The Myanmar government on Feb 27 ordered Médecins Sans Frontières-Holland (MSF-H) to cease activities in Rakhine State. The move came after the agency reported that it had treated 22 patients affected by violence in Du Char Yar Tan village, where up to 40 people were reportedly killed in January. The government denies that the killings took place, and the state authorities and local politicians have accused MSF of spreading false information. MSF has also been accused of providing preferential medical treatment for Rakhine State's Muslim population. MSF’s statement last week claimed that for over 22 years, the agency has provided health care to the people of Myanmar based solely on need, irrespective of race, religion, gender, HIV status or political affiliation.
This removal of vital humanitarian aid in one of Myanmar’s most vulnerable regions leaves tens of thousands of people without health care. Myanmar’s health infrastructure is weak and communicable diseases, including drug-resistant strains of malaria and TB, are widespread.
MSF has provided medical care to people in Myanmar since 1992, and is the largest provider of anti-retroviral treatment in the country. The agency is also the largest international medical aid provider in Rakhine State. The suspension of its operations leaves a gap that no agency – government, UN or NGO – has the capacity to fill.
The expulsion also risks derailing Myanmar’s reform process. The reforms, which began in 2011, encompass political, economic and social changes, including achieving universal health coverage by 2030. Problems in Rakhine State have already marred Myanmar’s transition; waves of deadly violence in 2012 left hundreds dead and more than 140,000 displaced. Even before the 2012 violence, Rakhine State was one of Myanmar’s least developed regions, with high rates of malnutrition, infant and maternal mortality, food insecurity and poverty. If the humanitarian situation in Rakhine State worsens, the government’s stated commitment to universal health coverage will be set back dramatically, undermining the credibility of its entire reform agenda.
In 2014, Myanmar assumed the role of chair of the Association of Southeast Asian Nations (Asean). As chair of Asean, how can Myanmar promote the principles of the Asean Charter – peace, tolerance, the protection of human rights and inclusive development – if within its own borders humanitarian aid is blocked and suffering increased? Myanmar’s democratic journey cannot be expected to be easy after 50 years of military rule; there will be many setbacks and challenges along the way. But if something as fundamental as the basic right to humanitarian assistance for those in need is so easily withdrawn, then the people of Myanmar cannot expect the promise of reform to go very far in bringing real improvements to their lives.
Lilianne Fan is a Research Fellow at the Humanitarian Policy Group (HPG). HPG is based at London think-tank the Overseas Development Institute.