International relief organizations forced to flee western Myanmar after being targeted by Buddhist mobs say it will be almost impossible to return without strong diplomatic pressure on the government to depoliticize the distribution of aid: Until then, they say, the lives of more than 140,000 Rohingya Muslims in overcrowded, dirty camps will be at even greater risk.

In the next two weeks food stocks will run out and at least 20,000 people will be without clean water, according to humanitarian aid workers who gathered with colleagues in the country’s main city of Yangon on Monday to discuss the spiraling crisis.

The heath situation is even more dire, they said, with almost no life-saving services such as emergency hospital referrals.

“It’s not that we don’t want to go back, we can’t,” said one of the aid workers, who like others at the small, informal meeting asked not to be identified because he was worried about the safety of the local staff who stayed in Rakhine state.

Myanmar, a predominantly Buddhist nation of 60 million people, only recently emerged from a half-century of brutal military rule. Nascent democratic reforms under a nominally civilian government have generated optimism and brought billions of dollars from international donors – but a violent strain of religious extremism is threatening the progress.

In the past two years, Buddhist mobs torched and pillaged Muslim neighborhoods, killing up to 280 people and forcing another 140,000 from their homes, most of them Rohingya on the outskirts of Rakhine’s state capital, Sittwe.

The delivery of food, water and medical care to camps since then has been highly politicized.

Buddhist extremists see humanitarian aid groups, and those who assist them, as a lifeline for the long-persecuted religious minority. They have threatened staff, including posting names and addresses on social networking sites, and staged frequent protests.

As pressure on aid groups mounted, the government in February expelled Doctors Without Borders from Rakhine, where it was by far the biggest health care provider, in part because it hired Rohingya.

Then last week, hundreds of Buddhists spent two days attacking the offices and residences of U.N. agencies, OXFAM, Save the Children, Solidarities International and others in Sittwe, forcing aid groups to evacuate almost 700 staff statewide.

It was the biggest disruption of aid in two years.

The Ministry of Health has deployed 17 of its own doctors and health assistants to try to fill the gap, said Dr. Liviu Vedrasco, a technical officer for the World Health Organization in Myanmar, but with such tiny numbers there is only so much they can do.

They’ve started conducting their own mobile clinics, he said, but had to cancel plans Sunday and Monday to visit Muslim camps because they did not feel safe.

Humanitarian agencies, Vedrasco said, have to find a way back in. Even if the government works to depoliticize the situation, “it will take time to change feelings and attitudes” at the community level, he said. “There needs to be some interim solution.”

Johannes Kaltenbach, country director of the German medical program Malteser International, who was not among those present at Monday’s meeting, acknowledged that even if the government ensures protection of aid workers and their premises in the future, it will be difficult to get back to work.

“It’s hard to find staff,” he said. “House owners will be reluctant to rent office space, especially after their property was destroyed. The cars we rent, the people that work for us, all of them are afraid, they feel threatened.”

The United Nations, meanwhile, sent a high-level delegation to Sittwe on Tuesday to meet with senior officials from the central and state government to work on a short-term solution, including delivering water to Pauk Taw camp, reachable only by boat, and the remaining rations from the World Food Program warehouse.

“We are doing what we can,” said Pierre Peron, the spokesman for the U.N. Office for the Coordination of Humanitarian Affairs, “but we really need NGOs (non-governmental agencies) back.”

Aid groups urged the U.S., the European Union and other members of the international community, to step up the pressure.

“The diplomatic community – and the government – needs to understand, unless they can shift this situation, the fate of those in the camps will be on their shoulders,” they said.

Even before international aid groups left, the Rohingya were desperate for health care. Respiratory infections and diarrhea – the two biggest child killers worldwide – were rampant in the sprawling camps that are blanketed by choking clouds of dust. With rainy season approaching, they will soon be overflowing with water and impenetrable mud, sparking fear cholera or other waterborne outbreaks.

Measles, tuberculosis and other spreadable diseases also remain a worry.

Rakhine, the second poorest state in the country, is home to 1.3 million Rohingya. The government considers members of the religious minority to be illegal immigrants from neighboring Bangladesh, though many arrived generations ago. Denied citizenship by national law, they are not allowed to travel outside of the state. There are also restrictions on the jobs they can hold, how many children they can have, and access to education.

Those living in camps under apartheid-like conditions cannot leave without paying hefty bribes.

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