Since 25 August, following the violence perpetrated by the Myanmar Army in Rakhine State, more than 600,000 Rohingya have fled Myanmar to Bangladesh, adding to the 307,500 refugees already living in the camps in the Cox’s Bazar district of South-East Bangladesh. They are densely populated and living conditions are extremely precarious.
The camps were built quickly as refugees crossed the border into Bangladesh, with more than 600,000 arriving over a space of three months. The Rohingya people have made do with what little they could carry as they fled their homes and whatever they have found in the camps. The shelters (made from bamboo and plastic tarpaulin) have multiplied, piled up one on top of the other on hilltops, where there is a high risk of landslides and it is difficult to install adequate water and sanitation services. All of this increases the risk of diseases spreading.
The Rohingya have dug thousands of makeshift wells all over. The problem is that they are not very deep. “The most pressing need is to improve the health situation in the camps in order to reduce the incidence of water-borne diseases, such as watery diarrhoea and bloody diarrhoea, cases of which we are seeing at our health centres,” stated Paul Delaunois, Director of MSF Luxembourg. One solution for preventing faecal contamination of the surface water is to dig deep wells to collect water from depths of more than 100 metres.
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A severely malnourished 15-day-old baby receives treatment in the neonatal unit of MSF's medical facility in Kutupalong. © Paula Bronstein/Getty Images
While the initial concern for the Rohingya may have been to deal with the most urgent needs, the solutions found for making latrines are showing their limitations. There are not enough of them, and many do not work and are full to the point of overflowing. The excreta runs down the hills and flows into the water table. According to the MSF teams responsible for sanitation, almost 40% of the wells are contaminated. The need to improve health conditions seems more prevalent than ever if we are to prevent the spread of diseases.
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Mainnerghona camp, Bangladesh. © MSF
The consequences seen by the MSF teams in the health centres are a high percentage of diarrhoeal and skin diseases and respiratory infections. More alarming still is the fact that MSF has already counted 1,500 cases of measles, particularly in children. This is a clear indication of insufficient access to routine vaccination in Myanmar, as well as the poor living conditions in the camps.
The Rohingya arriving in Bangladesh have shared stories with our teams about the violence perpetrated by the Myanmar Army. Since 25 August, MSF has treated 78 survivors of sexual violence at its Sexual and Reproductive Health Department in Kutupalong. As many as 50% of the survivors are aged under 18, several of whom are not even 10 years old.
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Hatea Ullah is nine months old, she suffers from acute pneumonia and was admitted to the paediatric unit of the MSF medical centre in Kutupalong. © Paula Bronstein/Getty Images
In an effort to cope with the massive influx of refugees, MSF has upped its operations tremendously with 2,300 people working in the Cox’s Bazar district. MSF has set up 15 health posts and two mobile clinics to meet the population’s needs in terms of primary healthcare, as well as three hospitals. Since the end of August, more than 70,000 patients have received care from the MSF teams.
Over time, our teams are seeing more and more cases of severe acute malnutrition.
"Over time, our teams are seeing more and more cases of severe acute malnutrition. Screenings of children under five and pregnant women is carried out regularly. We provide complementary feeding programs to ensure that women have all the necessary nutrients throughout their pregnancy to prevent the risk of prenatal complications and underweight children. We also offer a therapeutic feeding program in hospitals to help malnourished children," explains Paul Delaunois.
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A road in construction in the Mainnerghona camp, Bangladesh. © MSF
“Despite some improvements, such as building roads, setting up reception and transit centres, increased aid and a large-scale measles vaccination campaign, we remain extremely concerned. If the situation does not improve rapidly, the public health emergency we are facing will escalate dramatically. That is why we must continue to take steps to improve the living conditions of the Rohingya population inside the camps,” Paul Delaunois explained.
The World Health Organization (WHO) has classified this humanitarian crisis as Level 3 (the highest level). Currently, 1.2 million people are in need of healthcare in the area. The international community must not turn its back on the Rohingya people.
