INN DIN: Visitors to the medical facility in one of Myanmar’s poorest and most remote regions are greeted by a padlocked gate and a sign reading: “Clinic closed until further notice.”
A vehicle that used to ferry around doctors and patients parked next to the neat compound of bamboo and brick buildings in the western state of Rakhine is covered in thick dust. Since international aid groups were forced out of the area in February and March, members of the minority Muslim Rohingya community who relied on them say basic health care services have all but disappeared.
Worst affected are those in Northern Rakhine State (NRS), home to most of Myanmar’s 1.3 million Rohingya who are stalked by sickness and malnourishment and as yet untouched by reforms under a semi-civilian government which took power in 2011. Many people in and around the village of Inn Din, a collection of bamboo houses with thatched roofs and earthern floors a two-hour drive from NRS’s biggest town Maungdaw, speak of disease and preventable death.
Nurfasa, born in late May, fidgeted in her grandmother’s arms, her chest rising and falling with laboured breaths. The desperately weak infant opened her mouth wide as if to cry, but no sound came out. For the first 20 days of her life, all Nurfasa had for nutrition was ground-up rice powder mixed with water, because her mother, legs swollen and womb racked with pain, could not produce enough milk to feed her. “We don’t have the money to go to Maungdaw and the MSF clinic here is closed,” said her grandmother Montai Begum. “We showed the baby to the government midwife in the village, but she asked for money.”
The expulsion of international aid organisations stems from the violence that erupted across Rakhine state in 2012 between ethnic Rakhine Buddhists and Rohingya Muslims, killing at least 200 people and displacing 140,000, most of them Rohingya. When Medecins Sans Frontieres-Holland said it had treated people it believed were victims of sectarian violence near Maungdaw in January, the government expelled the group for favouring Muslims. Myanmar denies the attack took place. And after a foreign staff member from another aid organisation, Malteser International, was rumoured to have desecrated a Buddhist flag, NGO and U.N. offices in Rakhine came under attack and groups withdrew.
MSF’s departure has had “a major humanitarian impact”, said Pierre Peron, spokesman for the United Nations’ coordination agency UNOCHA. “MSF had built up a programme over 20 years and it was reaching places that were very difficult to reach, and that’s not something that can be done overnight,” he said. MSF hopes it can return soon after the government announced on Thursday that the group could go back to Rakhine, a decision the organisation welcomed. Whether that commitment is fulfilled, and under what conditions, may be questions for talks over the coming days.
Some aid workers fret that the announcement has more to do with politics than resolving the humanitarian crisis. Yanghee Lee, the new UN human rights envoy to Myanmar, is in the country on a 10-day visit that included a trip to Rakhine. U.S. Secretary of State John Kerry may visit Myanmar for the ASEAN foreign ministers’ meeting in August, and President Barack Obama is also expected before the end of 2014.
Timing is crucial. The health crisis could worsen as monsoon rains set in, making sanitation more difficult, and experts warn of the risk of diseases such as malaria and tuberculosis spreading in the absence of reliable medical care. Than Tun, a Buddhist community leader and member of the Emergency Coordination Centre (ECC) set up by the government to oversee international NGOs (non-governmental organisations), confirmed MSF-Holland would be allowed back to NRS. But he underlined the level of mistrust between the Buddhist community and anyone it suspected of siding with Muslims.
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