Daw Saw Nu’s house was battered by the heavy rains and 280km/h winds of Mocha, a category–five cyclone making landfall in Myanmar in mid-May, the largest of its kind to hit Rakhine state and the northwest of the country in over a decade. Â
Response delayed by restrictionsÂ
More than two months on, despite the magnitude of this disaster, scaling up of an emergency response to address the immense needs of people impacted is still not happening. Â
Humanitarian relief is at a standstill due to restrictions imposed by military authorities which permit only regular pre-cyclone activities to run and prohibit any scale up of a cyclone specific response. This includes restrictions on large-scale distributions of relief items like food supplies, hygiene kits, and much needed bamboo and tarpaulins for building or repairing shelters.Â
Military authorities should lift these restrictions to facilitate an urgent scaling up of humanitarian action to prevent further harm, outbreak of diseases and loss of life. Â
Escalating needs on top of existing hardship Â
Those most severely impacted by Cyclone Mocha are communities who are already displaced by conflict and often living in camps, people living in low-lying areas, as well as people living in remote areas, far from where assistance efforts have been concentrated. Â
Shelter, reconstruction of destroyed or damaged water and sanitation infrastructure, safe drinking water, food, and access to healthcare remain the most urgent, vast and unmet needs.Â
This destruction comes on top of existing hardship, particularly for Rohingya and ethnic Rakhine communities displaced by conflict and already heavily reliant on humanitarian assistance. For Rohingya people specifically, they face severe restrictions on all aspects of their life such as freedom of movement, access to healthcare, livelihood opportunities and education.  Â
Initial response shows positive engagement possibleÂ
On 14 May when Mocha made landfall it was a deadly combination of spiralling winds around a centre of low atmospheric pressure that caused the scale of destruction that Daw Saw Nuw and an estimated 670,000 others experienced.  Â
Initial response efforts were positive. The military authorities and armed groups such as the Arakan Army led on cleaning debris from roads. Telecommunications and electricity were restored within a reasonable time. Â
As the scale of destruction became clearer, humanitarian organisations readied themselves to scale up and prevent further loss of life and suffering. Â
MSF prioritised prevention of water-borne diseases through distribution of drinking water to 9,000 people per week and repairs of destroyed latrines and water systems. We were also gradually resuming our regular mobile clinics, and emergency medical referrals for patients in need of more specialised treatment. Â
Response efforts disruptedÂ
This came to a halt on 8 June when three weeks after the cyclone hit, travel authorisations for Rakhine state were suspended temporarily. Revoking MSF’s travel authorisations meant we were unable to open any of our 25 primary healthcare clinics and provision of life-saving medical humanitarian assistance covering an estimated 214,000 people in central Rakhine and 250,000 people in northern Rakhine was disrupted.  Â
After a three-day interruption, activities were officially permitted to resume on 11 June but only those already agreed before the cyclone. Authorisation to scale up responses based on the additional needs created by the cyclone were not granted.  Â
Temporary disruptions shift to long-term obstructionsÂ
Today, the current response is far from what is required after a cyclone. Among the restrictions imposed on scaling up is a requirement to hand over relief items to the military authorities who will manage distribution. Â
This requirement jeopardizes the neutrality of humanitarian assistance, which in a conflict-affected state like Rakhine, will affect the trust communities have in humanitarian organisations. It also goes against the humanitarian principles of impartiality, neutrality and independence, which MSF and other organisations abide by. Â
The initial momentum witnessed among the humanitarian community to draw attention to these restrictions has waned. Â
Current situation cannot become the new normalÂ
MSF is deeply concerned that the dire living conditions the cyclone has caused, the unnecessary restrictions that actively sustain these unacceptable conditions, and the lack of public attention being drawn to this situation are gradually becoming the new normal in Rakhine.Â
These restrictions are also contributing to a continued lack of financial commitment shown by donors towards people in Myanmar. Â
The military authorities and other parties to the conflict have the responsibility to take care of people impacted by Cyclone Mocha. Â
As such, the military authorities should lift the current restrictions and facilitate unimpeded passage of medical and humanitarian relief items to people in need in a manner that does not compromise their impartiality and neutrality.Â
MSF has teams based in seven townships of Rakhine state, including some of the worst affected areas of Sittwe, Maungdaw, Rathedaung, Buthidaung and Pauktaw with over 550 staff carrying out our regular medical humanitarian activities. Â
MSF has been working in Myanmar since 1992, supporting long-term healthcare programmes focused on TB, HIV, Hepatitis C, Malaria and primary health care initiatives. Today, over 1,200 international and national staff work closely together to provide high-quality care and treatment through a network of health facilities and mobile clinics. We continue to care for HIV, tuberculosis and hepatitis C patients, provide basic healthcare along with reproductive and sexual healthcare services, and respond to medical emergencies. Operating in Rakhine, Shan and Kachin states, as well as in Yangon and Tanintharyi regions.Â
