Excellent news at the end of last week that MSF-Holland is being allowed to resume aid operations in Rakhine State. Unexpected, too, since the fierce drumbeat of grassroots public opinion ever since activities were suspended in late February has been not on any account to let that happen. Matters of detail still need to be worked out, but this is undeniably a positive step. As UNOCHA official Pierre Peron notes, MSF’s absence from Rakhine has had “a major humanitarian impact”. Most serious has been the inability of any other organization to process its caseload of roughly 400 patient referrals per month.

The Irrawaddy reports that the relevant Ministry of Health statement, carried in government media on Thursday, held that assistance from international organizations would contribute to local stability and development. A parallel announcement from Rakhine State authorities affirmed that “our government would like to invite all organizations, as well as other UN agencies and including MSF, to participate in implementing the Rakhine Action Plan”. A June 27 meeting at Myanmar Peace Centre (in fact at the Centre for Diversity and Social Harmony within the MPC compound) was instrumental in securing agreement from key stakeholders.

At last week’s press conference, covered by the BBC, President’s Office Minister Soe Thein said that MSF “was especially welcome” to work in Rakhine, and added what was clearly intended to be a conciliatory remark: “As human beings we all commit errors and the errors usually lie on both sides.” By the early months of this year, MSF’s Rakhine programme was problematic for several reasons. Its memorandum of understanding with the Union government had expired a year previously, and it was operating on the basis of a verbal agreement with the MoH. Although the lapsed MoU authorized 19 foreigners to work in Rakhine, far larger numbers were actually present – always 200, and sometimes up to 500. Most entered the country on tourist visas and proceeded to work in clinics. While such informal arrangements are standard MSF practice in many failed states around the world, they are not appropriate for long-term engagement with Myanmar.

Going forward, progress will depend largely on issues of governance. Throughout the current crisis there have been divisions between the Union government and Rakhine State officials, between both tiers and Rakhine civil society, and within Rakhine civil society itself. Tellingly, the agreement reached at MPC was repudiated by members of Rakhine Social Network as soon as it filtered out. When asked last week about MSF’s return, Sittwe town elder Than Tun, who participated in the MPC meeting, also struck a cautionary note: “We find it difficult to trust them.” Certainly national authorities are becoming more assertive, notably through Thein Sein’s appointment, again at the end of June, of a new chief minister for Rakhine. To signal a more decisive course, Major General Maung Maung Ohn was asked to take over from Hla Maung Tin. Nevertheless, it remains an open question whether the fresh approach will succeed in winning over, or at least neutralizing, local hostility.

There was a strange sentence in one of the Irrawaddy articles: “Some aid workers fret that the announcement has more to do with politics than resolving the humanitarian crisis.” The explanation was that UN Special Rapporteur Yanghee Lee was in Myanmar last week, that US Secretary of State John Kerry may visit next month, and that US President Barack Obama is expected later in the year. Indeed – but in Rakhine State, as elsewhere, it’s impossible to isolate humanitarian action fully from politics.