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Ongoing military operations in Rakhine State have resulted in more than 688,000 Rohingya refugees fleeing to Bangladesh since late August 2017.
“We are concerned that if the response to this crisis does not increase to meet the huge demand for shelter, clean water, medical care and food, then the risk of disease outbreaks looms, and with that, a public health emergency,” said MSF Emergency Coordinator, Robert Onus.
Those arriving in Bangladesh have shared stories with Médecins Sans Frontières/Doctors Without Borders (MSF) about their villages being systematically raided and burnt by the Myanmar military.
Mob groups are targeting the Rohingya and women and children are being raped and killed.
It is one of the largest displacements of people in recent memory, in such a short period of time.Recent surveys conducted by MSF in refugee settlements in Bangladesh estimate that at least 9,000 Rohingya died in Myanmar's Rakhine State between 25 August and 24 September 2017.
As 71.7 percent of the reported deaths were caused by violence, at least 6,700 Rohingya, in the most conservative estimations, are estimated to have been killed, including at least 730 children below the age of five.
We are treating more than 35,000 patients in a country where fewer than one in three people who need antiretrovirals receive them.
Médecins Sans Frontières/Doctors Without Borders (MSF) first worked in Myanmar in 1992.
In 2016, we continued to work with the Ministry of Health to provide care for HIV and TB patients, primary healthcare, as well as vaccination activities.
DAWEI, TANINTHARYI REGION
We remain the main provider of HIV care in Dawei, Tanintharyi region, and treated 2,355 people with the disease in 2016.
Teams are targeting high-risk and vulnerable groups, such as sex workers, men who have sex with men and migrant workers, and supporting the NAP to decentralise treatment.
During the year, 742 stable patients were transferred to NAP care. Also this year, the diagnostic capacity of the project was improved with the introduction of a machine to detect viral load in patients.
In addition, we treat HIV patients co-infected with diseases such as tuberculosis (TB), cytomegalovirus retinitis and hepatitis C. This year, some hepatitis C patients started a new, more affordable and more effective oral treatment in Dawei and also in Yangon.
PRIMARY HEALTHCARE IN WA SPECIAL REGION 2, SHAN STATE
Due to a worsening political situation and the inability for us to secure access for international staff to work in the region, medical activities in Wa Special Region 2 were limited in 2016.
Despite this, in the remote Pang Yang and Lin Haw townships, where access to healthcare is minimal, we conducted over 9,000 outpatient consultations through fixed and mobile clinics and supported Ministry of Health vaccination campaigns.
VACCINATIONS IN NAGA, SAGAING REGION
Between January and March, we supported the Ministry of Health’s catch-up vaccination campaign for 10,951 children under five in Lahe township.
Children were immunised against a number of diseases, including polio, diphtheria, tetanus, whooping cough, measles, hepatitis B and haemophilus influenza type B.
In Yangon, we provided care to 16,869 patients with HIV, TB or multidrug-resistant TB (MDR-TB) at two clinics, and started its first patient on extensively drug-resistant TB treatment, as part of the endTB programme.
KACHIN AND SHAN STATES
During the second half of 2016, conflicts in Kachin and northern Shan state intensified, hampering access for staff and patients.
In Kachin, we continued providing care to 11,020 patients with HIV, TB and MDR-TB. Teams also conducted 68 mental health consultations at a camp for internally displaced people. In Shan, we provided treatment to 4,628 patients with HIV and MDR-TB, and a mobile team conducted 900 primary healthcare consultations across the north.
New project in Wa Special Region 2
In Lin Haw, we have opened a new clinic inside a local health facility. Since September, teams have been running weekly mobile clinics providing basic healthcare at the market in Pang Yang.
Teams also conducted general health and hygiene education and information sessions in two nearby schools.
Caring for people living with HIV
In 2015, MSF provided care for more than 35,000 people living with HIV in its projects in Yangon and Tanintharyi regions, as well as in Shan and Kachin states – our most substantial activity in Myanmar. The government has made great progress in the provision of HIV treatment but unfortunately only half of the estimated 210,000 people who need it receive antiretroviral (ARV) therapy.
Mental health projects in Myanmar and Indonesia
MSF teams offered medical and psychosocial care to more than 700 people who had been detained after being rescued from abandoned smuggling boats in the Bay of Bengal in May and June.
In August, MSF started a mental health project for Rohingya refugees from Myanmar in Lhokseumawe camp in Banda Aceh, Indonesia. In November, the activities were extended to two camps in Langsa.
REDUCED HUMANITARIAN ACCESS IN RAKHINE STATE
The attacks on border police in northern Rakhine on 9 October prompted a complete lock-down and all humanitarian assistance was suspended, leaving thousands of patients without access to primary healthcare for over two months.
We conducted just over 2,000 medical consultations during the last quarter of 2016, compared to the roughly 15,000 staff would have expected based on the monthly average.
Hospital referrals were also halted, increasing the likelihood of avoidable deaths.
A partial resumption of programmes was allowed in mid-December, albeit in limited areas.
Checkpoints hindered access to emergency and specialist care, particularly for the Rohinyga, while movement restrictions for international staff prevented MSF from providing support to its teams and raising awareness about the urgent humanitarian needs in the area.