The 706,000 Rohingya who fled into Cox’s Bazar, Bangladesh last August joined some 200,000 others already there who escaped previous waves of violence. Over 919,000 Rohingya are now in Cox’s Bazar, making this the largest refugee camp in the world.
While Bangladesh showed extraordinary generosity by opening its doors to those fleeing persecution last August, a year later the Rohingya’s fate remains uncertain. Even though they are refugees and have been made stateless by Myanmar, host states in the region deny them formal legal status.
“We are in a situation where it is difficult to even refer to Rohingya refugees as exactly that,” says Pavlo Kolovos, MSF head of mission in Bangladesh. “By refusing to acknowledge the legal rights of Rohingya as refugees, or granting them any other legal status, intervening governments and organisations keep them in a state of acute vulnerability.”
Under the pretext that the Rohingya will soon be returning to Myanmar, restrictions have also been placed on the provision of long term or substantial aid. Men, women and children remain forcibly confined to the camps with little access to clean water, latrines, education, job opportunities or healthcare.
“These restrictions not only limit the quality and scale of aid, but also force the Rohingya to depend entirely on humanitarian aid. It deprives them of any chance to build a dignified future for themselves and makes every day an unnecessary struggle for survival,” says Kolovos.
Conditions in the hilly, muddy makeshift camps which run through Cox’s Bazar fall far short of accepted international humanitarian standards. In a region where cyclones and monsoons are common, refugees are still living in the same temporary plastic and bamboo shelters they built when they first arrived.
One refugee told MSF how vulnerable his family felt in the camp: “When it rains we sit together, all our family members, so the house won’t blow away. At night it is very dark here, we have no lights.”
At first, more than half of MSF’s patients were treated for violence-related injuries but over the 12 months that followed, other health concerns have become more common as a result of the overcrowded and unhygienic conditions. Compounding this, the UN-led humanitarian response in Bangladesh is currently just 31.7 percent funded while the healthcare fund stands at a mere 16.9 percent, leaving significant gaps in the provision of vital medical services.
“It is unacceptable that watery diarrhoea remains one of the biggest health issues we see in the camps,” says Kolovos. “The infrastructure to meet even the most basic needs of the population is still not in place.”
Many of the refugees that MSF teams speak to are very anxious about the future.
"I've lost my strength, my ability to work. I always have so many worries, worries about the future,” says Abu Ahmad, a Rohingya father of eight. “I think about food, clothes, peace and our suffering... If I stay in this place for 10 years … or even for one month, I will have to suffer this pain."
Solutions must be found, both immediately and in the long-term, to respond to what is likely to be a protracted period of displacement. The issue of the Rohingya's statelessness must be urgently addressed to allow them access to basic healthcare, education and protection.
“The reality is that hundreds of thousands of Rohingya have been displaced in Bangladesh and elsewhere for decades, and it may be decades until they can safely return to Myanmar, if ever. The scale and scope of the Rohingya’s suffering merits a much more robust response – locally, regionally and globally,” says Kolovos. “Pressure must meanwhile continue to be exerted on the Government of Myanmar to halt its campaign against the Rohingya”.
Note to editors:
- MSF first worked in Bangladesh in 1985. Since 2009, MSF has run a medical facility and a clinic close to the Kutupalong makeshift settlement in Cox’s Bazar district, offering comprehensive basic and emergency healthcare, as well as inpatient and laboratory services to Rohingya refugees and the local community. In response to the influx of refugees in Cox’s Bazar, MSF significantly increased its presence in the area, with vastly expanded operations covering water, sanitation and medical activities for the refugee population. To date MSF has provided over 656,228 consultations.
- The Rohingya have been forced to flee to Bangladesh in the past, though August 2017 was the biggest displacement. Previous mass movements of people from Myanmar to Bangladesh peaked in 1978 and 1992. When the August 2017 campaign of violence erupted, MSF was still responding to an influx of Rohingyas into Bangladesh that started in October 2016.
- In December 2017, retrospective mortality surveys conducted by MSF in refugee settlements in Bangladesh found that that at least 9,000 Rohingya died in Myanmar, in Rakhine state, between 25 August and 24 September. As 71.7% of the reported deaths were caused by violence, at least 6,700 Rohingya, in the most conservative estimations, were estimated to have been killed, including at least 730 children below the age of five years. See here for the links to the surveys: https://www.msf.org/myanmarbangladesh-msf-surveys-estimate-least-6700-rohingya-were-killed-during-attacks-myanmar
- Elsewhere in Bangladesh, MSF works in Kamrangirchar slum, in the capital, Dhaka, providing mental health, reproductive healthcare, family planning and antenatal consultations, as well as an occupational health programme for factory workers.
- MSF also provides healthcare to Rohingya and other marginalised communities in Malaysia and Myanmar. In Myanmar, MSF has provided healthcare to all communities in northern Rakhine since 1994. At the time its medical operations were suspended on 11 August 2017, MSF was operating four primary healthcare clinics in northern Rakhine – three of which were subsequently burnt down – and was providing over 11,000 primary and reproductive healthcare consultations per month, as well as emergency transport and assistance for patients requiring hospitalisation.
- MSF maintains staff presence in Maungdaw despite being unable to run medical activities, and our teams continue to hear from the Rohingya community there about the difficulties they face accessing healthcare. Muslim patients continue to face restrictions on their freedom of movement and unaffordable medical fees.
- MSF continues to provide primary healthcare and emergency referrals for patients in Sittwe district, central Rakhine. Elsewhere in Myanmar, MSF continues to run medical projects in Shan, Kachin and Yangon, as well as in the Naga Self-Administered Zone and Tanintharyi region.