How desperate and distrustful of your government do you have to be to refuse an offer of relocation when a cyclone is about to hit your home? That many of the displaced Rohingya people in Burma's Rakhine state took this decision demonstrates how difficult their lives have become.

For months now, the Rohingya Muslim people have been targeted in a campaign that a Human Rights Watch report (pdf) has described as "ethnic cleansing". Rohingya Muslims in Burma have been forced into segregated settlements and camps, and – in many cases – cut off from lifesaving aid.

I visited displacement camps in Rakhine in May with Refugees International and Burma Campaign UK, meeting with displaced people who – after suffering horrific attacks by members of the Rakhine Buddhist community in October –were forced to flee into remote areas of the countryside, areas completely unsuitable for displacement camps.

Drinking water had to be brought in on boats by NGOs, and primary healthcare was provided one morning a week. If you needed medical help at other times, you had to hope an NGO would come by boat to get you.

Residents of this squalid community fall ill frequently due to insanitary conditions. I travelled by boat for two hours to Pauktaw, where a UNHCR-supported camp is home to thousands of Rohingya people. The shores adjacent to the camps were covered in faeces, with dead rats floating in the water just metres from where children were bathing to keep cool in the heat.

Since it was attacked, the Rohingya community has been totally cut off from markets and job opportunities; living in a segregated area, its people are barred by the authorities from travelling to the sites where they used to work and trade. Donor governments – including the UK – have helped provide some basic services, but it is nowhere near enough to give these people a safe and dignified existence.

The Rohingyas I met were living in flimsy tents so close to the shore that there was no way they could survive the monsoon season, let alone a cyclone. Even the emergency evacuations now underway will not be enough to get them safely through the coming months. During my visit, I was told that it would take at least two months to build temporary shelters on higher ground, and the government has delayed allocating the necessary land, perhaps in an attempt to assuage local Rakhine extremists. All of this demonstrates the unwillingness of the government to prioritise the safety of the Rohingya community.

Aid agencies have had real difficulties in getting help to people. Apart from the logistical problems created by the camps' isolation, the government has introduced bureaucratic obstacles, including serious delays in providing travel authorisations and visas for aid staff. Most troubling, some Rakhine Buddhist political and religious leaders have made threats against aid agencies because they object to assistance being offered to to the Rohingyas. Instead of taking action, the government refuses to let aid workers operate in areas where threats are made.

Displaced people told me about family members they had lost in the October attacks, speaking of their grief. Most wanted to return home, but were too scared to do so without appropriate protection. And they were aware that rather than focusing on moving people to higher ground during April, the government was conducting a "verification exercise" in displacement camps, in which they tried to force Rohingyas to sign forms admitting that they were "Bengalis". This only added to their distrust of the authorities, which was already high after many of the security services either committed or condoned attacks on their community last year. People told me that they would never be allowed to return home because local authorities were trying to create Muslim-free zones.

In a discussion with a group of Rohingya women, I listened to stories of family members being killed; some had lost seven, eight, nine loved ones. After hearing these testimonies, I wasn't surprised that some Rohingya people took the seemingly irrational decision to refuse relocation in the face of a cyclone. They are so desperate that they do not know who to trust or where they may be sent next. And, as a woman who lost her entire family said, "If, after having lost everything – including my whole family – because we are Rohingya Muslims, [the government] still don't recognise me as Rohingya in my own country, then I might as well be dead".

The UK government, together with the rest of the international community, must keep the pressure on the Burmese government to facilitate full humanitarian access to the Rohingya, end segregation in Rakhine state, provide them with the protection they need to return home, and restore their Burmese citizenship.

• A video documenting Rushanara Ali's trip to Burma can be found here