Medical Aid Group Seeks ‘Unfettered Access’ in Myanmar’s Rakhine State

An international medical aid agency called Friday for “unfettered access” to Myanmar’s restive Rakhine state as it warily welcomed a government invitation to return to the region three months after being expelled for highlighting injuries suffered by minority Muslim Rohingyas in communal violence.

The Rakhine government announced a day earlier that it had invited Paris-based Doctors Without Borders (MSF) back to the state following its expulsion in February and also called for the return of other international aid organizations which fled a month later after Buddhist mobs disrupted their work helping displaced Rohingyas.

In a statement, MSF said it was “cautiously optimistic” about the invitation to return.

“Given that for many people in Rakhine access to medical services remains a major challenge, we hope that MSF can restart treating patients as soon as possible,” said Marcel Langenbach, director of operations for MSF in Amsterdam.

But the relief group urged the government to allow humanitarian aid agencies “unfettered access” to the region, to ensure that people can receive medical care.

“We understand that this is a sensitive environment, particularly with regard to inter-communal tensions. This makes it all the more important that independent international organizations can play their role in treating those most vulnerable,” Lagenbach said.

MSF said it had a team of national and international staff ready to provide care immediately in Rakhine, where the group was the largest nongovernmental medical provider in the state before it was forced to suspend operations in February following a series of protests.

MSF was expelled from Rakhine after it said it had treated injured people in northern Rakhine near a village where the U.N. alleged dozens of Rohingya were killed in an attack by Buddhist mobs. The government has dismissed the allegations.

The Rakhine government said on Thursday that it “would like to invite all” two dozen international organizations, including MSF and U.N. agencies, “to participate in development, humanitarian, education, and health-care programs in accordance with the wishes of the Rakhine people.”

"As human beings we all commit errors and the errors usually lie on both sides," Soe Thein, a minister in Myanmar President Thein Sein’s Office, was quoted saying at a press conference Thursday.

Citing 24 international aid groups operating in Rakhine, he said "we invite all to join hands with us ... especially MSF."

Forced to flee

The agencies had been accused earlier of giving preferential treatment to the Buddhist-majority region’s Muslim Rohingya population, who rights groups say have borne the brunt of bloody communal violence that has left more than 280 people dead and tens of thousands displaced since 2012.

Many of them were forced to flee in March when mobs of hundreds of ethnic Rakhines ransacked and hurled stones at their offices following reports that an aid worker from Malteser International had taken down a Buddhist flag.

After a series of consultations following their departure, the government began to soften its stance on allowing aid groups back to Rakhine state, though not without conditions.

In April, a government-led panel informed United Nations agencies and international nongovernmental organizations that they would be required to report on their activities in advance and receive approval for them as part of new regulations guiding their operations in the region.

The panel—called the Emergency Coordination Center (ECC) and comprised of state and central government officials, as well as representatives from the U.N., NGOs, and the local ethnic Rakhine community—had said at the time that it would not allow MSF or Malteser to return to the region.

It is unclear whether any additional restrictions will be placed on MSF if it reopens its operations in Rakhine.

Humanitarian crisis

The U.N. estimates that 70 percent of workers from aid groups have already returned to Rakhine, but this does not include the approximately 500 MSF staff who had been operating in the state prior to February.

Aid workers were providing assistance to 140,000 Rohingyas living in crowded displacement camps near the Rakhine capital Sittwe and more than 700,000 other vulnerable people in remote, hard-to-reach villages, leaving the region unequipped to face a humanitarian crisis.

According to MSF, in 2013 alone the group’s doctors and community health workers performed more than 400,000 consultations in Rakhine treating HIV, tuberculosis, malnutrition, and malaria, and providing antenatal and postnatal care and mental health services.

Despite the government’s decision to welcome back the international aid groups, concerns remain among the Buddhist community.

Than Tun, a member of the ECC, was quoted as saying that the community mistrusts any group it suspects of siding with the region’s Muslims.

“Although we have agreed to allow [MSF] in, we are rather worried that they will not cooperate with us with full transparency like other INGOs [international nongovernmental organizations],” Reuters news agency quoted him as saying on Thursday.

“We find it difficult to trust them.”

He also downplayed the role of INGOs in the region, though foreign aid workers have said that work by government medical teams is largely inadequate.

“The Ministry of Health has been providing better health care than MSF or Malteser,” Than Tun told Reuters. “And we can see this with our own eyes.”

Political points

Rights groups have expressed concerns that the move by President Thein Sein’s quasi-civilian government to allow aid groups back to Rakhine may be purely politically-motivated.

The United Nation's assistant secretary general Kyung-Wha Kang in June raised concerns about “appalling conditions” in the Sittwe camps.

But according to rights groups, Rohingyas in severely restricted northern Rakhine state live in an even worse situation, with soaring malnutrition and maternal mortality rates.

Rohingyas, who are considered illegal immigrants from Bangladesh, often cannot travel, marry, or seek medical treatment without official permission.

Yanghee Lee, the new U.N. human rights envoy to Myanmar, warned during a visit to Rakhine last week that religious conflict in the state could adversely impact the tenuous democratic transition and peace process.

“The grievances that fuel or result in the current tensions and conflict … are still ongoing,” she said at a meeting with the state government in the capital Sittwe.

“If we do not address the situation, I am afraid it will undermine democratic reform and the peace process,” warned Lee, who is on a 10-day fact-finding mission to the country.