Death Stalks Muslims as Myanmar Cuts Off Aid
In Myanmar, Deaths Rise Among Minority Muslims as Aid Is Withheld
Credit 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.
200 mileS
INDIA
CHINA
MYANMAR
Irrawaddy R.
LAOS
Sittwe
THAILAND
Bay of
Bengal
Yangon
Andaman
Sea
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.
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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.
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