Nearly 750,000 people, most of them members of a Muslim minority in one of the poorest parts of Myanmar, have been deprived of most medical services since the government banned the operations of Doctors Without Borders, the international health care organization and the main provider of medical care in the region.

The government ordered a halt to the work of Doctors Without Borders two weeks ago after some officials accused the group of favoring the Muslims, members of the Rohingya ethnic group, over a rival group, Rakhine Buddhists.

Already, anecdotal evidence and medical estimates show that about 150 of the most vulnerable have died since Feb. 28, more than 20 of them pregnant women facing life-threatening deliveries, medical professionals said. Doctors Without Borders had been the only way for pregnant women facing difficult deliveries to get a referral to a government hospital, they said.

At the time of the order, the government said it was suspending the group’s operations in Rakhine State in the far north, but it has offered no time frame for when services might be resumed. The deputy director general of the Ministry of Health, Dr. Soe Lwin Nyein, said in a statement that his department would manage the health needs of the “whole community.” A spokesman for President Thein Sein, Ye Htut, said the government dispatched an emergency response team with eight ambulances after the Doctors Without Borders clinics were closed.

Myanmar’s health services are among the most rudimentary in Asia, and with severe government restrictions on movement that prevent Muslims from seeking medical help outside their villages in Rakhine State, the impact of the shutdown will be severe, medical professionals said.

Doctors Without Borders was by far the biggest health provider in the northern part of Rakhine around the townships of Maungdaw and Buthidaung, serving about 500,000 people, most of them Rohingya, they said. An additional 200,000 people, many of them Rohingya in displaced camps around the state capital, Sittwe, had access to the group’s services.

In Aung Mingla, a Muslim neighborhood in Sittwe, patients with tuberculosis, a common disease in the area, said they were down to their last supplies of medicine. The Rohingya who live in Aung Mingla are prevented from leaving the district by barbed-wire security posts and police officers.

“Since Doctors Without Borders is not in Rakhine, I don’t know who will provide medicine when my supply runs out in three months,” said one patient, Muklan, 30, who like many people in Myanmar goes by a single name. “I hope Doctors can come back as soon as possible.”

Another Rohingya man, Shafiul, who worked for Doctors Without Borders in Aung Mingla, said he was concerned for his patients with tuberculosis, malaria and H.I.V. “These patients have been getting help from Doctors Without Borders for years,” he said.

In northern Rakhine State, where Doctors Without Borders had run five permanent clinics and 30 mobile ones, about 20 percent of children are acutely malnourished, medical professionals said. An intensive feeding center for those patients was shuttered as part of the government’s directive.

For the most part, Western donors and the United Nations say they are reluctant to antagonize the government of Myanmar, which has started along the path of economic and political reform. The donors have chosen quiet diplomacy over outspoken criticism of the government’s policies toward the Rohingya.

But the action against Doctors Without Borders raised some public alarm.

“We are extremely concerned about the situation,” said Mark Cutts, the head of the United Nations Office for the Coordination of Humanitarian Affairs in Myanmar. “We are in intense discussion with the government in a way that will allow operations to resume as soon as possible.”

The deputy health director, Dr. Soe Lwin Nyein, said the government would accept supplies of medicine for tuberculosis and H.I.V. from Doctors Without Borders. But how these supplies will be distributed remains unclear. Negotiations are underway with the government over the distribution, Western officials said.

Other international organizations, including the International Committee of the Red Cross, which supports government health centers around the towns of Sittwe and Mrauk U, have been allowed to continue operations in Rakhine. But Doctors Without Borders was by far the largest health provider.

The government targeted the group after its rural clinics provided treatment to 22 Muslims in the aftermath of a rampage by Rakhine security officers and civilians in the village of Du Chee Yar Tan in January. The United Nations says 40 people were killed in the violence that night.

The government has denied that the deaths occurred, and on Tuesday, a presidential commission sent to the village to conduct an inquiry reported that it could find no evidence of the killings. The commission was the third investigative group sent by the government, and its findings matched those of the previous inquiries.

After the killings in January, the government criticized Doctors Without Borders for hiring Rohingya and said the group was giving disproportionate attention to Rohingya patients. Under state regulations in Rakhine, Rohingya are prevented from visiting many of the state-run clinics.

Doctors Without Borders says it has treated patients in Rakhine since 1994 regardless of ethnicity, and foreign aid workers point out that the Rakhine Buddhist ethnic group has access to government health facilities that are generally denied to the Rohingya.

A radical Buddhist leader in Myanmar, Ashin Wirathu, who has compared Muslims to dogs, arrived in Sittwe on Wednesday for a five-day visit that was likely to stir anti-Muslim sentiments further. In a sermon at the main Buddhist temple Wednesday night, he said that if Western democracies were allowed to have influence in Myanmar, the Rakhine people would be overwhelmed by increasing numbers of Muslims, and would eventually disappear.

The monk’s visit appeared to be timed ahead of a national census — the first in Myanmar in more than 30 years — that is due to take place March 30 to April 10 across Myanmar. Tensions during the census, funded in part by the United Nations and the British government, are expected to be high in Rakhine.

Rakhine politicians have said they oppose allowing the Rohingya to identify themselves as Rohingya when they fill out the census forms. If they did, the census would probably show that their numbers are greater than the current estimate of 1.3 million. The overall population is estimated at 60 million.

By shutting down Doctors Without Borders, the government is ensuring that there will be fewer foreigners to witness any outbreaks of violence during the census process, aid workers said.

Link: http://www.nytimes.com/2014/03/14/world/asia/myanmar-bans-doctors-without-borders.html?&_r=0