Welcome to the Jungle
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“I have to work to save another life. I have to forget the past! That’s what revolution taught me: You have to accept death, and keep moving to save the rest,” Hector says, encapsulating the resilience and determination that have defined his and Dr. Paing’s experiences in Karenni State. Their story offers a raw and detailed account of the challenges they have faced in providing urgent medical care under the most adverse conditions.
Before the military coup in Myanmar in 2021, Dr. Paing was already established in the field; meanwhile, Hector had been a medical student for 10 years. They met as medical volunteers during the COVID-19 outbreak. But the coup shattered both their career plans, culminating in a decisive and perilous decision to leave their homes and lend medical expertise to the revolution.
Their decision to go to Karenni State in particular was motivated by reports of inadequate medical support in the face of intense conflict. Strangers to the region and its predominantly Karenni population, they were initially met with mistrust due to their Bamar background. They explain that the Karenni people, having suffered under decades of oppression, equate the word “Bamar” with “soldier” in their language. Therefore, building trust required persistent, patient effort, starting with the establishment of clinics in villages, and proving their commitment and trustworthiness through their work.
At first, resources were painfully scarce. And what is worse, in February 2022, a nighttime bombing raid reduced the town’s hospital they were working out of to rubble, forcing the team to relocate to a jungle setting. Despite the constant threat of drones and airstrikes, they constructed a makeshift clinic with bamboo and wood. Over time, it evolved with brick structures and ceramic tiles, reflecting incremental progress despite limited funding and resources. Throughout that process, secrecy was paramount: the new hospital’s location remains carefully hidden to avoid detection by the regime, ensuring the safety of patients and staff.
The conditions early on were particularly grueling, and they have certainly not improved much since. Medical supplies were sourced through convoluted and often unreliable channels, and needed to be smuggled across the border. International aid, which could have been transformative, was largely unavailable due to bureaucratic and political barriers. Generators provided electricity, while water—a precious resource—was rationed and had to be shared with nearby villages. Internet connectivity only became feasible in 2023 with the arrival of Starlink. This was crucial, as it replaced the long, laborious, daily trips to reach somewhere they could pick up a signal! So in order for their mission to succeed, Dr. Paing and Hector are forced to rely on ingenuity, the goodwill of local communities, and the few donors who knew of their predicament and stepped forward to help.
Their medical work has been a harrowing adaptation to the horrors of war, where injuries from landmines, airstrikes, and suicide drones are grim daily realities. Civilian patients arrive with devastating wounds—amputated limbs, severe head trauma, and bodies torn apart by explosive devices. One haunting case involved a 20-year-old landmine victim who had just lost both legs; despite massive transfusions, he tragically succumbed to his injuries. In his final moments, he spoke of his home and family, leaving the medical team profoundly shaken. Hector describes the relentless psychological toll, recounting vivid dreams and hallucinations about patients, like this young man, whom he couldn’t save. Even after their passing, he still sees their faces or imagines them speaking to him, a haunting reminder of the lives lost. In fact, to preserve his sanity, he has had to leave the operating theater altogether and take over office work, as he can no longer cope with the trauma.
And the emotional burden extends far beyond the staff. Karenni civilians suffer widespread PTSD and depression, grappling with displacement, the loss of loved ones, and the unrelenting threat of violence. Families have been uprooted, homes destroyed, and entire villages wiped out, leaving survivors clinging to fragile hope. Patients frequently talk about their sleepless nights, despair and overwhelming sense of uncertainty that has pervaded their lives. Yet, amid the anguish, Hector and his team continue their work, knowing that their medical care, however limited, is often the only lifeline for those caught in the conflict.
Beyond their grueling medical duties, Dr. Paing and Hector have also had to become builders, administrators, fundraisers, import managers, and documentarians, roles they never anticipated but took on out of necessity. After their first hospital was bombed, they oversaw the construction of a new jungle facility, learning on the job as they designed operating rooms, sourced materials, and worked alongside local youth to bring it to life. They manage logistical challenges ranging from securing scarce water and fuel supplies to ensuring that their volunteers, who work tirelessly without pay, have enough to eat. They meticulously document atrocities and patient data, driven by a commitment to hold the junta accountable and lay the groundwork for a post-conflict healthcare system. And of course they must also oversee all security concerns as the military has been actively searching for their new hospital, hoping to target and destroy it.
The medical team’s approach to coping is multifaceted. A key aspect of it involves wholeheartedly embracing their mission, and finding solace in the belief that their sacrifices contribute to a greater cause. Meditation, self-care routines, and moments of solitude are also strategies to help manage the unrelenting, emotional strain. At other times, they simply let loose, outfitting their rooms with improvised disco lights fashioned from tire reflectors and set against the dense jungle backdrop; the team will drink and dance without abandon! Music, both traditional and contemporary, fill the air, creating a fleeting but re-energizing reprieve, inspiring laughter and community.
An unexpected silver lining in their very challenging journey has been the growth they have experienced in inter-ethnic understanding and solidarity. Despite their limited grasp of the Karenni language and the difference in religious background—they are Buddhist among a predominantly Christian Karenni population—Hector and Dr. Paing have cultivated a deep appreciation for Karenni culture. This includes a genuine admiration for the unwavering courage of the people, their deep religious devotion, and the strong sense of community that binds them together. Dr. Paing reflects on this sense of kinship and solidarity as representing a “good result of the revolution.” He describes touching moments, such as when they prayed with Karenni elders in bombed-out churches. Hector shares that despite the hardships, being welcomed into this community has fundamentally changed his understanding of what “solidarity” really means. They both see cross-cultural connection and empathy as not just necessary for survival, but as the foundation for rebuilding a fractured nation.
Despite their dedication, the sustainability of their mission remains precarious. The hospital relies heavily on volunteers, many of whom have served for years without pay. This strain, coupled with familial obligations and the grueling nature of their work, has led to burnout and staff attrition. In addition, doctors have had to leave their families behind; they are rarely able to so much as speak with them due to security concerns, and will not be able to see them again until the revolution is won. Requests for international support have largely gone unanswered, leaving them to operate on a shoestring budget. Indeed, the doctors describe a feeling of being abandoned by the international community at large, whose inaction has left them struggling to keep their hospital running.
Their challenging situation also underscores the systemic failures that exacerbate the humanitarian crisis in Myanmar. They express frustration that millions of dollars in aid remain locked behind diplomatic red tape, at the same time that they face constant shortages of life-saving supplies like ventilators, blood analyzers, and basic medications. Dr. Paing speaks of the heartbreak of losing patients to preventable diseases like measles and rabies, illnesses that could have been treated if only the necessary resources had reached them. Hector underscores the injustice of the volunteer medical teams sacrificing their personal lives and education, while people in neighboring countries live comfortably with access to basic services they can only dream of. This lack of support has left Hector and Dr. Paing feeling suffocated, forcing them to improvise and rely on donations from Myanmar citizens, who are themselves struggling under the junta's oppression. The exasperation in their voices is unmistakable as they implore the world to act, not with more empty promises, but with tangible aid delivered directly to the people and communities fighting for their survival.
Their personal transformation over the past three years has been profound. Hector, once a medical student with a sheltered life, has matured into a leader managing the logistical and emotional challenges of operating in a warzone. Dr. Paing, who dreamed of public health advancements in a peaceful setting, now finds fulfillment in realizing aspects of that vision amid chaos. Both have adapted to unimaginable circumstances, finding strength in their mission and the hope of a better future. As Dr. Paing aptly states to listeners at the end, “Please, don't be trapped under the policy. Do what you can do urgently and immediately. You can give so many ways. Health is the human family, and health is peace. You have to do as much as you can in so many ways. There is no time to wait!”
If you would like to listen to past episodes on similar topics, we suggest the following from our archives:
· Matthew Wells shares his work with Amnesty International. He documents human rights violations, including the military's use of airstrikes to terrorize civilian populations in Myanmar. His descriptions of those deliberate and unlawful attacks highlight the devastating impact of oppressive tactics on communities, yet underscore the people’s resilience in the face of systematic brutality.
· Guillaume De Langre advised Myanmar's Ministry of Electricity and Energy. His research reveals the systemic neglect of rural and conflict-affected areas like Karenni State, where access to electricity remains a significant challenge. His insights into the deliberate underdevelopment of these regions illustrate how inequities in access to energy exemplify the broader struggle for dignity and survival.
· Sha Kerpaw Wah describes his journey from growing up in a conflict zone and displacement, to humanitarian work. His story reveals a deep connection to regions in Karen State, where the struggle of communities in the face of violence mirrors his own experiences. His reflections highlight the importance of preserving identity and fostering solidarity, even amid displacement and systemic neglect.
· Thomas van Linge discusses his time documenting the conflict on the ground in Karenni. His work shines a light on a region where junta forces are largely isolated in urban centers, with surrounding areas effectively under resistance control. His observations of the perseverance and organization of local resistance groups highlight the determination of communities to reclaim their autonomy despite the devastation caused by military tactics like airstrikes and village destruction.
· Saw Kapi speaks of his time in Karenni during the 1988 uprising, which allowed him to witness the resilience of ethnic communities and their critical role in the broader, democratic struggle. Now, through his work in education and governance, he emphasizes empowering future generations to lead with knowledge and understanding, addressing systemic neglect while fostering hope for long-term societal transformation.