Dr Phyu Phyu Thin Zaw
Healthcare Providers in Non-International Armed Conflict
Abstract
It is well recognised in international humanitarian law that the absence of an international jus ad bellum internum fails to ‘civilise’ the use of military force in a civil war that involves a state and non-state armed parties. Even where the intensity of a civil war should call into question the legitimacy of the state, its monopoly over the legal use of force – including the use of its law enforcement and criminal justice organs – against any act of armed resistance disincentivises reconciliation, compromise or observance of requirements under common Article 3 of the Geneva Conventions by either sides of the conflict. While Additional Protocol II could supplement this deficiency to a degree (e.g. in attributing a legal status to combatants in internal armed conflicts), its applicability depends on whether its provisions reflect international customary law where the state concerned is not a contracting party.
In the context of the civil war in Myanmar, we consider the legal status of medically qualified or trained individuals who have joined the resistance as healthcare providers and/or combatants. We focus on healthcare providers as many of them have joined the resistance since the coup d’état in 2021. This phenomenon likely had a devastating impact on the health system already weakened by the COVID-19 pandemic. We then consider the impact of this deficiency in international humanitarian law on the health and wellbeing of civilians in ‘liberated’ areas (or territories controlled by non-state armed parties) and in state-controlled areas, particularly in the aftermath of the devastating earthquake on 28 March 2025. While we do not go so far as to argue for jus ad bellum internum in civil war, we highlight the need for international humanitarian law to capacitate healthcare providers in rendering health and public health services beyond a ‘static’ protection of medical units and transport, especially in a protracted internal armed conflict.
Biography
MBBS (Mdy), MPP (Oxford), PhD (PSU), FHEA (UK)
Phyu Phyu Thin Zaw is a Myanmar Australian Fellow at both the University of Melbourne and the Australian National University. She is a medical doctor, epidemiologist, and lecturer at the University of Hong Kong. Phyu Phyu obtained her MBBS from the University of Medicine Mandalay, completed her Master of Public Policy at the Blavatnik School of Government, Oxford University, and earned her PhD in Epidemiology from Prince of Songkla University, Thailand. She also got her postdoctoral training as a WHO fellow/Visiting Scholar at the Asia Health Policy Program (AHPP) at Stanford's Shorenstein Asia-Pacific Research Centre. In addition to her academic work, Phyu Phyu serves a member of the "Steering Committee, Science in Exile Initiatives" at The World Academy of Sciences, UNESCO, advocating for displaced scientists in conflict-affected countries. Prior to her academic career, Phyu Phyu gained substantial experience in health system strengthening while working for the Ministry of Health and Sports in Myanmar for 12 years. She also serves as the Head of the School of Health at Spring University Myanmar delivering public health training tailored to the needs of the health workforce in crisis settings.