SITTWE, MYANMAR // A 16-year-old Muslim boy lay dying on a thin metal table. Bitten by a rabid dog more than a month ago, he convulsed and drooled as his parents wedged a stick between his teeth to prevent him from biting off his tongue.
Swift treatment might have saved Waadulae. But there are no doctors, painkillers or vaccines in this primitive hospital near Sittwe, capital of Rakhine State in western Myanmar. It is a lonely medical outpost that serves about 85,300 displaced people, almost all of them Muslims who lost their homes in fighting with Buddhist mobs last year.
"All we can give him is sedatives," said Maung Maung Hla, a former health ministry official who, despite lacking a medical degree, treats about 150 patients a day. The two doctors who once worked there haven't been seen in a month. Medical supplies stopped when they left, said Maung Maung Hla, a Muslim.
These rubbish-strewn camps represent the dark side of Myanmar's celebrated transition to democracy: policies reminiscent of apartheid segregating minority Muslims from the Buddhist majority. As communal violence spreads, nowhere are these practices more brutally enforced than around Sittwe.
In an echo of what happened in the Balkans after the fall of communist Yugoslavia, the loosening of authoritarian control in Myanmar is giving freer rein to ethnic hatred.
President Thein Sein, a former general, said in a speech this month that his government was committed to creating "a peaceful and harmonious society in Rakhine State".
But the sand dunes and barren paddy fields outside Sittwe hold a different story. Here, emergency shelters set up for the Rohingya last year have become permanent, prison-like ghettos. Muslims are stopped from leaving at gunpoint. Aid workers are threatened. Camps seethe with anger and disease.
In central Sittwe, ethnic Rakhine Buddhists and local officials exult in what they regard as a hard-won triumph - streets almost devoid of Muslims. Before last year's violence, the city's Muslims numbered about 73,000, nearly half its population. Today, fewer than 5,000 remain.
Myanmar's transformation from global pariah to budding democracy once seemed remarkably smooth. After nearly half a century of military dictatorship, the quasi-civilian government that took power in March 2011 astonished the world by releasing dissidents, relaxing censorship and re-engaging with the West.
Then came the worst sectarian violence for decades. Clashes between Rakhine Buddhists and the stateless Rohingya in June and October last year killed at least 192 people and displaced 140,000. Most of the dead and homeless were Muslims.
"Rakhine State is going through a profound crisis" that "has the potential to undermine the entire reform process", said Tomás Ojea Quintana, the United Nations special rapporteur on human rights in Myanmar.
Life here, he said, resembled junta-era Myanmar, with rampant human-rights abuses and a pervasive security apparatus. "What is happening in Rakhine state is following the pattern of what has happened in Myanmar during the military government."
The crisis posed the biggest domestic challenge yet for the reformist leaders of one of Asia's most ethnically diverse countries. Muslims make up about 5 per cent of its 60 million people. Minorities, such as the Kachin and the Shan, are watching closely after enduring persecution under the former junta.
As the first powerful storm of the monsoon season approached western Myanmar this week, the government and UN agencies began a chaotic evacuation from the camps, urging thousands of the Rohingya to move to safer areas on higher ground across Rakhine State.
Some resisted, fearing they would lose all they had left - their tarpaulin tents and huts. More than 50 are believed to have drowned in a botched evacuation by sea.
Sittwe's last remaining Muslim-dominated quarter, Aung Mingalar, is locked down by police and soldiers who patrol all streets leading in and out. Muslims cannot leave without written permission from Buddhist local authorities, which Muslims say is almost impossible to secure.
Metal barricades, topped with razor wire, are opened only for Buddhist Rakhines. Near-deserted streets were flanked by shuttered shops. Some Muslims peered from doors or windows.
On the other side of the barricades, Rakhine Buddhists revel in the segregation.
'They all tell lies'
"I don't trust them. They are not honest," said Khin Mya, 63, who owns a shop on Sittwe's main street. "Muslims are hotheaded. They like to fight, either with us or among themselves."
The state spokesman, Win Myaing, a Buddhist, explained why Aung Mingalar's besieged Muslims were forbidden from speaking to the media. "It's because they all tell lies," he said. He also denied the government had engaged in ethnic cleansing, a charge levelled most recently by Human Rights Watch in an April 22 report.
"How can it be ethnic cleansing? They are not an ethnic group," Mr Win said from an office on Sittwe's main street, overlooking an empty mosque guarded by soldiers and police.
His comments reflect a historic dispute over the origins of the country's estimated 800,000 Rohingya Muslims, who claim a centuries-old lineage in Rakhine State.
The government says they are Muslim migrants from Bangladesh who arrived during British rule from 1824. After independence in 1948, Myanmar's new rulers tried to limit citizenship to those whose roots in the country predated British rule. A 1982 Citizenship Act excluded Rohingya from the country's 135 recognised ethnic groups, denying them citizenship and rendering them stateless. Bangladesh also disowns them, and has refused to grant the Rohingya refugee status since 1992.
The United Nations calls them "virtually friendless" and among the world's most persecuted people.
Communal tensions ignited after the rape and murder of a Buddhist woman by Muslim men in May last year. Six days later a Buddhist mob beat 10 Muslims to death.
Violence then swept Maungdaw, one of the three Rohingya-majority districts bordering Bangladesh, on June 8. Rohingya mobs destroyed homes and killed an unknown number of Rakhines.
The clashes spread to Sittwe. More than 2,500 homes and buildings went up in flames, as Rohingya and Rakhine mobs rampaged. When the smoke cleared, both suffered losses, though the official Rohingya death toll of 57 was nearly double that for Buddhist Rakhines. Entire Muslim districts were razed.
October saw more violence. This time, Buddhist mobs attacked Muslim villages across the state over five days, led in some cases by Rakhine nationalists tied to a powerful political party, incited by Buddhist monks and abetted at times by local security forces.
The violence kept spreading. Anti-Muslim unrest, whipped up by Buddhist monks, killed at least 44 people in the central city of Meikhtila in March. In April and May, Buddhist mobs destroyed mosques and hundreds of Muslim homes just a few hours' drive from Yangon, the country's largest city.
On the morning of April 26, a group of state officials entered the Theak Kae Pyin refugee camp. With them were three policemen and several border guards, known as the Nasaka. Unique to the region, the Nasaka consists of officers from the police, military, customs and immigration. They control every aspect of Rohingya life, and are feared.
Documented human-rights abuses blamed on the Nasaka include rape, forced labour and extortion. Rohingya cannot travel or marry without the Nasaka's permission, which is never secured without paying bribes, activists say.
Mr Win said the Nasaka's mission was to compile a list identifying where people had lived before the violence, a precondition for resettlement. They wanted to know who was from Sittwe and who was from more remote townships such as Pauktaw and Kyaukphyu, areas that saw a near-total expulsion of Muslims in October.
Many fled for what Mr Win said were unregistered camps outside Sittwe, often in flood-prone areas. "We would like to move them back to where they came from in the next two months," he said. The list was the first step towards doing that. The list, however, also required Muslims to identify themselves as Bengali. It sent a chilling message: if they want to be resettled, they must deny their identity.
In Theak Kae Pyin camp, a sea of tarpaulin tents and huts built of straw from the last rice harvest, there is an air of growing permanence. More than 11,000 live in this camp alone, according to UN data. Naked children bathe in a murky-brown pond and play on sewage-lined paths.
A year ago, before the unrest, Haleda Somisian lived in Narzi, a Sittwe district of more than 10,000 people. Today, it is rubble and scorched earth. Ms Somisian, 20, wants to return and rebuild. Her husband, she said, has started to beat her. In Narzi, he worked. Now he is jobless, restless and despondent. "I want to leave this place," she said.
Beyond Sittwe, another 50,000 people, mostly Rohingya, live in similar camps in other parts of the state destroyed in last year's sectarian violence.
Across the state, the UN relief agency has provided about 4,000 tents and built about 300 bamboo homes, each of which can hold eight families. Another 500 bamboo homes are planned by the end of the year. None are designed to be permanent, said Vivian Tan, a relief agency spokeswoman. Tents can last six months to a year; bamboo homes about two years.
The agency wants to provide the temporary shelter that is badly needed. "But we don't want in any way to create permanent shelters and to condone any kind of segregation," Ms Tan said.
The aid group, Doctors Without Borders, has accused hardline nationalists of threatening its staff, impairing its ability to deliver care. Mobile clinics have appeared in some camps, but a UN report describes most as "insufficient".
Waadulae, suffering from rabies, was treated at Dar Paing hospital, whose lone worker, Maung Maung Hla, was overwhelmed. "We have run out of antibiotics," he said. "There is no malaria medicine. There's no medicine for tuberculosis or diabetes. No vaccines. There's no equipment to check peoples' condition. There are no drips for people suffering from acute diarrhoea."
Mr Win said Rakhine doctors feared entering the camps. "It's reached a stage where they say they'd quit their jobs before they would go to these places," he said.
The treatment of the Rohingya contrasts with that of some 4,080 displaced ethnic Rakhine Buddhists in central Sittwe. They can leave their camps freely, work in the city, move in with relatives in nearby villages and rebuild, helped by an outpouring of aid from Burmese business leaders.
Hset Hlaing, 33, who survives on handouts from aid agencies at Thae Chaung camp, recalled how he earned 10,000 kyat (Dh40) from a general-goods stall in Sittwe before his business and home went up in flames last June. Like other Muslims, he refuses to accept the term Bengali.
"I don't want to go to another country. I was born here," he said, sipping tea in a bamboo shack.
"But if the government won't accept us, we will leave. We'll go by boat. We'll go to a country that can accept us."