Buthidaung, Arakan State: In a harassment of the worst kind, a patient wanting to go to Sittwee (Akyab), the capital of Arakan State from Buthidaung Township for treatment has to spend Kyat 22,500 to get permission from authorities.

At first, one requires a recommendation letter from the Village Peace and Development Council (VPDC) Chairman, where he has to pay Kyat 500. And then, the patient has to get a recommendation letter from the doctor, he is being treated by. To get a recommendation letter from the doctor, he has to pay Kyat 10,000
He then goes to the Township Immigration Office, where he has to submit the recommendation letters of the VPDC Chairman and the doctor. Showing these documents, he gets a form from the immigration office. After filling up the form, all the recommendation letters will have to be submitted to the Township Immigration Officer for a recommendation, where he has to pay Kyat 10,000.

After getting the recommendation letter from the township Immigration Officer, all the documents will be sent again to the District immigration Officer of Maungdaw District.  There the patient has also to gift at least Kyat 5,000. After receiving all the documents, the District Immigration officer orders the Township Immigration Officer of Buthidaung Township to provide patient Form 4, which is used for foreigners for travelling.

The patient then has to go to the Township immigration office to get Form 4. To get this form, the patient has to pay Kyat 6,000 and has to give two copies of passport size photographs.

After getting Form 4 from the immigration office, the patient has to go to the local Nasaka and immigration out post near the jetty to get signatures.

The patient gets permission for 14 days for medical treatment in Sittwee. If he wants to extend the date, he will need to pay Kyat 1,000 a day.

When the patient gets down at Akyab jetty, he has to pay Kyat 1,000 to the immigration as an entrance fee to Sittwee.