For many families in Myanmar, the cost of health care – if it is even available – can drain a family’s already meagre income. Thinn Yamone, a mother of two young children aged five months and three years, used to work in a toy factory. She now depends on her husband, a mason - but as there is no demand for building jobs during the rainy season (April-October), he can only do low-paying jobs, such as cutting grass. Some days her husband cannot work at all, as he suffers from pulmonary arterial hypertension. “We barely earn enough to live on,” said Thinn Yamone. The impact of the COVID-19 pandemic and the ongoing crisis in the country has pushed an increasing number of families deep into poverty, particularly those living in urban areas under martial law, like North Okkalar Township in Yangon, where Thin Yamone lives. Her family lives in a makeshift home in her aunt’s compound. They have no electricity or running water and must buy water for drinking and fetch water for washing from a monastery, a 15-minute bike ride away. They share her aunt’s latrine. “We had plans to build a latrine of our own, but those plans have been dashed,” said Thinn Yamone. A rapid mini-survey conducted by UNICEF in 2021 on access to basic services in the Yangon townships of Hlaing-Thar-Yar and Shwe-Pyi-Thar found the main barriers to health services included: unavailability of services (61 per cent); financial barriers (30 per cent); and concerns about safety and security in accessing services (17 per cent). [1]   [1] UNICEF survey by phone to 306 household, 31 March to 2 April 2021. Responding to the needs identified, with generous contribution from the Japan International Cooperation Agency (JICA) and Swiss Natcom, UNICEF launched Bright Start in six townships in peri-urban Yangon, which are home to some of the very poorest families. Bright Start – a joint initiative between UNICEF and a private company, Common Health Myanmar, provides innovative, mobile-based innovative primary health care services. The scheme means that Thinn Yamone no longer has to cut back on food in order to afford to take her children to a doctor. “Since I enrolled in the Bright Start programme, I feel reassured that I have a place to turn to if my children get sick,” said Thinn Yamone. “It has really eased my anxieties,” said Thinn Yamone. “My doctor always explains things thoroughly and carefully. She’s patient. It helps reduce some of our worries so we can now focus on making a living.” The scheme includes free 24/7 on-call health services with a doctor, health information delivered via voice and text messages and other channels, as well as the provision of outpatient costs and hospital cash grants for serious illnesses or accidents. Pregnant women are entitled to free ultrasound, blood tests and tetanus shots. There is also a complaint and feedback mechanism. Dr. Thae Myat Cho, who joined Common Health Myanmar in February 2022, says she is monitoring about 2,000 service users. “I even treated a child with scabies,” said Dr Thae Myat Cho. “The family had been using ointments their neighbours recommended, but the scabies became infected, and the child developed a fever. I discovered the whole family had scabies. They recovered after using the antibiotics I prescribed.” To increase digital literacy and overcome communication challenges, Bright Start provides digital support through Viber chatbots. As of June 2022, it has provided free health care to more than 30,000 people, including more than 18,000 children under the age of five and 9,000 under the age of seven.  

Humanitarian needs in Myanmar continue to rise sharply since February 2021 as a result of political and economic upheaval and increased conflict. Approximately 27 percent of the population (14.4 million people) is in need of assistance and more than 700 000 people are internally displaced. Agriculture is a source of livelihoods for nearly 70 percent of the population of Myanmar. The ongoing crisis is compouding the impacts of recurrent climate-induced shocks and COVID-19, posing an enormous threat to the livelihoods and food security of agriculture-dependent communities. Food production is declining, food prices are soaring, and 13.2 million people are already food insecure (compared to 2.8 million before the crisis). Moreover, according to the latest Food Security Monitoring Assessment by the Food and Agriculture Organization of the United Nations (FAO) and the World Food Programme, 16 percent of surveyed households from 14 states/regions across the country do not have sufficient food intake1. In this context, vulnerable households are increasingly resorting to negative coping mechanisms such as the distress selling of their productive assets, which erodes their capacity to manage future shocks. Through SFERA, the Government of the Kingdom of Belgium contributed USD 500 000 to FAO to mitigate the impact of the crisis on the most vulnerable households. With this generous contribution, FAO will provide emergency agricultural assistance to 2 000 vulnerable households (10 000 people) in conflict-affected Kayin and Kayah states, in eastern Myanmar. The intervention will include cash-based interventions to enable food-insecure households to cover their immediate needs. Moreover, FAO will provide the beneficiaries with vegetable production packages to enable them to produce up to 500 kg of nutrient-rich vegetables (worth USD 200 on the local market). The intervention will focus on female headed households (61 percent) and will be implemented during the dry season (August 2022–May 2023).

Ji Taung and Htet Myat Aung, both 22, live in Kachin State, the northernmost state of Myanmar, bordering China. But their life experiences have been poles apart. For the past 11 years, Ji Taung has lived in a camp for internally displaced people (IDPs) with her parents, grandparents and six brothers and sisters. Her family, like tens of thousands of others in Kachin, were uprooted due to protracted conflict. At first, Ji Taung found it hard to adapt to conditions in the camp. “It was suffocating - there were too many people,” she said. “I missed our own home where we raised cattle and farmed. But we adapted to our situation here.” However, the communal unisex bathrooms and the lack of educational opportunities have been much harder for Ji Taung and other girls living in the camp to adjust to. By contrast, Htet Myat Aung has never been displaced and lives at home with his parents and two brothers in Myitkyina, the capital of Kachin State, where his family runs a rice store. Yet in recent years, his family has been facing hardships. “We used to make enough money before the COVID-19 pandemic, but the daily price increases and security challenges worsened our situation,” said Htet Myat Aung. Moreover, like Ji Tuang, his studies were disrupted by the current crisis. “Most of the youths here feel lost and hopeless” The huge rise in security incidents across conflict-affected states in Myanmar has been particularly catastrophic in Kachin State, coming on top of almost 50 years of conflict in the State that has left more than 97,000 people displaced. Girls are particularly at risk of early and forced marriages, trafficking, and gender-based violence, while boys are likely to be recruited into armed forces or fall into the hands of drug dealers. To support adolescents in Kachin State, UNICEF and Plan International, with funds from the Government of Canada, have started a life skills training programme called Champions of Change. The programme provides adolescents and young people like Ji Taung and Htet Myat Aung with eight weeks of curated training and ‘sharing sessions’ on topics like reproductive health, gender equality, and gender-based violence, and soft skills such as confidence building. The programme prioritises vulnerable children who cannot afford to pursue an education. Graduates of Champions of Change are given the opportunity to pursue vocational training that will prepare them to start small businesses or work in local organisations. Ji Taung and Htet Myat Aung were trained with other Champions of Change graduates for leadership roles as facilitators in peer-to-peer knowledge sharing in their community. Since 2021, Ji Taung has been facilitating discussions with pregnant women, mothers and young people. Htet Myat Aung saw for the first time how his peers in the camps have been living, after he became a facilitator. “Unlike our wards, the camps are tightly packed with not much spare space. Each family gets only one room, and it must be unbearably hot in summer,” said Htet Myat Aung. These days Htet Myat Aung visits the camps both to facilitate sessions and to meet friends that he has made there. “I have gained the ability and courage to speak up for myself and others.” Besides helping their peers and communities, Ji Tuang and Htet Myat Aung both say they have been empowered, too. Ji Taung recalls how she and her friends from IDP camps used to be bullied at school, and they were sometimes called ‘exiles’. “I was young and was afraid to stand up for myself,” she said. Now, Ji Tuang said, “I have gained the ability and courage to speak up for myself and others.” She also found the session on gender-based violence powerful. “We have a saying here that a husband beats his wife because he loves her too much, and I learned that it is wrong and it's just domestic violence. It has stayed in my mind ever since.” Htet Myat Aung, too, said he has personally gained from the programme. “I used to believe females were inferior to males and that they'll never become good leaders.” He admitted that hearing about gender equality “was challenging to accept at first.” But he said, “Now, I treat everyone equally with respect.” To date, the Champions of Change programme has benefited over 1,100 adolescents and young people from Kachin State. So far, 700 people have taken part in the vocational training, and 117 of them are now working as professionals.

Thousands of Myanmar families share a typical plight of being stuck in a cycle of conflict, rising levels of food insecurity and protracted healthcare crisis, and many have experienced multiple displacements,  leaving behind their homes, crops, and livestock.  For the first time, the number of displaced men, women and children in Myanmar has exceeded one million, including 700,000 people displaced by the conflict and insecurity since the military takeover in February last year. Host communities who were already struggling to sustain their livelihoods are also supporting those that have been displaced.  The Livelihoods and Food Security Fund (LIFT), a multi-donor fund managed by UNOPS delivers relief, livelihood and resilience programming to vulnerable communities across Myanmar aiming to sustainably improve household food security and community resilience to economic and climatic shocks and stresses. Below are several examples of how LIFT/UNOPS and its partners help support vulnerable communities and households through income generation and employment creation, strengthening of food systems and nutrition support, natural resource management, and community asset creation in a challenging environment   Support for community-based health services LIFT and partners work with local health practitioners, volunteers and ethnic health service providers to strengthen the community-based health services by providing a wide range of integrated health, WASH and essential nutrition services to more than 300,000 people including internally displaced people, the elderly, people with disabilities, migrants, pregnant and breastfeeding women and their children, and adolescent girls.   Cash-for-livelihoods support 38-year old Ma Toe Lwin (name changed) from Mawlamyinegyun has what’s called a ‘strong business intuition’. Knowing that a high fishing season is approaching, she launched a fishing net weaving and repairing business, with cash-for-livelihoods support from LIFT’s partners. Having been in the fishing business since her early 20s, Ma Toe Lwin is able to distinguish the quality of  fishing nets but it was the lack of capital that didn’t allow her to stock nets for trading before the fishing season. With cash support from LIFT, Ma Toe Lwin mobilised a group of women to produce about 100 fishing nets,  in time for the upcoming fishing season so they can be sold to the fishermen. During high seasons, Ma Toe Lwin’s enterprise can employ up to 75 women allowing for a faster production chain. Proceeds from their sales  are shared between the group members while a portion of earnings is saved for future investments.   Agriculture development support “We keep using traditional growing methods and our planting has faced a lot of problems like pest infection and plant diseases. We did not know very well about the proper usage of fertilizers and pesticides, which caused us low yields”, said U Saw. Having struggled for years, U Saw sought knowledge of advanced agricultural techniques that would help him to improve his farm production and support better access to healthy food for his family.  When the LIFT-supported project reached the village, U Saw eagerly joined the training on agriculture to learn small-scale agri-business, good agricultural practices, and plant protection techniques. The practical sessions led him to explore natural composting methods, soil preparation methods and soil pH measurements. “In the past, I used to apply ready-made pesticides on my farm. So, it was costly and I also didn’t wear any protection while I was using chemical fertilizers and I often suffered from nausea and vomiting”.  Saw was convinced of the health benefits of organically grown crops, and he upgraded his farm to an organic farm. “The project supported me with a capital fund and black bamboos which are necessary in cultivating tomatoes. Tomato is the main crop I grow and I had an acre for purely organic cultivation this year. I applied all the agricultural techniques I learned from the training and the capital support of the project also helped me step up my farm. The yield this year has really increased as I expected. I am really happy that my earnings are pretty well and I can even repay all my debts,” said U Saw with a big smile on his face.   The traditional farmer who used the chemical fertilizers in the past is now stepping up as a leading farmer in the area who shares with his peers on Good Agricultural Practices (GAP) that he received from the training. “We need to protect our land and environment by reducing the usage of chemicals so we are introducing organic farming step by step”, a proud and dedicated farmer U Saw said.    Support and assistance for internally displaced persons For Khine Mar, it has been a hard year. His family had to flee their home village to conflict and insecurity, leaving behind their rice fields and belongings. Khine Mar managed to secure a part-time job as a health assistant at the Camp Management Centre while also performing his parental duties such as helping his children with their studies and managing all the house chores with extreme devotion. But as the COVID-19 crisis deepened, Khine Mar lost all sources of income. “It has not been easy for us since the pandemic hit. Some organizations provided us with assistance such as food and essentials, but travel and access restrictions made such support irregular”, he said. So he sought domestic work around his neighbourhood but there was little demand. He thought he had left such uncertainty behind when he fled his home village. Khine Mar was among other residents of the camp to receive a cash transfer of 65,000 MMK, provided by LIFT through its partners as a means to help IDPs cover their most basic food needs or purchase other basic items and services to protect themselves from COVID-19 and its  socio-economic impacts. “It’s the first time I receive such significant support and it was timely and helpful”, said Khine Mar of the cash transfer. He used part of the payment to buy food for his children and is cooking more nutritious meals for his children. By scaling up multi-purpose cash transfer assistance, food assistance in kind and vouchers, cash/food for work schemes, psychosocial support and counselling services for trauma and gender-based violence, LIFT and partners have reached over 131,000 vulnerable people with social protection programmes in 2021 alone.    Supporting small-scale community enterprises “We all joined a dry fish (snakehead fish) production training and learned how to cut fish by removing skin and bones and preserve it without using chemicals. We sell our product locally and online, and then share the profit while keeping 5 per cent of earnings in our group’s saving fund,” said Daw Myint. It takes the group seven to ten days for a full production cycle - from purchasing raw fish to selling the ready product. Each member’s profit is sufficient to cover their household expenses such as food, education and healthcare while savings are planned for investing into other businesses. “Dried fish production is a seasonal business, and we are thinking of launching some farming enterprises too”, concluded Daw Myint.   Relief & Resilience response across Myanmar, including people living with disabilities In 2021, 30 of LIFT’s partners from different thematics and geographic regions utilized $11.6 million USD for Relief & Resilience response to reach about 900,000 vulnerable people including internally displaced persons and people living with disabilities in different states and regions of Myanmar with multi-sectoral emergency aid. It is the hand-in-hand collaboration with partners that enabled LIFT-funded support to help restore and boost resilient livelihoods while strengthening the food security of vulnerable groups.   Nutrition and WASH awareness In Kachin and Northern Shan, over 12,000 women from the most vulnerable households have been part of LIFT-funded nutrition-sensitive activities which included nutrition and WASH awareness, training in home gardening and in-kind support (food and WASH items).   Improving working conditions for women garment factory workers Everyday, hundreds of unskilled women come from rural areas to cities to work in one of over 400  garment factories. Working in a garment factory is often the only possibility for young women from rural areas to earn money and become economically independent, and the income they generate is also used to support the families they’ve left behind. However, working in a garment factory also poses  several challenges for these young women:  while trying to navigate life in a new city without their family, friends and support network, the women also  face harsh working conditions in the factory every day.  In an effort to improve working conditions for women workers at garment factories, LIFT’s partners initiated a pilot to collaborate with a factory to upgrade its infrastructure by building or renovating canteens, toilets and healthcare facilities as well as installing cooling systems to provide some basic comfort and amenities as well as to create a space where the women are able to interact with each other. Though at its very early stage, the pilot has already proved success as workers appreciated improvements and it resulted in higher productivity and higher incomes.