The invisible scars of recovery and the path to healing

Recovery in Myanmar is not only measured by what has been rebuilt, but by whether people are able to return to daily life. Many continue to live with the psychological impact of the disaster – fear that disrupts sleep, anxiety that limits movement, and loss that shapes how people make decisions. In this context, mental health and psychosocial support has become a critical part of recovery, helping people regain a sense of stability, reconnect with others, and rebuild their lives.

In a small group session in Mandalay, Daw Khine had been asked to draw her face, then crush the paper into a ball. Slowly, she was asked to unfold it again.

The cracks and creases remained, but her face was still there. “I realised how much I had been holding inside”, said Daw Khine.

When the earthquake struck last year, she ran as her wooden home collapsed behind her. She survived. But long after the shaking stopped, the fear stayed. “I couldn’t sleep. My mind always went back to that moment,” she said.

For many across central Myanmar, recovery has not only been about rebuilding what was destroyed. It has also meant living with what cannot be seen. Sessions like these, supported by organisations including the United Nations Office for Project Services (UNOPS) and funds managed by the agency, and local partners, have created space for people to begin processing their experiences after the earthquake.

When recovery is not only physical

In Mandalay and Sagaing Regions, where the earthquake caused widespread destruction, the demand for mental health and psychosocial support has not faded with time. It has grown.

In many communities, however, speaking about mental health is not always easy. Emotional distress is often kept private, discussed within families or not at all. For some, seeking support can simply feel unfamiliar.

“It has been one year since the earthquake, but more people are now coming forward to seek help,” said Daw Su Su, a volunteer supporting affected communities. “Even now, I still see fear and concern in people’s eyes.”

Aftershocks continue to trigger memories of the disaster. For some, the ground no longer feels stable – even when it is.

“When people come to us, we first try to help them feel safe,” she said. “If they need more support, we provide counselling or refer them for further care.”

These services, supported by organisations such as the World Health Organization (WHO) and its partners, have expanded access to mental health care in affected communities.

But recovery, she explains, is not only about trauma.

In the aftermath of disasters, mental health support is often less visible than food, shelter or livelihoods assistance, but no less essential. Without it, many people struggle to return to daily routines, to work, or to care for their families. Fear, anxiety and grief can quietly shape decisions, limit movement and affect whether people are able to rebuild their livelihoods at all.

In communities already facing financial strain, these pressures are often compounded. When families are focused on immediate needs such as repairing damaged homes, finding food, or restoring income, mental health care is often pushed aside, even as the stress of those same pressures continues to build.

This kind of support is often delivered by international organisations, local volunteers, organisations and community groups who remain embedded in affected areas long after the immediate response has passed. Their role becomes more important over time, as needs shift from emergency assistance to longer-term recovery. For many communities, these are the only services available in providing consistent, accessible support that helps people regain stability and continue rebuilding their lives.

Balancing recovery and daily survival

For families already living with financial strain, emotional recovery is closely tied to daily survival. Ei Ei*, a mother in Mandalay, spends her days working to support her household. Since the earthquake damaged her home, the challenges have only increased.

During the rainy season, water leaks through the roof. Repairs are slow, constrained by what she can afford. At the same time, she has had to find ways to care for her children while earning an income.

“The Child Safe Space has been very helpful for both my children and me,” she said. “While I am working, they are in a safe place where they can learn and spend time with others.” Without that support, working consistently would be difficult for Ei Ei.

Child-friendly spaces like these, supported by organisations like WHO, and complemented in some areas by initiatives such as UNICEF’s recreation kits, provide structured environments where children can learn, play and begin to recover.

For her, the support is practical as much as emotional. It allows her to work, knowing her children are safe. “My children enjoy going there,” she said. “As a mother, I want them to feel safe and happy.”

For children, recovery often takes a different form.

Inside these spaces, support something goes beyond supervision. Through structured activities, drawing and play have become ways to express experiences that are difficult to explain. Images of broken homes and dark shapes appear on paper, fragments of memory, translated into something visible. While some images are not always easy to interpret, it offers a way for children to process fear, regain a sense of normalcy, and begin to make sense of what happened.

Similar activities, supported through programmes including those implemented by UNOPS  and funds managed by the agency, and partners, have helped children express and process their experiences in safe and structured ways.

Regaining independence, step by step

Recovery takes many forms – from returning to work and daily routines, to adapting to new physical realities.

In Sagaing Region, U Sein lost his right hand when the building he had taken shelter in collapsed during the earthquake. For a farmer and head of household, the loss affected every aspect of his daily life. With emergency health care services and support, he received a prosthetic hand.

“I am not ashamed anymore about my lost hand,” he said. “Before, I always tried to hide it.”

The change has allowed him to return to daily activities and continue supporting his family. For him, recovery meant being able to work again. But just as importantly, it has restored a sense of confidence.

Across affected areas, similar support has helped people regain mobility and independence, whether through rehabilitation services, assistive devices, or community-based care. For Daw Aye Aye*, a 70-year-old survivor, receiving a wheelchair meant being able to move again after her injury.

“Before, I could go to the market and support my family,” she said. “Now it is difficult. But the wheelchair allows me to move and visit my neighbours. It makes me feel more alive.”

Across these experiences, recovery is not only about rebuilding homes or restoring income, but about regaining the stability that makes both possible.

“What happened has already happened,” Daw Khine said. “Now I must focus on living.”

She still thinks about the piece of paper, the one she crumpled and unfolded. The creases are still there. But over time, she says, they become easier to carry.

*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, 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.