Even Shootouts on Buses… Pediatric Surgeon Hideto Oka Talks About the Harsh Reality of “Saving Lives in Myanmar Amid Ongoing Civil War”

In Myanmar, where a civil war continues amid ethnic tensions and the struggle between the military regime and the pro-democracy movement, there is a doctor who has been providing medical care for over 30 years.He is Dr. Hideto Oka (60), a pediatric surgeon and founder of the international medical NGO “Japan Heart,” who is featured in the new book *The Story of Pediatric Surgeon Hideto Oka: If I Don’t Go, Who Will?* (Kodansha). Dr. Oka continues to save children in this country who cannot receive medical care.It is said that in Myanmar, there are many children whose conditions have become difficult to treat because they were left unattended. What is the reality in Myanmar, as described by Dr. Hideto Oka, who leads “Japan Heart”—an organization that has mobilized more than 4,500 medical professionals to date?

――Myanmar was formerly known as Burma.It is said that during British colonization in the 1800s, the policy of “divide and rule” applied to more than 130 ethnic minorities—in contrast to the majority Burman ethnic group—complicated ethnic tensions. Furthermore, a civil war continues due to the pro-democracy movement against the military regime. What is the current situation regarding medical activities on the ground?

Hidetoshi Oka (hereinafter Oka): Since 2004, I have been providing free medical care to children at the Wache Charity Hospital, located in a small village in Sagaing Region in central Myanmar. Previously, I also used to visit a hospital located nearly a two-hour drive north of Wache.

The paved road along the way is riddled with potholes where landmines have exploded. When vehicles belonging to opposing factions pass by, the landmines are detonated remotely. Since our car is for medical use, we aren’t specifically targeted, but…

At the hospital up north, there was an incident where government and rebel forces stormed in and got into a scuffle. I wasn’t there at the time, but after several incidents like that, we can no longer go to the hospital up north.

  ――Landmines, you say! It must be scary to drive through there…

Oka: I haven’t seen it firsthand, but I’ve heard that sometimes they hide on bridges or inside buses and exchange fire. That’s why, when I need to travel, I don’t take the bus—I use the hospital’s vehicle instead. The checkpoints are strict, too.

The rebel forces issue statements saying, “We will launch a full-scale attack on such-and-such a date.” When that happens, we evacuate the patients and staff. Right now, the only Japanese people receiving treatment at Watche Charity Hospital are myself and a nurse; the rest of the medical staff are Myanmar nationals who are providing care.

“A Contract with Myself”

—Is it safe for volunteer medical professionals traveling from Japan?

Oka: Given the current situation, we’ve recently been sending staff to our bases in Cambodia and Laos instead of Myanmar. The only times we enter the country are when I’m there, when long-term staff members are present, or when we invite specialists from Japan each month.However, due to security concerns and other issues, I am the only Japanese doctor who enters Wat Chee Charity Hospital. Since Japan Heart operates children’s hospitals in the relatively safer cities of Yangon and Mandalay, we have Japanese doctors provide treatment there instead.

If the military were to show up in the middle of open-abdominal surgery, I certainly couldn’t just pick a patient up and run away, could I? That’s why children who need major surgery are transferred to our partner children’s hospitals in Yangon or Mandalay, where we perform the surgeries in a focused manner when Japanese doctors are present. Since the facilities there are better, it’s also more reassuring to monitor their postoperative progress at children’s hospitals in major cities.Right now, the surgeries being performed at Wache Charity Hospital are primarily reconstructive surgeries for children that can be completed in a relatively short time.

――Even so, Mr. Oka, aren’t you going to stop providing medical care at Wache Charity Hospital?

Oka: I’ve promised the people of Myanmar that I’ll “provide medical care here.” It’s also a “commitment I’ve made to myself,” so I’ll keep doing it. Staying here and not giving up will, over time, build “trust.”

――What kinds of illnesses do the children come in with?

Oka: In Myanmar, patients’ families bear the full cost of gauze, syringes, and medication. Since a system like Japan’s universal health insurance doesn’t function properly, the financial burden on patients is heavy.

If a family is poor, a child’s illness or injury is often left untreated, and they only come to the hospital once the condition has become severe. Since there are few hospitals and doctors, many parents and children hear rumors that a Japanese organization runs a hospital offering free treatment, so they take multiple buses from distant villages, spending days on the journey to get here.

“Do-Nothing Medicine”

――The scenes of children making their way to the hospital are also depicted in your new book, *The Story of Pediatric Surgeon Hidehito Oka: If I Don’t Go, Who Will?*. It’s heartbreaking.

Oka: When I see parents and children coming to me as if clinging to a lifeline, I feel compelled to do whatever I can to help them. For children with serious illnesses, I not only perform surgery on-site but also, with the cooperation of medical institutions in Japan, sometimes arrange for them to undergo surgery in Japan.

――In Japan, they’d be treated at a hospital before their condition deteriorated this much. So this is what you mean by “places where medical care doesn’t reach,” isn’t it?

Oka: Last fall, we opened the “Japan Heart Asia Pediatric Medical Center” in Cambodia. Japan Heart has been fully committed to providing free pediatric cancer treatment since 2018. However, because such care typically requires advanced medical technology and is extremely expensive, many children with cancer were previously destined to die simply because they lacked access to treatment and couldn’t afford the costs.However, with the opening of this hospital near the international airport, we can now transport and treat children with cancer not only from Cambodia but also from Myanmar.

It is a doctor’s instinct to want to cure sick children. When there is nothing left to do, I feel nothing but a sense of defeat. That is why, when I was younger, I sometimes performed risky surgeries in an attempt to cure them at all costs.

However, around the time I turned 50, my perspective began to shift slightly. I had seen many children die even after undergoing surgery. I came to realize that, for a doctor, taking the lead isn’t always the best course of action.

For children with terminal cancer, the survival rate remains low even with all-out treatment. In that case, let’s accept reality.Let’s practice “do-nothing medicine.” If we do nothing, they will eventually pass away, but in the meantime, they can spend as much quality time as possible with their families. They won’t have to endure pain either. This is my current belief after more than 30 years of practicing medicine in Asia. Of course, if there is a chance of recovery, I will do my absolute best, no matter how difficult it may be.

――I take my hat off to you for continuing to provide medical care while facing such risks over the years. Thank you very much for sharing your valuable insights with us today.

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Hidetoshi Yoshioka

Pediatric surgeon. Founder and Senior Advisor of the certified NPO Japan Heart. Born in Osaka Prefecture in 1965. He has been active in Myanmar since 1995, in Cambodia since 2009, and in Laos since 2013. In 2004, he founded the international medical volunteer organization “Japan Heart.”Overseas, in addition to medical activities, he supports the independence of the visually impaired; operates “Dream Train,” a residential facility that protects and supports children who have lost parents to AIDS or are at risk of human trafficking due to poverty; and trains medical personnel.In Japan, the organization provides disaster relief, regional medical support to remote islands and isolated areas facing a shortage of medical personnel, and runs the “Smile Smile Project” to support children with cancer and their families.In 2021, the organization received the 69th Kikuchi Kan Award. As an organization under Japan Heart, it has received awards from the United Nations, the Okinawa Peace Prize, and the SDGs Award from the Japanese government.