SITTWE, Burma — When the kicking stopped, Zura Begum suspected something was wrong with the twins she was supposed to deliver soon. When the pain started shooting through her body, all doubt was erased.
The 20-year-old needed help. But she was trapped with thousands of other Muslim Rohingya in a squalid, dusty camp in Rakhine state in western Burma, also known as Myanmar.
The foreign aid workers she had relied on early in her pregnancy were gone — forced out by a distrustful government and extremist Buddhist mobs. Getting help outside the camps, in hospitals run by the Buddhist Rakhine majority, requires special permission.
And there was one more obstacle: The fear that has grown over two years in which ethnic violence in Rakhine, mostly by Buddhist mobs against Rohingya, has left up to 280 people dead and forced another 140,000 from their homes. Rohingya worry Buddhist doctors and nurses will hurt or even kill them, though aid workers, now just beginning to return to Rakhine, say there is nothing to suggest that the rumors are true.
Myanmar, a predominantly Buddhist nation of 60 million, has been gripped by ethnic and religious violence — mostly in Rakhine — since it began its bumpy transition to democracy three years ago.
Though many Rohingya here are from families that arrived generations ago, the government considers them all illegal migrants from Bangladesh. Many of those displaced by recent violence live on the outskirts of Sittwe, the capital of Rakhine.
There are reports almost daily about deaths, many of them pregnant women experiencing complications that could have been prevented, according to aid workers and Rohingya in the camps.
The government expelled the aid group Doctors Without Borders from Rakhine in February. It had angered officials by hiring some Rohingya staff, and by saying it had treated victims of an attack on a village in northern Rakhine state early this year. The United Nations has said more than 40 people may have been killed in that attack, but the government says the only death was that of a policeman.
Weeks later, more than 700 other foreign aid workers fled after their guest houses, offices and warehouses were attacked by Buddhist mobs.
The government insisted it could fill the gap. The state deployed dozens of its own doctors into Muslim camps. They show up several times a week, but only for a few hours.
The government also promised to let Save the Children, Oxfam and other humanitarian groups return to Sittwe within days, but few staff have returned so far. Those who have say they must operate under greater restrictions than they had before.
Begum and her husband, Mohamad Rafis, entered the camp after Buddhist mobs destroyed their village. Like most men in the camps, Rafis is not working.
But Begum had held on to hope. She was getting the prenatal care she needed — until Doctors Without Borders was forced out in February. As her due date neared, something went wrong with her pregnancy, and when the pain came, it was obvious that she needed a doctor.
On April 13, Begum’s family took her to a small hospital in Dapaing village, but the doctor wasn’t there. He told the nurses by phone that she should go to Sittwe General Hospital.
Like others in the camp, Begum had heard rumors that several Rohingya admitted to the hospital had not made it out alive. Foreign aid workers said they have not seen evidence of Buddhist doctors treating Rohingya improperly.
A more certain risk was not getting medical help. At the camp, Begum’s husband and parents took turns holding her hand, rubbing her stomach with ice, trying to console her.
“She was screaming, ‘I’m dying! This is so painful! The pain comes from the belly! Help me!’” said Abdul Melik,” a friend of Begum’s family.
When the International Red Cross, which has managed to maintain a tiny presence in Sittwe, learned about Begum’s case, the group was able to convince her to go to Sittwe General.
She went to the Sittwe hospital three days after she had gone to the one in Dapaing. One baby was believed to have died several days before the other, and sepsis may have set in by the time she was admitted. But after her surgery, Begum appeared to be in stable condition. She spent a week in recovery and was supposed to be released April 25.
Begum’s aunt Mastaba Khatu, who stayed with her in the hospital, said that hours before her niece was due to go home, a doctor led her to another room, saying he just needed to give her one final injection.
Twenty minutes later, pain started surging again through Begum’s stomach. And moments later, she was dead.
Tin Aung, an obstetrics doctor at the hospital, would not comment about Begum’s case but said Rohingya and Buddhist Rakhine patients are all treated the same.
“We have so many patients here. ... Whether we can help them depends somewhat on what condition they were in when they arrived,” he said. “We do the best we can.”
--The Associated Press