As political structures in Myanmar shift and UN coordination recalibrates under the UN80 initiatives, so too do the needs of the people. But beyond these changes, this visit laid bare the human realities behind the crisis, ones that cannot be fully captured in reports and numbers.Across Shan State, that reality is visible in everyday details. The first rains had begun to fall, bringing a sense of relief but also a familiar uncertainty, as rising waters can quickly turn into flooding. Movement slows after dark, even in areas without formal curfews. In Nyaungshwe, once a thriving tourism hub on Inle Lake, shuttered businesses and quiet streets reflect the wider national crisis. Yet, communities are finding ways to rebuild in ways that are both practical and transformative. In Pyar Pin village, recovery is being driven from within. A community development committee, more than half of its members women, has become a space not just for decision-making, but for rebuilding trust and cohesion. Small livelihood initiatives tell equally powerful stories. One 73-year-old woman now earns a modest but steady income weaving for a few hours each week, free from middlemen who once controlled the trade. These are more than projects. They are expressions of dignity, and communities are determined to sustain them, and continue to build on the support from the United Nations Development Programme – UNDP. The hidden toll of lives shaped by displacement A different reality unfolds in nearby Kayah State, where conflict has forced widespread displacement. One elderly man shared his opinion of the scale starkly: “the whole of Pekon division has been displaced.” While some families are now slowly returning to Pekon, many still need support to rebuild their lives. His words reflect a broader reality as Myanmar is home to an estimated 3.7 million displaced people, with around 126,000 currently in Shan State, most of them from Kayah.  Despite a strong desire to return, families face a web of obstacles that include ongoing insecurity, landmines and unexploded ordnance, destroyed homes, and the absence of livelihoods or basic services.  “People think we stay because of the assistance, but the truth is we would rather go back home even if our homes were gone,” one displaced woman said.For many, the question is not whether to return, but when, and under what conditions. While some have begun to move back, these returns are not always safe or sustainable or a choice. Communities need security, basic services, and the means to rebuild their lives. When these are lacking, returns risk taking place under pressure rather than as a genuine choice, exposing families to the same—or harsher—conditions that displaced them. Among the most vulnerable are people with disabilities, present in nearly every location visited, some of them very young children. Without access to specialised care and inclusive services, their futures remain precarious, many facing exclusion, stigma, and limited opportunities from an early age. Yet there are signs of what more inclusive approaches can achieve. At the Inle Heritage School, supported by the United Nations Children Fund – UNICEF, children with disabilities, many from displaced families, are accessing education for the first time in environments intentionally designed to meet their needs. These inclusive spaces do more than deliver learning: they affirm dignity, build confidence, and enable children to participate fully alongside their peers.For their parents, seeing their children welcomed, supported, and able to learn has fostered a renewed sense of progress, belonging, and renewed hope.  Rethinking the way forwardOne clear message from the visit is the need to move beyond short-term, project-based responses. In discussions with communities, the Humanitarian Coordinator repeatedly heard community members explained that they do not want to simply receive aid. Instead, they want real opportunities to rebuild their lives: they are asking for opportunities to work, to be more self-reliant and a pathway to long-term recovery. Local partners reinforced this point, noting that when communities are involved in shaping programmes, they help identify what works in their context, what is sustainable, and what restores a sense of agency.At a time when resources are shrinking and needs continue to grow, realities on the ground reflect point to the urgency of a more connected approach. Pressures are beginning to surface. In some areas, uneven aid distribution has strained relationships between displaced populations and host communities. With funding declining, difficult prioritization decisions are leaving some households at risk of being overlooked.All of this is unfolding in a context where access remains limited and uneven. While there have been signs of cautious progress, with some areas becoming more reachable in recent months, limitations continue to shape what is possible. The message is clear: if the United Nations is to effectively support people, it must be able to operate across the country, including in remote and hard-to-reach areas. Beyond opium, where alternate development is making a differenceIn Hopong, located in the Pa’O Self-Administered Zone, and an area that remains difficult to access, alternative development programmes led by United Nations Office on Drugs and Crime – UNODC is partnering with communities to promote sustainable alternatives to opium cultivation, including the development of long‑term coffee farming. 1,127 households from 50 villages involved in this programme are now engaged in coffee production, reporting improved incomes and greater stability. The effects extend beyond economics – migration to Thailand for jobs has decreased, local markets are strengthening, and neighbouring villages are beginning to take interest and are following in their footsteps. One of the farmers said that they now earn ten times more with coffee cultivation than they did with opium.Beyond coffee, other community-led efforts that are beginning to take root. A women’s group established in 2024 is developing bamboo products as an additional source of income, with ambitions to improve quality and expand into wider markets. At the same time, a community forest initiative, managed collectively by local households from the village, is laying the groundwork for longer-term sustainability, both as a future source of timber and to support agricultural expansion. While still in early stages, these efforts reflect a broader shift that communities are diversifying livelihoods, strengthening local cooperation, and building more resilient futures on their own terms.“Time and time again, what people have told us is that they don’t just want support, but a way forward. We are seeing real potential across several programmes but delivering impact at scale means listening to communities and bringing the UN system together to work in a more joined-up way. There is no easy path ahead, but there is a direction that the communities themselves are steering us in, and it is up to us, as partners and donors, to collectively advocate for and invest in the solutions that restore dignity and hope”, said Ms. Lewis, reflecting on her visit. There has been progress in saving lives, in supporting communities to recover, and in finding new and innovative ways to rebuild livelihoods. But these gains remain fragile, shaped by the realities of displacement and uncertainly. What stays with you is that, despite everything, people still believe they can rebuild and they know what it will take to get there.

MAGWAY, Myanmar — When Ei first visited the midwife, she was only two months pregnant. Like many women in Myanmar today, she was carrying more than a child. She was carrying uncertainty — about her health, the cost of care, and whether she would be able to reach a hospital safely when the time came to give birth.When she learned about a local midwife at a clinic in Magway, that uncertainty began to ease.“I have been receiving antenatal care from Sayarma (the local midwife) since I was two months pregnant,” she said. “I also received a clean delivery kit. With her support and referral, I was able to give birth at the hospital. Both my baby and I were safe.”For Ei, the support did not end at childbirth. The clinic also helped cover the costs of going to hospital — a critical lifeline at a time when many families are struggling with rising costs, displacement and shrinking access to essential services.“At a time when many families are facing economic hardship, this support was extremely helpful for me,” she said. “Because of the support from this clinic, I was able to save some costs and, most importantly, I felt safe and reassured.”Her story reflects a wider reality across Myanmar. In a country facing a protracted humanitarian crisis, women and girls are among those most affected by conflict, displacement, economic hardship and the continuing impacts of natural disasters like the March 2025 earthquake. Access to sexual and reproductive health services remains severely constrained by insecurity of health workers, attacks on health facilities, shortages of essential medicines, transportation barriers and protection risks. Myanmar has the highest maternal mortality in South-East Asia, while an estimated 2.4 million women and girls of reproductive age require basic health care services. UNFPA estimates that over 400,000 pregnancies will require life-saving maternal and newborn care in 2026.In these conditions, midwives are not only health workers. They are often the first person a pregnant woman trusts, the first to identify danger signs, the first to arrange a referral, and the first to reassure a mother that she is not alone.“This support is as important as life itself” For Ohnmar Lwin, who is nine months pregnant, the presence of a midwife in the community gives women confidence at one of the most critical moments in their lives.“Having this clinic and the midwife here gives hope to pregnant women like us,” she said. “The clinic has provided us with essential support for pregnancy, including vaccinations, supplements, important health information and everything we need to know.”In emergencies, safe childbirth begins long before labour. It begins with antenatal check-ups, nutrition support, accurate information, birth preparedness, early identification of complications and a referral plan when emergency care is needed.For women affected by conflict, these services can be lifesaving.“For people affected by conflict, this kind of support is as important as life itself,” Ohnmar Lwin said.This year’s International Day of the Midwife, marked globally on 5 May under the theme “One Million More Midwives,” calls attention to the urgent need to invest in midwives as a foundation of stronger, more resilient health systems. Globally, midwives can deliver 90 per cent of essential sexual and reproductive health services, yet the world is short of at least one million midwives. Universal coverage of midwife-led care by 2035 could prevent 67 per cent of maternal deaths, 64 per cent of newborn deaths and 65 per cent of stillbirths, saving millions of lives annually.In Myanmar, this global call has a deeply local meaning: every trained, supported and protected midwife can mean the difference between fear and safety, delay and timely care, risk and survival.A referral that saved two lives For May Moe, a displaced woman from Lashio and mother of a 42-day-old infant, the support of a midwife became critical when complications arose during pregnancy.“I am a woman displaced from Lashio, Northern Shan State,” she said. “Being in an unfamiliar place while pregnant made me very worried about my baby.”Far from home, surrounded by uncertainty, she was able to access care through the support of a midwife. During check-ups, the midwife identified that the baby was not in the correct position. May Moe was referred to the hospital, where her baby was delivered through a surgical operation. “It was through the midwife’s support and care that I found out this was an emergency situation,” she said. “If I had not known, both my baby and I could have been at serious risk.”Her experience highlights the often unseen value of midwifery: careful monitoring, timely referral, technical knowledge of when a pregnancy is no longer routine, and the ability to connect a woman with emergency obstetric care before it is too late.Across the country, UNFPA supports local partners to provide life-saving sexual and reproductive health services in some of the most insecure and underserved settings. This included support for safe deliveries, referral of pregnant women for emergency obstetric care, and distribution of clean delivery kits. In 2025, UNFPA-supported mobile clinics and static facilities reached over 120,000 people in conflict-affected and hard-to-reach areas, with sexual and reproductive health services.Behind each number is a woman like May Moe — a woman who needed care in time, and a midwife who helped her reach it.The midwife as caregiver, protector and guide Daw Khin Hla Win, 70, has worked as a midwife for 33 years. After more than three decades of service, her motivation remains simple: to support pregnant women who have limited access to care.“I want to help pregnant women in hard-to-reach and difficult areas,” she said.She has seen how the crisis has deepened the needs of women and families.“At this time, displaced people, especially pregnant women, need particular support,” she said. “Many do not have enough money even to buy the supplements they need.”The challenges are not only faced by pregnant women. Midwives and health workers are also working under severe constraints, including shortages of medicines and supplies, insecurity, and difficulty travelling during emergencies.“At night, when we are called to assist with childbirth, there are also security-related barriers and difficulties in travelling during emergencies,” Daw Khin Hla Win said.Still, midwives continue to serve. They provide antenatal care, help women prepare for birth, distribute clean delivery kits, counsel couples on family planning, identify complications, support referrals and follow up with mothers after childbirth.In many communities, midwives also play a vital protection role. As trusted frontline health workers, they are often among the first to notice when a woman or girl may be facing violence, distress or heightened protection risks — and can help connect her safely and confidentially to available gender-based violence response services, psychosocial support and referral pathways.For Ei, postnatal care included information on voluntary family planning.“After I gave birth, the midwife also explained family planning methods to me,” she said. “I chose to use Depo, one of the available contraceptive methods.” Family planning is not only about preventing unintended pregnancy. It is about giving women and couples the power to make informed decisions about their bodies, their families and their futures — even in the most difficult circumstances.Investing in midwives means investing in survival of women in the communities The need for sustained funding is urgent. UNFPA Myanmar is seeking USD 15.8 million in 2026 to safeguard and expand life-saving sexual and reproductive health services. This includes a proposed USD 500,000 investment to sustain and strengthen the midwifery workforce, directly supporting frontline midwives and improving the quality and continuity of maternal and newborn care.For communities, this investment is not abstract. It means a pregnant woman can receive a routine medical check-up. A midwife can carry the supplies she needs to save lives. A mother with complications can be referred to the hospital in time. A baby can be delivered safely. A displaced woman can feel less alone. A woman facing violence or distress can be connected to confidential care and protection.Daw Khin Hla Win describes childbirth through a Myanmar proverb: “For men, crossing the river by raft; for women, giving birth.” The meaning, she said, is that childbirth is one of the most dangerous moments in a woman’s life. “Whatever the situation, women must be able to access basic health care,” she said. “For the community, midwives are close caregivers and protectors.”Commemorating this International Day of the Midwife, UNFPA honours the midwives of Myanmar who continue to stand beside women and girls — in clinics, communities, displacement sites and hard-to-reach areas. Their work is quiet, skilled and often carried out under difficult conditions. But its impact is profound.Because when a midwife is present, a woman is not alone.And when midwives are supported, protected and empowered, more women and newborns survive — with dignity, safety and hope.  *This story was originally published on the UNFPA Myanmar website.

Across Myanmar, where overlapping crises continue to disrupt access to essential health services, United Nations agencies are working together to deliver a more integrated, people-centred approach to health. By aligning expertise across sectors – from community engagement and family support to service delivery and system strengthening – these joint efforts are expanding access to life-saving services and helping ensure that even in the most challenging settings, individuals and communities can lead, healthier, more resilient lives. Light in the DarknessIn the quiet, pre-dawn hours of Southern Shan State, the darkness is usually absolute. But inside a newly constructed health clinic, the hum of solar-powered electricity brings not just light, but safety, reliability and uninterrupted health care. For Nang Hom, a mother carrying twins, this clinic was her only option. "In the old facility, we didn’t even have beds", recalls Ma Nang*, a local health worker who has spent years navigating the gaps in the system. “It was just a simple, dusty building where the power cut out constantly," Today, that fear is being replaced by dignity and security. The facility, built by the UNOPS-managed Access to Health Fund with support from a private sector partner. It features wide corridors for disability access and dedicated maternity rooms, along with features that make services more accessible for all patients. "Thanks to the solar lighting, there was no problem even at three in the morning," explains Nang Hom, holding her healthy twins. "We feel safe and well-cared for here”. Building Systems That Communities Can TrustSuch investments in infrastructure do more than improve buildings. When services are safe, reliable and accessible, communities are more likely to seek and receive the care they need.In 2025 alone, WHO supported more than 668,000 people with life-saving medical supplies and enabled over 183,000 individuals to access safe primary and secondary health services through its partners. These figures are indicative of the importance of continued health interventions in Myanmar, where access to care remains constrained and sustainable support is critical in preventing disease outbreaks, managing chronic conditions and saving lives.  The Science of a Stronger HomeThe impact of this unified health approach extends beyond clinical care and into the foundations of family life. In Pinlong Township, this is reflected in the implementation of the UNODC Strong Families Programme, which is a structured, evidence-based intervention designed to strengthen parenting skills, improve communication between caregivers and children, and build emotional resilience in communities facing social and economic stress. Delivered through short, practical sessions, the programme equips parents with tools to support their children’s mental well-being, reduce family conflict, and create protective environments that lowers the risk of substance use and other harmful behaviours. As the UN agency leading efforts on drug prevention, UNODC plays a critical role in the wider health ecosystem. By addressing the root causes of vulnerability such as stress, disconnection and lack of awareness, the Strong Families Programme contributes directly to preventing substance misuse and strengthening community well-being. A mother of three once felt a growing distance between herself and her children. "I used to think that providing food and sending my children to school was enough. But I didn’t know how to really talk to them... or understand what they were going through", she shared.Through the programme, her perspectives began to shift. She discovered that the "science of health" is not confined to clinics, but is also built through everyday interactions, through listening, trust and open communication within the home.Strengthening Continuity of Care While partners like WHO and UNOPS strengthen clinical care and continuity of care through community volunteers, UNODC strengthens the home environment where health behaviours are shaped. Together, these interventions form a holistic system anchored in both medical and psychosocial wellbeing.Building on this foundation, under WHO’s community-led breastfeeding promotion, 252 pregnant mothers of children under two have been supported during the critical first 1,000 days of a child's development. "I learned that breastfeeding is not just feeding; it is protection. Breast milk is the best vaccine for a newborn," says one mother after a WHO education session. These localized, peer-supported sessions are part of a boarder risk communication and community engagement efforts, which reached 4.6 million people with tailored health messaging in 2025, helping communities better understand health risks, adopt healthier practices, and reduce exposure to disease. The Road to ResilienceIn the Bago Region, the challenge of health is often measured by the length of the road and the cost of the journey. For eleven-year-old Su, who is living with HIV, life follows the rhythm of a daily antiretroviral tablet. While WHO helped maintain treatment continuity for 75 per cent of the 290,000 people living with HIV in Myanmar, specialized pediatric services remain concentrated in a few distant centers."It’s not the illness that is hard," explains Ma Win, Su’s mother. "It’s the road to reach the medicine". To ensure Su and others like her don't fall through the cracks, UNICEF and partners support a network of peer volunteers who act as a human bridge to care.  Ko Ko, now 21, grew up on the same treatment and now spends his days comforting younger children who are scared of their HIV diagnosis. In communities where HIV is still stigmatized, this kind of peer support is vital, helping children feel less isolated and more willing to seek and continue care. "He didn’t need a doctor that day. He needed someone who had lived the same life," Ko Ko says of a young boy he recently supported. This same community-based approach contributed to broader treatment outcomes, including sustaining an 85 per cent treatment success rate for over 116,000 people diagnosed with Tuberculosis last year.Myanmar’s health landscape remains deeply fractured by the conflict and requires coordinated approaches thar combine service delivery, community outreach and resilience building. In total, WHO’s Health in Emergencies (WHE) Programme reached over 970,000 people in 2025 (more than half of whom were women), helping ensure that even in the most disrupted environments, essential services remain accessible. By standing with science and acting together, the United Nations in Myanmar is helping to build a health system where access to care is not a privilege, but a fundamental right. From solar‑powered clinics to parenting sessions and peer support networks, each intervention forms part of a connected health ecosystem — one that ensures no one is left behind on the road to a healthier future. *Some names have been changed for safety reasons to protect the identities of those interviewed.This story is informed by field inputs and programme data from United Nations agencies and their partners supporting health assistance and essential service delivery across Myanmar.

After the earthquake disrupted life across central Myanmar, recovery in farming communities is being shaped by the need to start again with limited resources. Many farmers lost not only their homes but also their crops and income at a critical moment in the agricultural cycle. As a result, recovery has often meant making difficult choices: between rebuilding shelter and restoring livelihoods. With the return to planting, and with support providing access to seeds and practical assistance, farmers are gradually resuming cultivation, taking the first steps toward rebuilding both their income and food security.Daw Cho Than stood beside the cracked wall of her partially collapsed house, calculating what she could afford to lose.To repair the damage, she pawned half her farmland – three of the six acres her family depended on. Without it, she wasn’t sure how she would plant the next season.“When the earthquake destroyed our home, I had no choice,” she said. “But I worried about how we would continue farming and support our family.”Across central Myanmar, that same calculation – what to rebuild first, and what to sacrifice – has shaped recovery over the past year.When the 7.7-magnitude earthquake struck on 28 March 2025, it hit communities already living close to the edge. In Mandalay and Sagaing regions, where agriculture underpins daily life, the damage extended beyond homes. Fields cracked, irrigation systems were disrupted and, in the days that followed, heavy rains destroyed crops that were ready for harvest.Across affected areas, livelihoods were severely disrupted, with around 64 per cent of localities surveyed after the earthquake reporting job losses, alongside crop damage and workplace destruction.In some areas, agricultural losses ranged between 20 and 60 per cent, wiping out income at the start of the planting season. For many farmers, the disaster did not just interrupt a season, it threatened the ability to continue farming at all.In Kyaukse Township, Mandalay Region, Daw Cho Than’s monsoon rice harvest provided just enough food to get by, but little else. The loss of her green gram crop meant there was no income to cover rebuilding costs, healthcare or the next planting season.Faced with limited options, she pawned land to repair her home, knowing only too well this was a decision that will take time to reverse. Her experience reflects a broader reality: without access to affordable credit, even basic repairs can come at the cost of long-term productivity.In Sagaing Region, Daw Mar Yee faced a similar pressure. As the sole provider for her family, she needed to repair her damaged roof while continuing to support her husband, who has a disability.“The cash support came at the right time,” she said. “Without it, I would have had to borrow money with high interest just to repair our roof.”In the months that followed, stabilization efforts helped households bridge immediate income gaps, including through short-term employment and livelihood inputs. Nearly 6,000 people were supported through cash-for-work activities, while more than 28,000 people received inputs to restart livelihoods. UN agencies, including UNDP, has supported close to 4,800 cash-for-work opportunities and reached more than 28,000 people with livelihood inputs, illustrating the scale of support provided alongside other partners.Starting again with what is leftFor most people, seeds are easy to overlook – something small, inexpensive, almost incidental. But in farming communities, they are the starting point of everything. Without seeds, there is no planting. Without planting, there is no harvest, no income, and no way to recover.After the earthquake, many farmers had lost not only their crops, but also the seeds they would normally save or buy for the next season. Local markets had stalled, turning what is usually routine into a barrier. For many families, access to seeds marked the difference between waiting and beginning again.In the weeks that followed, some farmers were able to return to their fields as support reached communities, including assurance delivered by the UN agencies such as the Food and Agriculture Organization of the United Nations (FAO) and its partners, providing seeds, basic inputs and practical guidance to restart production.For Daw Cho Than, this meant planting again.Using techniques introduced through training, she cultivated green gram on her remaining land during the winter season. The results were modest but enough to begin rebuilding — saving seed for the next cycle and selling a portion to others struggling to find quality inputs.“The Good Agricultural Practices training and seeds helped me start over again,” she said. “Now I can save seeds for the next season and even sell them when others need them.”The training focused on practical adjustments: how to manage soil altered by the earthquake, conserve water and reduce input costs using locally available materials. In a landscape reshaped by both the earthquake and subsequent flooding, recovery has depended not only on restoring inputs, but on adapting how farming is done. These efforts were part of wider support provided by the UN agencies including FAO and local partners working with 9300 farming households across affected areas. Such efforts have helped thousands of farming households resume cultivation, not replacing what was lost but restoring a degree of stability.Not all livelihoods could be restored in the same way.In parts of Shan State, where support from organizations such as Mercy Corps has focused on restoring mixed livelihoods, families depend on a mix of farming and fishing, the earthquake disrupted not only crops but the tools needed to sustain daily life. For U Kyaw Soe, the loss of his boat engine made it difficult to fish, transport goods and move between places.Replacing it allowed him to return to work more regularly, increasing his daily catch and easing the strain on his household. “The boat engine was urgently needed and has already made a significant difference for the entire family,” he said.For families like his, recovery has meant restoring not only what they grow, but the means to sustain a range of livelihoods. Alongside these efforts, support has also extended to small businesses and skills development, helping people diversify income sources beyond agriculture. Across affected areas, hundreds of people have participated in group-based livelihood activities, business development training and technical and vocational education, while micro, small and medium enterprises have received start-up support to resume operations. UNDP-supported programmes have reached over 700 people through group livelihoods, more than 400 through business training, and supported vocational training and enterprise recovery initiatives.But even with support, recovery has not been straightforward.In some areas, fields were buried under sand or altered by shifting water levels after the earthquake and flooding that followed. In Mandalay’s Yamethin Township, U Thein Min Htet found his rice fields severely affected.“We thought only groundnut could grow here now,” he said. “But with the support we received, we were able to plant again. It gave us hope and a way forward.”Adapting has required more than inputs. It has meant learning how to farm under new conditions. For many farmers, recovery is no longer about restoring previous harvests, but about adjusting to a changed environment.Progress, but still fragileThere are signs of progress.Fields that once lay idle are being cultivated again. Farmers are returning to markets with small but growing harvests. In some communities, seeds are being shared among neighbours, helping others restart production.But recovery remains fragile. For households that lost both shelter and income, progress has been slow and is shaped by limited resources and the need to balance immediate needs with long-term survival.Recovery efforts are expected to scale up significantly in the coming period, with plans to reach up to 150,000 people through cash-for-work and 250,000 through livelihood inputs. UNDP is expected to contribute to a substantial share of this scale-up, alongside continued support for skills development, enterprise recovery and access to finance, including targeted support to small businesses and training opportunities.While these efforts have helped many families begin again, a large number of households continue to face ongoing livelihood challenges, with limited assets, reduced income and uncertainty about future harvests. Continued, coordinated support will be essential to ensure recovery can be sustained and expanded.For Daw Cho Than, the improvement in her harvest is only part of the story. The land she pawned to repair her home is still out of reach.Recovery, she says, is not about returning to what was lost.It is about finding a way forward, with less than before. This story is informed by field inputs and programme data from United Nations agencies, international and national non-governmental organizations and local partners supporting recovery efforts in earthquake-affected areas of Myanmar, including the provision of livelihoods support, agricultural inputs, cash assistance, training and essential services.