Ethical Science Continues in Myanmar amid Extreme Persecution (by Dr Phyu Phyu Thin Zaw)
Part 1. Scientific Challenges & Repression
Amidst great uncertainty and escalating humanitarian emergencies, a group of brilliant scientists, shrouded in anonymity, and coming from various scientific fields in Myanmar gathered for a mysterious Zoom meeting under various surreal pseudonyms, such as ‘Victory,’ ‘Pokemon,’ ‘Mr. Hulk,’ and ‘Mr. X-man.’ The reason? To address a crucial matter within the scientific community - the establishment of an Ethical Review Board (ERB) for research purposes which would be free from the military’s control and allow for vital research to continue.
These cute sounding pseudonyms were no game, however. On the contrary, this was a matter of life and death. You see, in Myanmar, attending any meeting which is seen as being against the military junta and the coup they launched in 2021 can lead to severe punishment, including mandatory life imprisonment. This chilling reality underscores the vital importance of anonymity, but also the importance of establishing an ERB itself.
ERBs are crucial committees that ensure research projects involving human subjects are conducted ethically. However researchers, both local and abroad, are concerned about undergoing ethical reviews under junta-controlled ERBs within Myanmar. It has become clear that any research that could politically backfire on the military or examine the costs of the coup will not be permitted by these bodies. This raises serious concerns about academic freedom and the ability of researchers to conduct ethical and unbiased research in a politically charged environment.
I myself have seen that some research proposals, including one examining the rise of mental health crises in the general public after the February 2021 coup, have been rejected by Myanmar’s so-called neutral ERBs, which are military backed. The situation is not well understood outside of the country, and this lack of attention has unfortunate consequences.
A particularly egregious example is an article published in a prestigious journal, the BMC Tropical Medicine and Health,[1] in 2022. The majority of the researchers of this article are military academics and mostly from the Defence Services Medical Academy in Myanmar. They argued that strict containment measures: stay-at-home restrictions, school closures, and office closure had reduced “the community mobility, confirmed cases and mortality” of Covid 19 during the 3rd wave. This publication outraged a lot of medical researchers in Myanmar as well as the families who lost loved ones during the Covid-19 third wave because the Covid-19 related mortality rate was actually the highest during the third wave. Meanwhile the containment situation the military researchers described, and which the BMC apparently endorses, was far from accurate.
To begin with, there was almost no proper testing service to confirm the number of cases.[2] There was also almost no containment measures, contact tracing services or any other measures since after the coup by the military.[3] On the contrary, some leaders of the Covid-19 prevention programme were even arrested or were then hiding for their safety.[4] No Covid-19 data was systematically collected or updated during the third wave on the military-controlled health ministry’s website.[5] However during this time millions of social media profiles were turned black due to the loss of at least one relative for most people. I myself lost my uncle during the 3rd wave. The disaster of the third wave is not just anecdotal.[6] As the unpublished data collected by an anonymous PhD student demonstrates, nearly half of the positive cases even in a small town in Myanmar’s Chin State died. I have this unpublished data in hand as evidence.
Despite the devastating human loss during the third wave of Covid-19 in Myanmar, it was possible for military-led researchers to claim that military-led containment measures led to a reduction in Covid-19 deaths, and for this controversial article to be published in a prestigious international journal. As medical scientists in Myanmar, we were saddened and angered by this, especially given the collective trauma and loss of human life we were experiencing. We saw this article as a total disgrace to our international science community. However, what could we do in return?
We couldn’t openly collect data or publish evidence to disprove the aforementioned article, however, in 2023, scientists in hiding were able to publish an article proving the high COVID-19 case fatality rate during the third wave in Myanmar. For safety reasons, they published it under the name “Spring Research Team,” so as not to reveal their real names.[7] Unlike the military-related authors, these researchers who joined the Civil Disobedience Movement (CDM) cannot receive recognition for their work due to safety concerns.
This case, which highlights the struggles and lack of justice in Myanmar’s scientific field, is but one example of the challenges faced. The authors of that study were not alone. As of June 2021, the data indicates that 90% of college teachers and professors who were at the forefront of the fight for democracy had left their positions to join the Civil Disobedience Movement (CDM). An estimated 19,000 university professors were expelled for joining the CDM and the majority went into hiding due to extreme persecutions.[8] For nearly three years, almost all universities in the region have remained closed, causing significant disruptions in the education of many thousands of students.[9] Unfortunately, student union leaders who played a critical role in mobilizing large-scale protests were subjected to violent persecution, including the raiding of their campus offices.[10] The situation has left many students uncertain about their academic futures, and the ongoing turmoil has created a challenging environment for all those seeking higher education.[11] A similar situation has occurred for medical doctors, who have been forced to work underground.[12]
Yet with the political turmoil and violence in Myanmar, it is more important than ever to ensure that scientific research and education continue. This brings us back to the zoom meeting establishing an Interim Ethical Review Board, which will be discussed in part 2. The very fact that this ERB is being initiated in the post-coup era is particularly noteworthy and speaks to the unwavering dedication of the scientific community in Myanmar. While the situation in Myanmar remains complex and challenging, it's reassuring to see that the pursuit of knowledge and ethical research practices remain a priority among scientists.
Part 2. Scientific Resistance
As I logged onto the zoom meeting – the first of what the Myanmar scientific community has called our Interim Ethical Review Board (IERB) – I was met with odd sounding pseudonyms and cute pictures and avatars. As someone who is currently outside Myanmar, I used my real identity, but I recognize the danger of doing so if I were residing in the country. It's a reminder of the difficult circumstances that many in Myanmar are currently facing and the lengths they must go to protect themselves. Despite these challenges, the establishment of an ERB within the scientific community that is free from military control is an encouraging step towards progress and ethical research practices, even in the midst of political turmoil and oppression.
Our IERB included not only medical scientists but also researchers from various arts and science fields. Recruiting such high-profile individuals from Myanmar's higher education sector was a risky, complex, and precarious process. It was crucial to ensure that none of the attendees were military spies. Invitations were sent secretly and anonymously through personal networks only, and attendees' true identities remained unknown. However, some of us needed to know each other's identities to ensure the safety and scientific rigor of the IERB board. Despite the risks and complexities, our team successfully established the IERB and moved forward with our ethical review process.
During the meeting, we pledged to adhere to international research ethics, laws, and regulations without any political influence. It is uncertain if there are any other ERBs in the world where all board members must remain anonymous. Furthermore, researchers submitting proposals to our IERB must also remain anonymous to protect the privacy and safety of researchers themselves and their participants. This initiative may be one-of-a-kind in the world of science. Despite the complexity of the process, this attempt highlighted the efforts of many Myanmar scientists to continue conducting ethical research amid extreme persecutions and adversities.
What fascinated me most during the meeting was the mystery of people's identities. For instance, a gentleman named ‘Pokemon,’ with a Pokemon profile picture, could have been an outstanding Vice-Chancellor from a well-known science university in Myanmar. Similarly, a kind lady with a soft voice named ‘Mulan,’ who encouraged us to lead the science revolution using technology with her authentic British English accent, could have been one of those admirable female professors in that particular field who studied at a British university. However, all we could do is only speculate. The mystery of "who is who" would remain unsolved, at least for the time being.
Since 2021, the majority of people in Myanmar have adopted a strict principle of "anonymity and pseudonymity" in all counter-coup activities. I have attended many secret Zoom meetings and met different types of activists whose real names I have never known. We do not need to know each other's real names to make things work. Furthermore, seemingly innocent questions like "Where are you now?" have become highly sensitive and prohibited, even inviting general suspicion and disgust. However, such suspicion and disgust are understandable given our current situation.
Understandably, caution is paramount for everyone attending anti-coup meetings in Myanmar. However, it's disheartening that the world seems to have lost interest in or awareness of the ongoing crisis in the country. Despite the continued struggles of the people, international attention has waned, and support is sorely lacking. The international science community's severe neglect and ignorance towards Myanmar have caused significant harm, as discussed in part one.
On the other hand, I am not very surprised to witness the international science community’s ignorance towards what is happening in Myanmar. As one of the members of the steering committee of the Science in Exile Initiative,[1] I have hands-on experience of the difficulties of displaced scientists in conflict-affected countries – not only in Myanmar, but also in Sudan, Ethiopia, and Afghanistan, etc. The notable finding of my observation is that there is no proper international framework on how the international community should effectively deliver necessary aid and support to such scientists in exile.
Despite international neglect, it is heart-warming to witness that scientists under severe suppression in Myanmar are consistently finding ways to continue ethical science and education. Some parallel higher education systems using technologies that are free of military control are slowly emerging. For example, some young scholars established Spring University Myanmar (SUM) with a dual mission of supporting the interim education of youths and fundraising for scholars at risk and vulnerable communities.[2] SUM also uses a strict digital privacy policy and a principal of “anonymity and pseudonymity” for all the students and teachers in the system. Other pathways for continuing science and education were Ethnic Education Departments, Online Education Platforms, Interim University Councils and Students’ Unions, Ministries under the National Unity Government (NUG), the opposition government, and many other community initiatives in conflicted areas.[3]
The IERB discussed here is thus only one of many initiatives which the Myanmar scientific and educational communities have developed. I am 100% sure that Mr. Pokemon, Miss Mulan, Mr. X-man and many others with cute pseudonyms attending that IERB meeting are in fact some high-ranking scientists from top universities in Myanmar, many of whom might also be in exile. Leaving their high-level positions and going into hiding to protest against injustice was already an enormous sacrifice. Continuing to support science amid brutal suppression despite these sacrifices is something beyond valiant and selfless. It is also an act of resistance and a signal to the military junta that, despite all the force at their disposal, it is they who are powerless to stop the Myanmar scientific community continuing its work.
I am aware of the fact that even mentioning the attempt to initiate such an IERB in Myanmar still holds some kind of risks for everyone involved. I have been careful that nothing I write should accidentally reveal “who is who” except myself – and I myself hold some enormous risks since I am still holding a Myanmar passport. Nonetheless I cannot help feeling obliged to write about the unimaginable sacrifices of the Myanmar scientists so that the world’s science community may probably become aware of their endurance and determination to fight against injustice. I don’t know if we will ever meet in this life. Their names may have to remain anonymous for some time, and perhaps the mystery of “who is who” might never be solved. Nonetheless, their actions should never remain unknown to the rest of the world.
Dr. Phyu Phyu Thin Zaw, (MBBS, MPP, PhD, FHEA) is a medical doctor, an Epidemiologist and a lecturer at the School of Public Health, HKU. She is a visiting fellow at the Myanmar Australia Fellowship Programme at Australian National University and Melbourne University. She is also a member of “Steering Committee, Science in Exile Initiatives” advocating for the continuing science in conflict-affected countries.
[2] https://www.reuters.com/article/us-health-coronavirus-myanmar-coup/coronavirus-testing-collapses-in-myanmar-after-coup-idUSKBN2A90CK/
[3]https://www.voanews.com/a/covid-19-pandemic_myanmar-coup-aftermath-faces-exploding-pandemic/6208879.html
[4] https://www.reuters.com/world/asia-pacific/ex-head-myanmars-covid-19-vaccination-programme-arrested-2021-06-14/
[5] https://www.iseas.edu.sg/articles-commentaries/iseas-perspective/2021-67-crisis-upon-crisis-fighting-covid-19-becomes-a-political-struggle-after-myanmars-military-coup-by-courtney-t-wittekind/
[8] https://www.reuters.com/world/asia-pacific/more-than-125000-myanmar-teachers-suspended-opposing-coup-2021-05-23/
[11] https://www.aljazeera.com/news/2021/11/3/military-coup-kills-higher-education-dreams-in-myanmar
[12] https://www.telegraph.co.uk/global-health/terror-and-security/secret-health-service-myanmars-military-junta-drives-medics/
Nice post, reflecting the current situation (not only politics but also forgetting research arena) in Myanmar