As Myanmar grapples with the aftermath of a devastating 7.7-magnitude earthquake, its already fragile healthcare system is buckling under the intense strain.
The UN World Health Organization ( WHO ) has been at the forefront of the emergency response, delivering critical medical supplies and coordinating lifesaving care. However, hospitals are overwhelmed, medical supplies are running dangerously low, and aid workers are racing to prevent deadly disease outbreaks among displaced communities.
Speaking from the stricken capital Nay Pyi Taw, Elena Vuolo, WHO Deputy Representative in Myanmar, told UN News the situation was "an emergency within an emergency".
"Even before the disaster, nearly 12 million people in Myanmar required healthcare assistance. Now, with this earthquake, the situation has worsened."
More than 3,900 deaths and nearly 6,000 serious injuries have been reported, and there are concerns over potentially deadly outbreaks of cholera and malaria.
"There are other needs - water, food, security and shelter that are becoming bigger. An already fragile outlook "has become even more fragile, an emergency within an emergency," she warned.
In an interview with UN News, she details the scale of the crisis, the biggest health risks facing survivors and why urgent global action is essential.
Read the full interview below. The text has been edited for brevity and clarity.
UN News: It has been one week since the devastating 7.7 earthquake struck Myanmar. Can you give us an overview of the current situation in the affected areas?
Elena Vuolo: Unfortunately, one week has passed, which means that our window of hope to extract and find people alive is narrowing because usually, the "golden window" is the first three days after an earthquake strikes.
In the first 24 hours, we at WHO mobilized supplies, including trauma care kits from our warehouse in Yangon and transported them for immediate relief.
Over the past week, we have been working around the clock, alongside other UN agencies, emergency medical teams from abroad and our respective headquarters and regional offices to mobilize the response.
Unfortunately, we have witnessed the collapse of several hospitals. This was already a health system that was overstretched and severely impacted by four years of crisis. The earthquake has only exacerbated the humanitarian and healthcare needs.
We are trying to deliver life-saving interventions, mental health support and trauma care…but we were already working in a fragile context that has become even more fragile, an emergency within an emergency
Right now, hospitals are overwhelmed. Despite emergency medical teams from various countries, there is limited capacity to properly treat all those in need - especially those with severe injuries requiring advanced surgical care.
UN News: You mentioned the strain on the medical infrastructure even before this disaster. Now that the earthquake has struck, what are the emerging needs you are seeing?
Ms. Vuolo: The most immediate and critical needs are surgical care and trauma care.
WHO has brought in almost 100 tonnes of supplies through humanitarian cargo over the past week. When you extract someone from the rubble, you need to ensure they receive the right surgery at the right time in the right facility.
One major challenge is that 86 per cent of healthcare facilities, including many hospitals, have been damaged by the earthquake.
Even before the disaster, nearly 12 million people in Myanmar required healthcare assistance under the humanitarian response plan. Now, with this earthquake, the situation has worsened.
As of today, more than 3,900 deaths and 5,900 injuries have been reported. Our priority is ensuring that the injured receive trauma and surgical care.
UN News: What about other health concerns and diseases, especially outbreaks?
Ms. Vuolo: We are also working to prevent disease outbreaks, particularly cholera, which is a major concern due to poor water and sanitation conditions. Last year, Mandalay, one of the hardest-hit areas in this disaster, already reported cholera cases. Nearly half of the townships in Mandalay state were affected by cholera.
In response, we carried out a vaccination campaign for 70,000 people, but due to limited vaccine availability, we were unable to cover all those in need. Given Mandalay's vulnerability, there is a high risk of a cholera resurgence.
Additionally, funding cuts and reduced international aid are not helping. We are trying to deliver life-saving interventions, mental health support, trauma care supplies and preventing further disruption of health services.
There are other needs related to water, food, security and shelter that are arising and becoming bigger, because we were already working in a fragile context - a context that has become even more fragile, an emergency within an emergency.
Like it was during the pandemic, the healthcare workers are on the frontline - they are the heroes of an emergency response: the nurses, the midwives, the doctors who continue working every day under very difficult circumstances
UN News: What about the mental and psychosocial impact? Are you seeing significant challenges and are there support structures in place?
Ms. Vuolo: WHO has always prioritized mental health and psychosocial support, especially in hard-to-reach and conflict-affected areas. We work with various partners, either directly or through the health cluster.
Now, and this takes me back even to the times of the COVID-19 pandemic response - there are two main groups in need of support: affected communities, who have been traumatized by this unprecedented earthquake, and there are healthcare workers.
Many are working in makeshift hospitals under extreme conditions - 39°C (102°F) temperatures in tents amid power cuts and without basic resources. They are working under very difficult situations despite their own personal losses.
Like it was during the pandemic, the healthcare workers are on the frontline - they are the heroes of an emergency response: the nurses, the midwives, the doctors who continue working every day in these temporary hospitals or in hospitals that are no longer fully functional and doing it in the best way they can.
To support them, we are providing psychosocial and mental health support to our health cluster partners. And then through these partners, we are also supporting community-based psychosocial support.
There is severe trauma. But let us not forget that Friday was one of the shockwaves. There was a shockwave on Saturday, and then since then, every day. Some of them are minor but others are strong.
I want to be very honest - when I or WHO colleagues feel some shaking, we are very worried. And if we do not feel safe, I cannot think how people living outside their own houses feel, spending nights in temporary shelters.
UN News: What are the most urgent needs for WHO and health partners in terms of access and supplies?
Ms. Vuolo: Supplies are the top priority. More than 5,000 injured people need treatment, and many will require long-term recovery, including physiotherapy and rehabilitation. Additionally, patients with pre-existing conditions, such as diabetes or other chronic diseases, still need access to their medications.
I experienced this firsthand when a colleague was injured during the earthquake. We took her to two hospitals, both of which could not treat her. We took her to another, smaller facility that did not even have the supplies to give her stitches. She had an injury on her foot.
We found a solution and evacuated her to Yangon. But this gives you the sense of what are the needs are. It was two hours after the earthquake, but the hospitals ran out of supplies. Nobody could predict the scale of the disaster.
There is urgent need for not only trauma-related supplies but also essential medicines to prevent the disruption of routine healthcare services - for mothers, children or the elderly, and for diseases like malaria or tuberculosis.
In just two hours after the earthquake, hospitals ran out of supplies. Nobody could predict the scale and impact of this disaster
We have launched an $8 million flash appeal to cover a 30-day emergency response, but beyond that, we also need resources for long-term recovery.
UN News: You mentioned an $8 million appeal, but even before this disaster in Myanmar and elsewhere, aid agencies were struggling with funding. With the United States and other key donors scaling back, how much of an impact are you seeing? How can the international community help?
Ms. Vuolo: The first three months of 2025 have been a game changer for the multilateral system in general. Several countries are, unfortunately, prioritizing military spending over global health, and international humanitarian aid and development.
Until December 2024, Myanmar was one of the least-funded humanitarian crises. I do not want to say that Myanmar is neglected, but certainly Myanmar deserves more attention. With the aid cuts from the US and some other countries, we have not been able to operate. As of March, the health cluster had received less than two per cent of the funding needed for this year.
Now, the $8 million flash appeal is for a window of 30 days. This is to allow our critical work to continue providing life-saving supplies and disease outbreak prevention, like what we do in other emergencies - from Gaza to Afghanistan. This will also allow to continue early detection response for disease that could become outbreaks - particularly cholera.
But beyond this immediate response - and I am speaking also for other UN agencies in Myanmar - we will have to work on recovery on reconstruction. Hospitals and schools have been destroyed, where the situation is already so fragile and limited in its capacity, and people need protection. We as the United Nations have a role to play.
Now when resources are going down, we need to find innovative solutions and partnerships, including with the community and with the others in the region, since this crisis has regional implications.
In addition, we appeal to the international community to also advocate with those countries that have decided to undermine the global aid architecture to rethink about the consequences of their actions. We know that elsewhere, people are dying from HIV because funding for lifesaving medicines have been cut. It is not only Myanmar, but there are also several other emergencies that are facing similar dire situation like us.
That said, I must say - I am very encouraged by the international support, like the deployment of medical teams from different corners from the world, which provide much-needed medical care.
