Myanmar continues to block humanitarian access in Rakhine state

Rohingyas continue to be hit especially hard as policies hinder access to treatment, medical fees remain too expensive

Nur and Amina at an MSF clinic in the Hakimpara refugee makeshift settlement in Bangladesh.
BANGLADESH 2018 © Pablo Tosco/Angular
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NEW YORK/AMSTERDAM, AUGUST 10, 2018—Independent humanitarian agencies remain largely blocked from accessing vulnerable communities in northern Rakhine state in Myanmar, raising major concerns about the unmet medical and humanitarian needs in an area where Doctors Without Borders/Médecins Sans Frontières (MSF) previously treated thousands of patients per month, the organization said today.

On August 11, 2017, two weeks prior to attacks by the Arakan Rohingya Salvation Army (ARSA) and the Myanmar Army’s so-called “clearance operations” that followed, MSF lost government authorization to carry out medical activities in northern Rakhine. One year later, MSF remains unable to operate in northern Rakhine. While MSF has repeatedly requested that the Myanmar government grant it the necessary travel and activity authorizations to provide medical care to those in need, administrative red tape has made this impossible.

“The lack of sustained independent assessments in northern Rakhine means that no one has a comprehensive picture of the situation on the ground and the medical and humanitarian needs,” said Benoit De Gryse, MSF’s operations manager for Myanmar. “MSF, once again, requests the government grant immediate and unfettered access to northern Rakhine to all independent and impartial humanitarian actors to ensure that the health care needs of the population can be evaluated and addressed.”

MSF had provided health care to all communities in northern Rakhine since 1994. At the time operations were suspended on August 11, 2017, MSF was operating four primary health care clinics in northern Rakhine—three of which were subsequently burnt down—and was providing over 11,000 primary and reproductive health care consultations per month, as well as emergency transport and assistance for patients requiring hospitalization.

The “clearance operations” that started around August 25, 2017—which are estimated to have resulted in the deaths of at least 6,700 Rohingya—spurred more than 700,000 Rohingya to flee targeted violence in northern Rakhine for safety in Bangladesh, leaving many areas of this state sparsely populated. However, there are still 550,000 to 600,000 stateless Rohingya across the state.

The Myanmar government claims that health care needs are being met, but the severe limitations on humanitarian access to northern Rakhine make it impossible to gather independent and impartial information about public health and medical humanitarian needs of people living in this region. This is especially important given discussions of repatriating Rohingya refugees from Bangladesh to Myanmar. MSF continues to assert that all repatriation must be voluntary, and that access to basic services like health care, water, sanitation, and shelter must be met for those who choose to return.

“The medical needs of the remaining Rohingya population in northern Rakhine, as well as those of ethnic Rakhine and other minorities, must be thoroughly and independently assessed,” De Gryse said. “Humanitarian access is key to understanding the situation on the ground; without credible information, there is no way to assess conditions for return.” De Gryse said.

MSF maintains a staff presence in Maungdaw, northern Rakhine, despite being unable to run medical activities, and teams continue to hear from the Rohingya community there about the difficulties they face accessing health care. For example, they continue to face restrictions on their freedom to move around the region, cannot reach better health facilities in the country, and face unaffordable medical fees.

One person* MSF spoke to was forced to seek medical care in recent months for their mother in Bangladesh, who died there. “We don’t have access to Sittwe or Yangon, so the only option is to cross the border to Bangladesh,” they told MSF. “This is a very risky route. If I could take my mother’s body back to my village and have a funeral next to my father I would be very happy. But that is not going to happen due to the situation of my country. If we had been able to see a specialist here, we wouldn’t have had to go to Bangladesh.”

MSF continues to provide primary health care and emergency referrals for patients in Sittwe district, Central Rakhine. Elsewhere in Myanmar, MSF continues to run its medical projects in Shan, Kachin, and Yangon, as well as in the Naga Self-Administered Zone and Tanintharyi Region.

*The identity of the person has been withheld at their request.