Authorities in Myanmar’s western Rakhine State say they are ready to take over the health programmes Médecins Sans Frontières (MSF)-Holland has been implementing in the conflict-hit state for the past 20 years, after the government ordered their closure.
“We can take over in one week,” Aye Nyein, director of Rakhine’s health department, told IRIN on 3 March from Sittwe, the Rakhine state capital.
His comments follow a written order by the Burmese government on 27 February for the medical charity to cease all operations in the country in an apparent response to a growing public perception that aid from the NGO in Rakhine State was being unevenly distributed, with greater assistance being provided to displaced Muslim Rohingyas over the ethnic Rakhine population.
State department heads met over the weekend to draft a strategy and timeframe for taking control of the medical charity’s programmes, he said, noting that an accelerated transfer was necessary to help reduce community anger against international NGOs working in the area.
“The people want them out as soon as possible and are very pleased with the news [of MSF’s expulsion],” Aye Nyein said, referring to the government order for MSF-Holland to cease all operations in the country.
The order was partially reversed the next day, after talks between MSF and the national government. MSF is now allowed to continue its work in Kachin and Shan states, as well as in the Yangon Region.
The suspension highlights an increasingly difficult working environment for humanitarian staff in Rakhine State, where hundreds of people were killed and more than 140,000, mostly Muslim Rohingyas were displaced following two deadly bouts of sectarian violence between ethnic Rakhine Buddhists and the minority Rohingya population in 2012.
According to the UN Office for the Coordination of Humanitarian Affairs (OCHA), community aversion to international organizations in Rakhine and anti-aid worker sentiment rose in the second half of 2013, affecting the ability of international agencies to provide assistance to both Rakhine and Muslim communities. In some cases, humanitarian assistance had to be temporarily suspended.
The situation is particularly difficult in Sittwe, Kyauktaw and Myebon townships, with incidents also reported in Minbya, Mrauk-U and Maungdaw, including harassment and intimidation of aid workers, as well as the blocking of aid to camps.
MSF-Holland and other international NGOs have been accused of favouring the Rohingyas, who are de jure stateless under Burmese law and are referred to locally as illegal immigrants from Bangladesh.
“Local Rakhine communities have explained that the negative view of the role and work of UN and INGOs [international NGOs] is primarily based on a perception that aid is unevenly distributed, with greater assistance being provided to Muslim IDPs and communities,” says OCHA’s latest humanitarian bulletin. Aid workers have been struggling to address this perception.
If MSF’s expulsion is not reversed, other international NGOs could also be expelled from the state, aid workers in Sittwe warn. “What we are all wondering is who is next?” an international aid worker in Sittwe said.
In February, OCHA launched a public information campaign in Sittwe to improve understanding of humanitarian response and development projects across the state.
“This was part of an effort to be more transparent about our work by increasing outreach to the public, local community leaders, and civil society groups to promote dialogue and improve the understanding of the humanitarian response and development projects across the state,” said Pierre Péron, the OCHA spokesman in Yangon. “Humanitarian workers are fully committed to assisting vulnerable people in need wherever they are found, regardless of their ethnicity, nationality, religion, gender or class.”
However, according to Aye Nyein, anger with MSF remains so intense that all of its staff in Rakhine would need to be replaced. “Once MSF is gone the protests will die down,” he insisted. "We don't want anything left from MSF. No staff, no medicine, no cars, no boats," he said.
Meanwhile, in a statement over the weekend, MSF said it was encouraged that the government was allowing it to resume its operations outside Rakhine, but remained “extremely concerned about the fate of tens of thousands of vulnerable people in Rakhine State who currently face a humanitarian medical crisis”.
With over 500 staff across the state, MSF is the widest reaching NGO with the most impact working on health in Rakhine; its programmes assist the most vulnerable and hard-to-reach communities with primary healthcare services, reproductive health, malaria, HIV and tuberculosis treatment, and emergency referral services. In 2013, MSF staff carried out over 400,000 primary healthcare consultations and over 2,900 emergency referrals in eight townships in Rakhine State.
Thousands of malaria patients are also treated across the state every year by MSF teams. Since 2004, MSF has treated over 1.24 million malaria patients in Rakhine State.
However, Aye Nyein insists there would be no disruption in services during the transfer of MSF’s programmes to the Department of Health.
According to Myanmar’s Ministry of Health, the state, one of the most remote, poorest, and most densely populated, has only 450 doctors for a population of 3.3 million.