A Red Cross officer adjusts a man's mask in Mrauk-U on August 21. (Hkun Lat | Frontier)
A red cross officer adjusts a man's mask in Mrauk-U on August 21, 2020. (Hkun Lat | Frontier)

Rakhine is in a state of emergency

COVID-19 travel restrictions will not keep people from fleeing when there are mortar shells falling around them, writes a medical doctor on the COVID-19 frontline in Sittwe.


This past week has been tragic for Sittwe, the Rakhine State capital. One person tested positive for COVID-19 on Monday, followed by three on Wednesday and 20 on Friday. There are now 72 new confirmed cases in Sittwe, three in Mrauk-U and two in Thandwe Township, in the state’s south. None of these have involved a history of foreign travel or known contact with COVID-19 patients, indicating community spread.

The authorities have responded decisively. The entire town has been issued a stay-at-home order, dine-in eating has been prohibited at restaurants and food markets are operating on limited hours. The town’s main market was closed on August 21. Additionally, anybody leaving Sittwe must undergo a 14-day quarantine, while primary contacts of current cases are being tested and made to quarantine – either at a hotel or a designated quarantine facility – and secondary contacts are being told to home quarantine. There is a curfew from 9pm until 4am and several streets are locked down. Local authorities are issuing K1,000 fines for anyone caught not wearing a mask here. NGO staff are being prevented from having direct contact with displaced communities.

All these measures have been implemented with good intentions, but each has its downsides. With nearly all travel shut down, seeking non-COVID-19 medical treatment – including in emergencies – will become extremely difficult. And the disruption to supply chains means the cost of masks and other personal protective equipment will rise – both for the public and for frontline medical staff. Right now, the only routes available into Sittwe are via air, and only one flight — from Yangon to Sittwe – is flying, making it very difficult to stock essential protective equipment in Sittwe. These measures will hopefully help stop the virus from spreading outside of town, but they will also make life in Sittwe much more difficult.

Doctors are now treating at least 50 COVID-19 patients at Sittwe General Hospital, which has a small medical staff and limited capacity in its isolation ward. A team of volunteer doctors and doctors from the Ministry of Health and Sports have arrived to help and additional isolated spaces are being set up, but the hospital is still likely to be overwhelmed if new cases continue emerging. More basic technicians are needed to conduct swab tests, as well as more nurses and infection control specialists in the hospital.

The health and safety of current and future hospital staff is also of primary concern. Many are locals that live with their families. They are afraid for go home now for fear of spreading the disease to relatives. It would be better if the hospital were able to provide staff accommodations as they battle this pandemic. Meanwhile, effective sanitation and infection control among staff, including social distancing, will be essential.

But perhaps what is most devastating is a possible indication that the virus may be spreading in camps for internally displaced people. Among the new cases are several non-governmental organization staffers that had recently visited camps around Sittwe. In these camps, thousands of people live clustered together in improper housing, making it impossible to avoid crowds or practice social distancing.

The residents of these camps – more than 100,000 of them in Sittwe alone – are among Myanmar’s most vulnerable people. The camps are spread throughout 10 townships, eight of which are still experiencing the world’s longest government-mandated internet blackout. It began in June 2019; mobile data was restored earlier this month but at 2G speeds, making it unusable for most tasks.

During this pandemic, access to information – particularly to news on COVID-19 and the best measures to prevent its spread – is essential, for nobody more so than the IDPs themselves. They already have limited access to healthcare and, in some camps, awareness and understanding of COVID-19 remains low. The internet block stymies efforts to ameliorate this. 

Local authorities said IDPs who had contact with positive cases are being quarantined in the camps. All NGOs in Sittwe have suspended their activities. Those suspected to have been in contact with patients are being sent to quarantine, but some quarantine centers are so crowded they’ve begun turning people away. These people then return to their homes outside of the township. The two new cases in Thandwe had just returned from Sittwe.

But there is also, of course, the matter of why these people are living in camps in the first place. IDPs fear COVID-19, but their dreams are also haunted by ongoing fighting between the Myanmar military and the Arakan Army. The longer this war continues, the more people will be displaced, moving from one village or township to another. When mortar shells fall, travel restrictions do not keep people from fleeing.

The government must immediately intervene to stop the fighting and show it believes that lives in Rakhine State matter.

Dr Nay Lin Tun is a medical doctor currently performing humanitarian work on the COVID-19 frontline in Sittwe.

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