearly 80 miles, just to get a medical checkup. The trip costs her nearly 70,000 kyats — about $22, a considerable sum in a region ravaged by conflict. Still, for Thangi, the opportunity to get a medical checkup and to hear her husband’s and son’s voices on the other end of a Facebook Messenger call is priceless. This is her small comfort in an otherwise onerous situation.

She looks out of a tiny window in a home stay, facing the heavily guarded border with India. Once a key trading post and a vital escape route for those seeking refuge from the war, the border is now completely sealed off.

The closure of the border has also made it impossible for Thangali, a 28-year-old rebel fighter from the People’s Defense Forces, to get a crucial MRI scan at a hospital in Aizawl, India. Thangali, who was injured during a night ambush whilst fighting against the Junta forces, used to travel to India, almost 200 kilometres because there is nowhere within reach in Myanmar that has a functioning hospital offering the advanced services he needs.

“We used to cross the border to get the care we needed,” Thangali said the next day, his voice weary but steady. “But now it’s too dangerous. With the border closed, we’re trapped—cut off from help. The treatment that once gave us hope is now out of reach, and we’re left to suffer in silence.”

The sudden termination of the Free Movement Regime (FMR), which allowed for cross-border access to essential services between Mizoram in India and the border areas of Myanmar, has plunged his home township of Kale into a healthcare crisis.  Kale Township connects central Myanmar to the Indian border through the Chin Hills, making it a key corridor for both humanitarian aid and displacement movements.

It was in the lead-up to February’s national elections that the Indian government decided to end FMR, allegedly to address security concerns. Unfortunately, it has instead largely just stranded thousands of people and left them in urgent need of medical attention.

"The closure of the border has dealt a heavy blow to our community," said Dr. Lalaramzaua, the only doctor at the RHI Hospital. "We're struggling to handle numerous cases with very limited resources. We rely on our neighbours in Mizoram for supplies and medication. With the border now closed, our ability to provide the care we need is severely compromised.

"In several documented cases, including over 38 individuals deported in June 2024 from Moreh, local authorities reportedly used allegations of rape and other charges—without due process—to justify forced returns.” 

Amnesty International warns that this conflation of unverified crime allegations with border enforcement effectively bars these refugees from seeking vital healthcare in India, particularly for reproductive and mental health.

Among those severely impacted is Malsawm Puia, a 28-year-old from Kale township in Myanmar, battling blood cancer.

Before the border closure, Malsawm Puia received treatment in Mizoram. With the end of the free movement agreement, he now faces an uncertain future as he is unable to access the necessary medical care. "The decision by the Indian government could be a death sentence for many of us," said Malsawm Puia's mother, who accompanied him to the hospital.

 Lalremtluanga, a 28-year-old rebel fighter, was injured in January during a mission.

Initially treated in Aizawl's Greenwood Hospital, he had to leave due to worsening conditions and was then treated at the RHI Hospital. His condition, worsened by a broken leg and concerns about infection, makes it even more urgent to receive cross-border medical support. 

"The situation is dire," said Lalremtluanga. "We lack proper healthcare and medication here. The border closure has put us in a difficult position."

The sudden end of the FMR and the ongoing construction of border fences have left nearly 100,000 residents of Kale township struggling with a failing healthcare system.

The only hospital, already stretched thin by the ongoing conflict and injuries from the unrest, now faces an unprecedented challenge in providing care due to a severe shortage of medical supplies and facilities.

"We have pregnant women and cancer patients here," Dr. Lalaramzaua said. "The lack of facilities means I can only treat basic conditions. The situation is heartbreaking, and we are doing everything we can with the limited resources available."

In terms of maternal health, women face perilous childbirths in Myanmar. Enok, a 38-year-old farmer in Kale township, gave birth to her fourth child at home with the help of a midwife. She considers herself lucky for managing a safe delivery amid the raging conflict in the region. Unable to travel to the hospital for a medical check-up, Enok still can’t obtain postnatal supplements and has to subsist on plain rice. 

“I can’t get enough sleep,” Enok, who used a pseudonym for security reasons, related, “People are so tired because they can’t sleep.”∎