Arakan News Agency
A young Rohingya woman who was found at a military compound in the Rakhine State capital Sittwe. The lack of medical support and justice for gender-based violence led to her untimely death.
The young Raysuana, who was found naked and barely conscious at a military compound, and died after being denied access to hospital care under a system of institutionalized discrimination tantamount to ethnic apartheid.
“I need to tell you we tried to save her,” says Taiba (not her real name), the clinic nurse who took care of Raysuana from the time she reached the clinic on the morning of August 18 until she died around 12 hours later.
“She couldn’t tell us what happened because she was not able to speak,” the nurse added, showing the public space where the young woman was treated at Thet Kya Pin Clinic.
The clinic is a small healthcare facility where people of the Rohingya Muslim minority living in IDP camps and villages outside the Rakhine State capital Sittwe can receive basic medical treatment under oppressive rules that deny them freedom of movement and many other rights, restricting their ability to receive proper hospital treatment.
“It was only with her final breathing that she could talk to us. She came round, then she called out for her mother. Maybe for a minute she was awake and she cried for her mother. ‘Ma’, she said. ‘Mother where are you?’ Then she died,” recalls Taiba.
Like the other medical staff involved in Raysuana’s case, the nurse says the main reason the young woman was not sent to hospital was that nobody knew who she was so there was no one to go with her to the hospital as attendant, and she “could not be sent alone”.
That belief was critical to Raysuana’s story, but the case also highlights a whole series of failures in system and in practice that means Rohingya people – and particularly women – are having their lives put at risk.
The world will never know the exact details that led to Raysuana’s death. What we do know is that she was Rohingya – a member of the mainly stateless Muslim minority in Myanmar who are denied basic human rights under internationally condemned policies.
Yet despite the disadvantages she faced in life, Raysuana was loved by those who knew her and considered a quiet, caring and notably intelligent young woman who was particularly thoughtful toward others and was fluent in three languages. She is missed.
When Raysuana arrived at Thet Kya Pin Clinic at around 8am on August 18, the odds were already stacked against the young woman who had been found naked and injured in the bushes at a military compound earlier that morning.
It would be another hour until the state doctor would turn up for duty, and so the Thet Kya Pin village administrator U Hla Myint handed Raysuana over to the clinic’s medical assistants for care. She was placed on the bare metal slats of one of the clinic’s mattressless beds to await the doctor’s arrival.
Some clothes were hurriedly found and a woman at the clinic dressed Raysuana, noting as she did that there was blood around the young woman’s vagina.
“On the way to the clinic, I called to police and reported it and then I reported it to [a second] police station,” said U Hla Myint, who had been contacted earlier that morning by officers at the nearby military compound where Raysuana had been found and told to take her to the clinic.
“I arrived with her at the same time as the police got there,” said U Hla Myint.
But the police, who are under the authority of the military, did not open a criminal case.
U Hla Myint set off to the neighbouring camps and villages to find out if anyone knew of a missing woman. Raysuana’s mother had fled to Malaysia after riots broke out between ethnic Rakhine and Rohingya Muslims in 2012, leaving 140,000 displaced. Raysuana had been taken in by another family.
The “in-patients” section of Thet Kya Pin Clinic is, in reality, more outside than “in”. No wall separates the open-sided “ward” from the rest of the sparse health facility, and the male and female patients who lie on the few beds are entirely exposed to public view.
Such circumstances are far from ideal for any victim of gender-based violence.
But despite Raysuana having been found naked, other than a bra, and despite the fact that the woman who helped care for her when she arrived at the clinic reported possible injuries to her vagina, Raysuana was not treated as a potential victim of Gender – Based violence.
Instead, sources have told media that after the state doctor arrived she was classified as a psychiatric case.
This is understood to have played a significant role in why more effort was not made to ensure she received the necessary permission to be taken to the nearby state hospital for proper examination and treatment.
The allegation has been denied by the state health department, which told Media that because Raysuana was unable to speak, the doctor could not ascertain whether her condition was psychiatric in nature or not.
However, medical staff who attended the clinic later in the day are understood to have been told Raysuana’s was a psychiatric case and explained to their seniors later that they were not informed of the circumstances in which she was found.
The reason for the discrepancy in accounts is unknown. What is clear, however, is that due to inadequate medical assessments, a flawed and unclear set of referral protocols, and fear of reprisals, Raysuana was not treated as an emergency case nor as a possible victim of sexual violence.
The possibility that a confused, naked and injured young woman may have suffered a sexual assault and/or traumatic head injuries – with potentially life-threatening internal injuries – did not appear to be considered significant enough to either of the male doctors who treated Raysuana that day, nor to hospital authorities, to ensure she received an emergency referral.
“I believe if she’d been taken to hospital, she would have lived,” said one witness with a medical background who saw Raysuana at different moments from her arrival at the clinic until her death.
Media spoke to three different medical workers involved in Raysuana’s treatment and each, separately, mentioned her most obvious injury was one to the back of her shoulder.
Yet according to the state medical department, no such injury was recorded in Raysuana’s medical notes.
As for the possibility that Raysuana had been sexually assaulted, he appeared skeptical.
“For rape – I don’t agree,” said Dr Thaung Hlaing. “We can’t even see … could not see for medical reasons. Our doctor was also reluctant to handle her,” he said, referring to the fact that there was not a qualified female nurse or doctor present.
The state doctor did do a basic examination of Raysuana, checking her “extremities” and analysing her state of consciousness.
“Our doctor examined her [using] the Glasgow Coma State [assessment] and she was in the middle, borderline. He informed us and started the transfer [process to send her] to the city general hospital,” Dr Thaung Hlaing.
But a second problem was coming to the fore. No one in the community had been found to identify Raysuana and there were no relatives to give any form of medical consent, so there was no one to travel with her to the hospital as an attendant.
According to international agencies based in Sittwe, in an emergency situation a patient can be transferred to the hospital from Rohingya camps or villages without an attendant.
Under “right to life” protocols and given the high possibility that Raysuana’s unconscious or semi-conscious state at the time she was found indicated the possibility of serious head trauma, she should have been sent straight to the hospital from the military compound rather than the clinic, an international expert in the state capital said.
But even following the doctor’s recommendation at the clinic, the local community and the medical authorities were reluctant to send Raysuana to hospital alone, and medical authorities denied her a transferral unless she had an attendant.
“Our department was ready to assist her to come, but unfortunately there was no one to come with her,” said Dr Thaung Hlaing. “I’m not making excuses; that’s just what happened.”
Source : Myanmar Times
