Episode #374: It Takes All Of Us
RELEASE DATE: AUGUST 5, 2025
For people who have experienced traumatic injuries, hope can be a lifeline. “Two or three years ago, one of the service users we provided for said, ‘At one point, I was thinking of putting my pistol to my head and killing myself,’” says Dr. Zaw Moe Aung, Country Leader for The Leprosy Mission Myanmar (TLMM), which provides prosthesis and care for people with leprosy and disabilities, including those caused by landmines and other injuries. “We came across a very difficult psychological mode for them to cope with, because of losing their limbs, and also especially because they did not know when they could receive a prosthesis.”
With TLMM’s support, that survivor has slowly made his recovery. Amid the many challenges of disability care in a time of conflict, and the devastating toll of landmines and explosive remnant of war (ERW), the experience points to the organization’s strengths grounded in holistic care, a social model of service based on human rights, peer support, and disabled champions able to take their own rightful place in society and as leaders of the disability movement.
In a recent interview with Insight Myanmar, as part of the Navigating a Minefield series, Dr. Zaw Moe Aung discussed TLMM's mission and how the organization has expanded into victim assistance for landmine and ERW survivors in recent years. His work continues the 150-year-old commitment of The Leprosy Mission founded in India by the Irish missionary Wellesley Bailey, and TLMM’s own origins in Myanmar in 1898. While keeping people affected by leprosy at its heart, informed by the Convention on the Rights of Persons with Disabilities, the organization has expanded to provide prosthetics and holistic care for all disabled people, limited only by access and resources. In recent years, that mission has encompassed support for survivors of landmines and ERW, in work that has, in turn, contributed to the survival of TLMM as a whole.
During the period of relative openness, which Dr. Zaw Moe Aung identified as beginning in 2008, the regime allowed increased access to international organizations, providing new avenues for disability partnerships. TLMM saw this as an opportunity to connect to the broader disability community and forge new alliances, strategically strengthening its mission to continue providing care to those affected by leprosy and expanding to help more people.
The organization’s expertise and experience has connected common themes among people affected by disabilities, including those caused by leprosy and, increasingly, injuries caused by the conflict and the terrible toll of landmines. Social stigma, loss of livelihoods and income, and psychological trauma can all contribute to people’s burdens, but so too can solidarity, peer support, and a human rights-based model help realize success.
The mission’s work with landmine survivors coincided with the then-government’s acknowledgment of landmines as a nationwide problem in 2011, opening avenues for humanitarian mine action organizations to provide victim assistance, including financial support for prosthetics. TLMM partnered with the Danish humanitarian NGO DanChurchAid, which supported the training of four staff members to become certified physiotherapists. They learned the meticulous process of providing prosthetics and holistic care, involving pre-prosthetic physiotherapy, psychosocial support, and facilitating peer interactions.
“Provision is not just production of the prosthetic as a material, but fitting it into the stump, properly nurturing, [and] helping the victim to be able to walk confidently on the new leg, the prosthetic, so that they can walk, they can climb, have different functions of the leg one would expect as if they had a natural original leg,” Dr. Zaw Moe Aung says. “These are the kind of the priorities, otherwise the money for the material we need to buy and make for them, the staff time, the transportation time, many things will be wasted if a patient cannot use that prosthetic properly.”
This holistic approach borne of experience questions past models of care, focused exclusively on “fixing” a medical problem or treating people as charity cases. Instead, people with disabilities should be advocates for their own care, exemplified in peer interactions. “Among peers, some of the service users return again for the second or third time of the prosthesis to change to a new prosthetic after a few years,” Dr. Zaw Moe Aung says. “They come back, with a success story experience with the new leg in their life, in their house or in their community, which is also a lot of help and support. Peer support is the very best thing among them.”
Leprosy, the flagship of TLMM’s work, has received diminishing attention, especially in higher income countries where the disease has been eradicated, and overshadowed by other health crises. TLMM, a locally registered and led organization, is staffed entirely by nationals, and remains steadfast in its determination and support for the estimated 300,000 people in Myanmar affected by the disease (about 100,000 of whom have disabilities caused by the infection).
Leprosy, or Hansen’s Disease, carries a burden of stigma and discrimination that dates back to Biblical times. While improved living standards and healthcare have largely eradicated leprosy in richer countries, it persists in lower-income regions. Before 2020, there were 2,000 to 3,000 new cases recorded annually, but the combined impact of the COVID-19 pandemic, the 2021 military coup and subsequent conflict has drastically reduced diagnoses, with numbers plummeting to just 585 cases in 2021 before slightly increasing.
A philosophy that informs the wider disability movement is “Nothing about us without us.” As TLMM emphasizes the centrality of all people with disabilities in decisions and advocacy efforts, Dr. Zaw Moe Aung would like a revision: “Nothing about us, without all of us.” He believes in empowering individuals with disabilities to become “champions” and vocal advocates for their own rights. While some changes are slowly happening, such as opportunities for disabled champions to attend international conferences, there is still a very large unmet need, particularly in rural areas. “What I would like to see is more and more champions in every corner of this big country, representing different constituencies,” he says.
Recent years have presented unprecedented challenges for the wider disability movement, while the number of landmine victims has soared, although a lack of complete data gives an incomplete picture. Dr. Zaw Moe Aung says there are hundreds of new victims identified in Shan and Rakhine states alone, and many more in other conflict-affected states such as Karen, Karenni, and Kachin, and regions including Sagaing, Magwe, and Bago. One tragic indicator has been the rise in child landmine survivors, with TLMM previously helping children mostly in Rakhine, and now seeing cases across the country.
The ability to reach these victims has become more difficult and hazardous due to the conflict, travel restrictions, and the exodus of professionals from the formal healthcare system, which occurred as part of the civil disobedience movement. TLMM’s own educational and training workshops face challenges, ranging from unreliable electricity to the expense of training technicians and specialists. The military’s reflexive labeling of landmine survivors as part of the resistance movement, despite the heavy toll exacted on civilians, exacerbates access issues by instilling fear in those needing help.
Despite these obstacles, Dr. Zaw Moe Aung maintains a sense of hope and purpose. He views disasters, such as Cyclone Nargis in 2008 and the recent earthquake, as opportunities for the country to open and mobilize support. Amid the earthquake’s devastating toll, it also brought international attention, potentially unlocking resources for rehabilitation. He expresses a cautious optimism about what he perceives as the military’s increasing focus on earthquake victims’ prosthetic needs. It will be necessary, he says, to train more physiotherapists and technicians and establish more facilities closer to communities, recognizing that prosthetic provision is a lifelong need, especially for growing children.
As social acceptance of people with disabilities is not yet widespread in Myanmar, Dr. Zaw Moe Aung believes that disability inclusion should be a mandatory aspect of humanitarian assistance. The existence of a comprehensive disability rights law, which came into effect in 2015, along with the increased visibility of physical disabilities due to conflict, have created a momentum that he hopes can lead to more comprehensive services and greater social integration, sustained effort, and sufficient resources.
Just as survivors of landmines and other people with disabilities have exemplified hope in their own lives, Dr. Zaw Moe Aung holds on to hope for a day when every person, regardless of their physical challenges, can be an equal participant in society.