“I hate being a Rohingya. We are being tortured in Myanmar. Now in Bangladesh, we have no rights. Nothing. We don’t have a roof. We are living under the sky. We have no future”
— 27 year-old Rohingya Refugee fled Bangladesh in February when her husband went missing.

In Myanmar the preconditions for genocide are now firmly in place. Racism has been normalized among the ethnical Burman population and the Rohingyas have already been subject to communal violence, state oppression and have been forced into both internal and external exile. 

A powerless minority is the victim of effective ethnic cleansing, in an environment where they are hated by their neighbors and actively discriminated against by state authorities. Despite the grim situation there is much that can be done, both domestically and internationally, to help the Rohingyas and hopefully avoid a genocide- but a real will to take action is needed, rather than the continuation of "business as usual" in the hope that nothing actually happens in Rakhine to make us complicit through inaction in a repeat of the genocide in Rwanda. 

Rohingya IDP camps, rekindling fears of being displaced and losing loved ones all over again. 

No adjectives to describe sufferings of Rohingya refugees especially after the monsoon. No shelter and nowhere to go in the middle of the monsoon. These are the poor conditions the Rohingya live in. Small dirty shacks in the mud, rain comes in, chickens walking in and out. in constant fear they will be attacked again. 

My time here in Sittwe, the major town of Rakhine State. Sittwe is the first place I’d ever been to that has a curfew, imposed in response to the civil unrest and violence that rocked the state last year. The beautiful landscape and bustling asian market mask the deep tensions that divide this part of Myanmar. One needs to have knowledge of the recent history of the area to appreciate the constant threat of violence that hangs over the town. It's impossible not to feel something when walking past numerous piles of rubble marked with red signs to highlight where houses once stood.

Yesterday afternoon a patient came in after being in labor for 48 hours at home. She’d been pushing for over 12 hours. She was running a high fever and the baby was dead. It’s head was visible when she pushed but it was mostly “caput”, the swelling of the top of the baby’s head.

The midwife I’m working with, Sally (originally from Australia but now living in Atlanta) tried delivering it with the vacuum extractor but the baby’s head was too large. I tried to place the forceps but the head was too large so, for exactly the second time in my career (the first was in Sierra Leone), I had to do a destructive delivery, making a stab incision with a scalpel through the soft spot in the baby’s skull in order to drain some of the brain matter and decompress the baby’s head making it small enough to pull out.

It’s a gruesome procedure and it was made worse by the awful smell of this mother’s infection. There’s a part of you that just disengages from the reality of what’s happening, thank goodness. We were able to get the baby out though, saving the mother an operation through an infected abdomen and pelvis. The baby had obviously been dead for several days which I guess made it easier to come to terms with.

I don’t think five years ago I could’ve imagined doing things like this. The most horrifying thing is not that I’m relatively comfortable doing it now, but the fact that there are places in the world where it’s necessary.