Disease stalks survivors of Myanmar’s earthquake

When the earthquake hit central Myanmar, Ko Ye Ko grabbed his children and sprinted downstairs as his apartment tumbled into little more than a pile of rubble.

With nowhere else to go, the family cobbled together a makeshift shelter on the side of the road. But within a week, that was gone too.

“The wind and rain were so strong that our little tent got completely blown away,” the 42-year-old father-of-two told the Telegraph. “My whole family had to climb into our car but even there, the wind was shaking the vehicle violently. [Yet] we had no choice.”

In the last week, heavy rains and 40C heat have worsened an already grim situation in conflict- ridden Myanmar, where a 7.7 magnitude earthquake struck on March 28. At least 3,500 people died, though rescuers warn thousands more are likely entombed inside their homes, offices, temples and mosques.

But there are fears that another wave of death is also on the horizon.

Survivors have limited access to clean water, food, shelter or medical help, while the hot, wet conditions in the ruined streets and makeshift displacement camps are ripe for outbreaks of diseases.

“Inside the car, the mosquitoes were biting us badly and we’re afraid of getting dengue fever,” said Ko Ye Ko, referring to the debilitating disease sometimes called ‘breakbone fever’.

Daw San Yee, who lost her son when the mosque he was praying in collapsed in the earthquake, said the fear of cholera has become overwhelming in  Sagaing – where locals estimate 80 per cent of buildings were flattened.

“Our tents are soaked, and there’s no dry place to sleep – kids and older people are starting to get sick,” she said. “The lack of water and toilets is a big concern… we’ve heard about cases of watery diarrhea spreading, probably from dirty water. If it turns into a full outbreak, it’ll be really hard to stop.”

The World Health Organization (WHO) has confirmed that their fears are not unfounded: clusters of acute watery diarrhea have already been detected in Sagaing and Mandalay.

“Without proper shelter and sanitation, the spread of illness and disease is inevitable,” said Madara Hettiarrachchi, director of programmes for the UK Disasters Emergency Committee.

“The levels of need are huge and growing, and with [the] monsoon season just a few weeks away there really is no time to waste.”

Yet so far, getting aid on the ground has been hampered by the military regime, and a conspicuous absence in the relief effort: America.

The disaster hit as the US foreign aid apparatus went into turmoil following sweeping cuts and a chaotic reorganisation ordered by Donald Trump and Elon Musk.

“There are no US rescue teams on the ground, and no real US role in the response,” said one international aid worker, who requested anonymity to speak more freely. “That is very, very impactful.”

When a crisis hits, the US would usually deploy Disaster Assistance Response Teams (DARTs) made up of rescue workers with sniffer dogs and specialist equipment within hours, in a race to pull people from the rubble in the immediate aftermath. They would then send in teams to help assess the damage and respond to long term challenges.

In 2023, when a 7.9 magnitude quake hit Turkey and Syria, two military flights with personnel were en-route within 24 hours, before 225 staff were deployed in an assessment team.

Instead when the Myanmar earthquake hit, only 78 people remained at USAID’s Bureau for Humanitarian Assistance. Three people were deployed to help the longer-term response – but just days after they reached Mandalay, they were fired over email in the latest round of terminations from the Trump administration, according to the New York Times.

“The demise of USAID is evident from the rather slow US response and the small initial pledge of $2 million,” said Richard Horsey, a Myanmar researcher at the Crisis Group think tank, noting that this was followed by another $7 million on April 5.

He added: “The US has among the best search and rescue capability globally, but this was not deployed. The fact that a large contingent of Chinese rescuers was on the ground quickly shows what a loss this is for the US in soft power terms.”

Some 135 search and rescue personnel from China, an ally of Myanmar’s junta, were sent to the epicentre of the crisis, along with $13.8m in aid. Russia, Hong Kong and India were also on the ground within days.

Other countries have also funnelled help into the country – including £10 million from the British government, and £15 million raised through the UK disaster emergency committee appeal. Most of this has gone to local NGOs on the ground, to avoid giving money through the military regime.

But America’s aid turmoil has also trickled down to these same NGOs. Before Trump’s cuts the US had been one of the largest financial backers of humanitarian groups working inside Myanmar.

“Partners are stretched,” the aid worker told the Telegraph. “[They are] in cost-cutting mode, [so it is] harder to adapt and mobilise. [And] partners don’t have any contingency budget because they’ve had to re-program everything to cover critical gaps.”

Mr Horsey added: “The bigger gap will be in the expertise and financing that the US would have traditionally brought to the relief effort. With other donors tightening their belts, it will be impossible to fill that gap.

“This goes beyond Myanmar, which just happens to be the first major natural disaster after the decimation of USAID. So this speaks to a soft power loss not just in this particular case, but across the board,” Mr Horsey said.

Earlier this week Marco Rubio, the US Secretary of State, defended his country’s response, insisting the US was “not the government of the world” when asked by the BBC why it has not sent more help.

“There’s a lot of other rich countries in the world, they should all be pitching in,” he said. “We’ll help as much as we can [but] it’s not the easiest place to work… they have a military junta that doesn’t like us.”

Despite declaring a ceasefire, the junta has continued airstrikes, and the UN has accused the regime of blocking supplies into opposition held territory and maintaining internet blackouts that hamper logistics.

In the capital Naypyidaw, aid workers also told the Telegraph they’ve seen “ants swarming over aid supplies” as the junta lacks the logistical capacity and expertise to store or distribute them effectively.

For many in the worst-hit areas, there is now a sense that staying alive, avoiding disease and rebuilding their communities is up to them.

“Right now, there’s no government that actually cares about our well-being,” said Daw San Yee. “So we’re just doing our best with what we know to keep people from getting sicker.”

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