[The crisis began with the government’s
expulsion of Doctors Without Borders, one of the world’s premier humanitarian
aid groups and the lifeline to health care for more than a million Rohingya
increasingly denied those services by their own government. But the situation
has grown more dire in recent weeks, as local Buddhist officials began severely
restricting other humanitarian aid to the camps and the rest of Rakhine State,
where tuberculosis, waterborne illnesses and malnutrition are endemic.]
By Jane Perlez
 |
Adam
Dean for The New York Times
|
SITTWE, Myanmar — By the time the baby girl was brought to the
makeshift pharmacy, her chest was heaving, her temperature soaring. The supply
of oxygen that might have helped was now off limits, in a Doctors Without
Borders clinic shut down by the government in February.
A hospital visit was
out of the question; admission for Rohingya Muslims, a long-persecuted
minority, always requires a lengthy approval process — time that the baby,
named Parmin, did not have. In desperation, the pharmacy owner sent the family
to the rarely staffed Dapaing clinic, the only government emergency health
center for the tens of thousands of Rohingya Muslims herded into displaced
people’s camps. Although it was just 4 p.m., the doors were shuttered.
“We became like crazy
people, running everywhere,” the child’s grandmother, Daw Mu Mu Lwin, said.
With no good choices left, the family returned to the pharmacy, where Parmin
died, untreated, three and a half hours later, cradled in her grandmother’s
arms.
The baby’s death was
part of a rapidly expanding death toll and humanitarian crisis among the
Rohingya, a Muslim minority that Myanmar’s Buddhist-led government has
increasingly deprived of the most basic liberties and aid even as it trumpets
its latest democratic reforms.
The crisis began with
the government’s expulsion of Doctors Without Borders, one of the world’s
premier humanitarian aid groups and the lifeline to health care for more than a
million Rohingya increasingly denied those services by their own government.
But the situation has grown more dire in recent weeks, as local Buddhist
officials began severely restricting other humanitarian aid to the camps and
the rest of Rakhine State, where tuberculosis, waterborne illnesses and
malnutrition are endemic.
Some aid workers fear
they are being kept away so there are fewer witnesses to rampant mistreatment
and occasional bloodletting; the doctor’s group was expelled from Rakhine State
after caring for victims of a violent assault on a Rohingya village that the
government denies ever happened.
The scope of the
government crackdown is serious enough that it has inspired at least some
rebukes from world leaders after near silence even as Myanmar’s government
ignored violence by local Buddhists in 2012 that left hundreds of Muslims dead
and drove many others into the displaced people’s camps. Loath to criticize the
government as it moves the country away from a military dictatorship,
international leaders also fear losing out in an international scramble for Myanmar’s
business, and allegiance.
The Obama
administration — which has been eager to keep strategically positioned Myanmar
away from China — weighed in when the president admonished Myanmar’s leaders
during his recent Asian tour, saying: “Myanmar won’t succeed if the Muslim
population is oppressed.”
And Tomas Ojea
Quintana, who was the United Nations representative responsible for human
rights in Myanmar until March, says the government’s obstruction of
humanitarian aid “could amount to crimes against humanity.”
Even those foreign aid
workers who have been able to return to work in recent days, do so amid
heightened security fears. State government officials recently allowed a
radical Buddhist monk to preach for 10 days in the region, stirring up passions
among Buddhists. After the visit by the monk, Ashin Wirahtu,
radical Buddhists ransacked the facilities of more than a dozen aid and U.N.
agencies, including the Red Cross, forcing more than 300 foreign aid workers to
evacuate.
Two battalions of riot
police officers, and a Myanmar Army division remained in their barracks.
With most foreign aid
workers gone, it is impossible to accurately assess the number of deaths caused
by the absence of lifesaving medical services; the government fails to keep or
share health records. Aid workers, however, say they see the evidence of a
building crisis.
“For sure the deaths
are accelerating,” said Dr. Liviu Vedrasco, the head of the health care cluster
for the World Health Organization in Myanmar.
One indicator of the
seriousness of the situation: Doctors Without Borders had sent about 400
emergency cases every month to local hospitals. In March, fewer than 20 people
got referrals required by the government, according to W.H.O.
Some of the only aid
currently being provided is food rations from the World Food Program, which has
been allowed to deliver rice and oil to the camps, a move some aid agencies say
they believe is aimed at averting the bad publicity that could come with mass
starvation. Even before the slashing of other aid, though, the World Health
Organization reported that the food program was not sufficient to prevent
malnutrition in the camps in Rakhine State or to stop the chronic acute
malnutrition in northern areas of Rakhine State where many other Rohingya live.
At a temporary clinic
set up by wealthy out-of-state Muslims after Doctors Without Borders was
banned, U Maung Maung Hla, a volunteer medical assistant, surveyed the women
clustered on the floor in front of him, holding emaciated babies. The children,
he said, needed more than the one-time ration of vitamins he was offering.
“These children are
only being fed rice,” he said. “If these conditions continue, all the babies
will die.”
The Rohingya, denied
citizenship, have long been outcasts in Myanmar, formerly called Burma. Many in
the Buddhist-majority country believe the Rohingya should go to Bangladesh,
even though many are not from there, or come from families that have been in
Myanmar for generations.
The camps outside
Sittwe, where more than 100,000 of the 1.3 million Rohingya in Myanmar live,
were set up after the 2012 burning of the Rohingya neighborhoods in the town, a
dilapidated trading center on the Bay of Bengal. Aid workers say the camps,
where tight security prevents people from leaving, even to work, have become
little more than sprawling prisons.
Until Doctors Without
Borders was chased out of the region, some of the few people who got to leave
the camps were the desperately ill, bound for the town’s hospital. Now, even
few of the sick leave.
In response to the
recent international criticism, the Myanmar government spokesman, Ye Htut, this
week told a radio network that “there is no state-sanctioned discrimination
against Muslims.” He also said there was no “outbreak of disease” in the camps
because Myanmar’s Ministry of Health had stepped in to provide health care,
sanitation and water.
But Dr. Vedrasco of
the World Health Organization noted that Myanmar was ranked second to last —
just above Sierra Leone — in the organization’s list of medical services, and
could not fulfill its promises.
Five government mobile
medical teams were sent to Sittwe at the end of March, but they were barely
seen.
In the camps, the
deaths often occur behind closed doors, in the cramped rooms of the bamboo
rowhouses built by the United Nations. Other people die in the small
mom-and-pop pharmacies where desperate families like Parmin’s go as a last
resort.
Some of the most
desperate cases are women with complicated pregnancies. Prenatal care is
scarce, resulting in high numbers of precarious births.
These days, most
pregnant women are reluctant to go to Sittwe General Hospital until it is too
late, put off by the elaborate series of permissions needed, and by fear. As
violence has increased, many Rohingya believe they will never emerge from the
14-bed ward set aside for them that used to be the prison ward.
Zhara Katu, 20, was
one of many too frightened to go to the hospital. In pain and pregnant with
twins, she instead chose the government-run Dapaing clinic. A Burmese doctor
determined the babies had died and recommended she go to the Sittwe hospital
for an urgent operation.
She went home instead.
Two days later, she
returned to the clinic but was so ill, she was transferred to the hospital. Her
father, Abdullah Mi, a scrawny, weather-beaten man, was terrified. “I worry
that the Rakhine will kill her there,” he said.
His daughter survived
the procedure to remove the babies, but died in the hospital a week later of
maternal sepsis, a very serious condition that Dr. Vedrasco said could have
been alleviated with earlier care.
By the last week of April,
some aid workers for international agencies were trickling back to the camps,
but reported facing conditions far less than the “return to normalcy” declared
by the national Ministry of Home Affairs.
A new emergency
coordinating committee established to oversee foreign assistance was dominated
by two Rakhine Buddhist community leaders who demanded approval rights over
their aid operations, a memo from the aid workers to the United Nations said.
The memo said the committee “is failing absolutely in its role to facilitate
the delivery of humanitarian assistance in Rakhine.”
It also urged the
United Nations to take a more aggressive stance with the government, saying
“there is a sense among nongovernmental organizations that at times the U.N.
advocacy could have been more robust.”
Sometimes, wondrously,
camp medicine works.
One of the busiest men
in the camps is Chit San Win, who once worked as a medical assistant in Sittwe,
and is now a popular amateur doctor racing from call to call on his motorcycle.
He arrived at one call
recently to find 4-year-old Roshan Bebe, lying unconscious, her head gushing
blood after a motorcycle knocked her over. He came equipped with a medical kit
he totes in a shopping bag — bandages, a few ointments, needle and thread.
As he cleaned and
stitched the gaping wound, Mr. Chit San Win said he was concerned about
internal bleeding that could prove fatal, but the child’s mother refused to try
the government hospital.
A few days later the
girl was sitting up, eating and talking, and Mr. Chit San Win declared “a
miracle.”
There was no such
happy ending for Nur Husain, 27.
On a recent day, he
traveled to the same pharmacy where Parmin died. He slumped in a chair in the
withering heat, gasping for air and running a temperature of 104 degrees. U
Maung Maung Tin, one of the pharmacy owners, called a doctor 400 miles away,
and on that advice injected Mr. Husain with four drugs.
Two hours later, the
muscular young man was dead.
It was unclear
precisely what killed him, according to a Western doctor who reviewed the four
medicines, which are commonly prescribed for asthma. But almost certainly,
proper monitoring and the oxygen ordinarily administered by Doctors Without
Borders could have saved him, said the doctor, who declined to be named because
he did not oversee the case.
Mr. Husain’s boss at a
rudimentary bakery called him a “dynamic” man, who held one of the few steady
jobs in the camp, earning two dollars a day as manager. His wife, Roshida
Begum, says she has no idea how she will now feed her two small children, and a
third who is on the way.
The family buried Mr.
Husain in a sandy plot on the shore of the Bay of Bengal within sight of tall,
slender coconut trees etched against the blue sky. His shallow grave site,
fenced with fresh bamboo, was surrounded by rows and rows of other graves dug in
recent months.
Wai Moe contributed reporting.
