On a stormy night in June, Rosemary was lying in the darkness of a desolate village in Minda Township, Myanmar. The 25-year-old midwife Mai Nightingale tried to suppress her crying. She was facing contractions.

“There are only two of us left in the village. We closed all the doors and windows of the house and stayed quietly inside,” said My Nightingale. “When she feels pain, I will put a blanket in her mouth because we are worried that the soldiers will hear her voice.” Like the others interviewed in this article, Al Jazeera uses the aliases of Mai Nightingale and Rosemary for safety. .

Rosemary’s contractions had started the night before, but as soldiers approached her village in southern Chin State, she and other villagers fled into the forest. But there is no proper place to escape the relentless rain, so Rosemary and MaiNandingale decided to risk encountering soldiers and return the next morning.

“This situation is not conducive to having children,” My Nightingale said. “We saw Burmese soldiers coming towards our village, but we couldn’t turn around because [Rosemary] Already exhausted. “

Rosemary’s husband dared not accompany her for fear that the soldiers would mistake him for a member of the local armed group. Since the military coup on February 1, civil defense forces, mainly equipped with shotguns and homemade weapons, have sprung up across the country to counter the regime, and since May, Mindat has been a hot spot for resistance.

meets the The army has used tactics for decades In order to suppress the armed rebellion and intimidate the people, the soldiers launched disproportionately Attack on Mindat According to local media reports, including the launch of artillery, rocket-propelled grenades and machine guns at residential areas while martial law was being enforced, the town was empty. Young men are particularly likely to be targets.

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Rosemary delivered her child shortly after the soldier’s voice disappeared. My Nightingale cut and tied the umbilical cord with a blade and some thread. For lack of other disinfection methods, she boiled in water. Although Rosemary and her baby are healthy and unharmed, the delivery situation highlights the increasing risks that mothers and newborns face in the escalating humanitarian crisis.

Mai Nightingale and two other nurses interviewed by Al Jazeera are providing maternal and newborn health services to people displaced by the armed conflict. They said their ability to deliver babies safely is severely restricted, and physical insecurity further endangers pregnant women and women. Newborn. Continued violence.

“The main health risk faced by pregnant women and newborns is their lives. They may die during or after delivery, because whenever soldiers approach their hiding place, they must run away,” said a person from Loikaw Township, Kayah State The nurse said her nickname is Smile. “There is not enough medical equipment or medicine…the baby cannot be vaccinated or get enough shelter.”

Collapsed health system

some 230,000 people According to United Nations estimates, it has been newly displaced since the coup.

The military not only attacked civilians, but also cut off food and water supplies for those affected by the conflict, shelled camps and refuge churches for displaced persons, shot and killed displaced people who were trying to get rice from the village, burned food and medical supplies, and an ambulance. car.

At the same time, Myanmar’s health system has almost collapsed, and even women who are ready to risk returning to towns or villages to give birth or vaccinate or treat their babies have little choice.

The ongoing strikes of medical workers amid the wider civil disobedience movement left government hospitals dilapidated, while some medical facilities were completely closed. The military has also repeatedly attacked healthcare professionals and facilities and occupied hospitals.

My mother put her hand on my cousin and prayed.Relying on God’s grace, she gave birth smoothly

Smiling, Burmese nurse

UNICEF Myanmar’s interim representative, Alessandra Dentice, told Al Jazeera that the vast majority of pregnant women displaced since the coup have no access to emergency obstetric care, and routine immunization of children “almost Stop completely”.

“If urgent action is not taken, we estimate that 600,000 newborns will miss basic newborn care each year, which poses a serious risk to their survival and long-term well-being across the country,” she said, adding that approximately 950,000 children also missed out Key vaccination services.

In Mindat, Mai Nightingale has so far helped three displaced women give birth. She said that in the days before delivery, two of them had to continue to move to find a safe place, which caused them physical pain and could cause them to give birth.

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Mai Nightingale knows that providing medical services to pregnant women and newborns without facilities or sanitary equipment is extremely dangerous for women and their babies, and security forces may also target her, but she said she feels This is the only option. “Even if the soldiers can arrest the patient and me, I will continue to help those in need of medical assistance,” she told Al Jazeera. “No one else can help them.”

It is estimated that 100,000 people have been displaced since the beginning of June, and pregnant women in Kayah State are also at risk. On June 8, the United Nations Special Rapporteur on Myanmar warned that due to military attacks and the blockade of food, water, and medicines for people who fled to the forest, the Kayah area will “cause mass deaths due to starvation, disease and exposure.”

Small, a 24-year-old nurse, fled her village Loikaw On June 11, she and her cousin came to town. She was in pain when she fled. “The cannon fell near the rock where we were hiding. That day was [my cousin’s] Deadline, but she could not deliver…We had to flee to a safe place,” said Smile. “When we ran, she had to carry heavy objects. “

Recalling the advice of her mother (also a nurse), Smile grabbed a childbirth kit with rubber gloves, tweezers, and scissors while escaping from the village. “My mother told me that even if the world is chaotic, the medical staff can’t stop,” she said.

She and her mother wiped the equipment with spirits, while her cousin’s husband set up a bamboo and tarpaulin tent under which they delivered her cousin’s child. “My mother put her hand on my cousin and prayed. Relying on the grace of God, she gave birth successfully [heavy] Bleeding,” said with a smile.

But tragedy has already happened to some displaced mothers.

Little time to grieve

In Loikaw town, Khu Meh delivered twins at a local clinic on April 8. In mid-May, Khu Meh fled home with another girl. “We walked very far, moved from one place to another, sometimes sleeping in the bushes,” she said. About three weeks later, the second pair of twins died in the jungle while drinking milk on Khu Meh’s breast.

About 40 kilometers (25 miles) north, in the town of Pekon in Shan State, Mary fled her home in the last week of May, when she had been pregnant for more than seven months.

“The army is firing every night… We are very scared to sleep at home,” she said.

She took refuge in the church, but after being shelled on June 6, she fled to the cornfield again. With the help of a local midwife, she delivered her fifth child, a baby boy, under a bamboo and tarpaulin shelter.

The following week brought endless rain, and Mary’s baby died suddenly. There is almost no time to grieve. A week later, due to the approach of soldiers, Mary and her remaining children had to flee again.

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According to UNICEF data, although Myanmar’s maternal mortality rate and under-five mortality rate declined between 2000 and 2017, it was still the most dangerous place for new mothers and babies in Southeast Asia even before the coup. One of the places.

The maternal mortality rate in 2017 was 250 deaths per 100,000 live births, while the under-five mortality rate was 48 per 100,000 live births.

Since the coup, Al Jazeera has been unable to find data on maternal and infant mortality among the displaced population in Myanmar.

Naw Winnie is a nurse in Demoso Township in Kayah State. She herself was displaced by the fighting. Now she is escaping from a local aid team in the mountainous area as a volunteer.

She told Al Jazeera that it is common for young children to get sick. She has treated dozens of skin infections and diarrhea cases, and is worried that due to lack of clean water and lack of toilets and other factors leading to poor sanitation, health problems will only increase.

The rainy season starts in June, making hygiene more difficult and increasing the risk of colds, flu or mosquito-borne diseases.

Naw Winnie has to take care of more than 10 pregnant women.

She initially planned to send them to a temporary clinic near the foot of the mountain, but during the fierce fighting on June 16, the clinic’s volunteers and patients were forced to evacuate.

Now she is not sure what she will do.

One of the women who had been pregnant for more than five months had given birth by C-section before. Naw Winnie was worried that if she gave birth through the vagina, she might bleed, but it was too risky to have a C-section in the jungle.

“We don’t have safe and hygienic facilities or equipment to deliver babies,” she said. “If I assist in delivering the baby without sanitary facilities, it will put both the mother and the baby at risk.”