Difficulties in accessing patients and delivering healthcare
Since November 2023, when the conflict between the Myanmar military and Arakan Army resumed, MSF teams faced major difficulties in accessing patients. For eight months, MSF did not have authorisation to run any mobile clinics in Rakhine State including in the displaced persons camps in Pauktaw Township, where MSF is often the only healthcare provider. These camps are only accessible by boat, but with the escalation of conflict in Pauktaw Township, our teams could no longer travel to provide healthcare, nor could patients in need of emergency care reach the hospital in Sittwe. This presents a major issue for patients with chronic health problems, emergency needs and complicated pregnancies.
This June 2024, MSF received travel authorisation to resume its mobile clinic for a month in the mainly Rohingya Aung Mingalar quarter in Downtown Sittwe. Our teams are operating here with reduced capacity, including due to severe supply constraints. Our clinics in Pauktaw and other Townships remain inaccessible for the time being.
Travel restrictions are not just affecting MSF, but also other organisations and institutions providing life-saving assistance and healthcare.
MSF is no longer authorised to send any medicines to the camps in Pauktaw. MSF community staff have managed to continue the provision of basic health services, but it is difficult to provide patients with basic healthcare as medical supplies dwindle and medical staff can’t reach them.
Emergency referrals blocked
Before the resumption of the conflict in November 2023, when people in the camps or villages supported by MSF needed secondary hospital care, they relied on MSF to provide emergency referrals, including pick up of patients and transportation to secondary hospitals by car or boat. This is no longer possible due to travel restrictions imposed by the authorities, leaving people without the option of receiving specialised medical care.
For people attempting to reach hospital independently, the journey is fraught with difficulty. For patients in Pauktaw, reaching Sittwe by sea is practically impossible, while healthcare services available to them in other Townships are limited, equally affected by the conflict, and often require an even longer journey.
People sometimes die on the way to seek healthcare—or they die because they cannot even attempt the journey due to the prohibitive cost and difficulty of travelling. As a result, MSF has seen an alarming trend in maternal and neo-natal deaths. In January, our teams reported the deaths of a mother and her twins, and of two mothers who have each lost a baby because they were forced to deliver at home. Just this June, our teams reported the death of another mother who was unable to receive antenatal care since April. She was scared to leave the displacement camp in Pauktaw Township due to the road blockages.