Dr Javid Abdelmoneim, International President of Médecins Sans Frontières (MSF) or commonly known as Doctors Without Borders, is a physician who has worked in challenging humanitarian settings, including Gaza and Sudan.
Ahead of the August 25 Rohingya influx anniversary, Abdelmoneim spoke with Dhaka Tribune Chief Reporter Ali Asif Shawon about the health situation in the camps and challenges facing the Rohingya after nearly nine years of displacement.
You visited Bangladesh in 2019. What is the biggest difference you see now?
The biggest change is that the response is no longer in the emergency phase. In 2019, the focus was establishing basic services amid recent violence. I vividly recall seeing no trees, only extensive stretches of plastic sheeting.
There are now roads and semi-permanent homes. While violence remains a concern, the situation has evolved into a health emergency. Restricted movement continues, while non-communicable diseases, mental health problems and gaps in services have increased. Water and sanitation have deteriorated.
Previously, the focus was survival; now it is managing persistent and worsening health problems.
What health problems have emerged since 2017?
About 10% of adults now suffer from NCDs such as diabetes and hypertension. MSF estimates 20% have active hepatitis C, prompting a test-and-treat campaign.
In 2025, MSF conducted 75,000 mental health consultations, mainly for depression, anxiety and psychiatric conditions. About 40% of the population has scabies because of inadequate water and sanitation, causing discomfort and disrupting daily life.
A bigger issue is the lack of hope and control over the future. People remain confined, unable to move freely, and live in limbo.
What concerns you most as a doctor?
Children are arriving at our hospitals with more advanced illnesses and requiring complex care. Referrals of children to higher levels of care have risen 74% in four years, indicating reduced prevention, health promotion and basic healthcare.
It is particularly distressing that one in four people treated for suicide attempts in our mental health clinics is a child.
Can you explain it?
At one Kutupalong clinic, 27% of suicide attempts treated between 2023 and 2025 involved children under 18.
What drives children to attempt suicide?
Reductions in education, food and water services have negatively affected health. These interwoven needs are breaking down, producing negative outcomes and higher interpersonal violence. We treated about 3,500 survivors of sexual and gender-based violence last year.
Imagine the hopelessness, fear, anxiety or powerlessness a child must experience to see ending their life as the only option.
What should be done to reduce self-harm?
All components of the humanitarian response must be in place: food, water, shelter, health and education. Mental health programs are important, but root causes must also be addressed. Most cases are not organic psychiatric illnesses, though a small number may be.
The 75,000 consultations last year highlight the extent of hopelessness.
How are funding cuts affecting healthcare?
Children are arriving later and in worse condition, while hospital attendance is increasing as preventive, public health and primary healthcare decline.
We sometimes have to turn away patients with minor, non-urgent conditions. We’ve had to cap daily patient numbers to maintain quality of care.
Services from other organizations are also declining. Unreliable drug supplies are causing gaps in medication, testing, vaccination and staffing, showing that resources are insufficient.
Are doctors being forced to make difficult choices?
Yes. Patients requiring advanced or tertiary care unavailable in Cox’s Bazar must be referred to Chittagong, a journey that can take eight to nine hours. When facilities are full, few alternatives remain.
Has the crisis become normalized?
We must not accept the normalization of suffering. While death rates alone might suggest it is not an emergency, the statistics clearly indicate a health emergency.
What similarities do you see with Gaza and Sudan?
Every situation is different, but there are similarities: violence, civilians living under extreme pressure, and limited healthcare access. Water and sanitation, prevention and health promotion are key issues in Gaza, Sudan and here. Women and girls are particularly affected in violent or prolonged crises.
What are the implications for children born in the camps?
Children are growing up separated from their cultural roots. Rohingya leaders say adults and elders feel a loss of cultural identity and connection to their lands, which is more pronounced among camp-born children.
Bangladesh has shown remarkable generosity by hosting over a million refugees. But services are declining. Education has been reduced, families have less money for food, and rations are distributed under a three-tier vulnerability system.
Children need safe spaces, education, food, clean water and security, which are not consistently available.
Is safe, sustainable return to Myanmar possible?
No. Returning to Rakhine is currently unrealistic because violent conflict continues. Hospitals have been attacked, including one just months ago and another at the end of December.
A survey of 400 Rohingya found over 85% did not feel safe returning. Safe and dignified return remains important in principle, but it is not currently realistic.
What if funding continues to decline for two or three years?
The situation will worsen. Around 500 Rohingyas have died attempting to cross the Bay of Bengal by boat in recent months. With growing hopelessness, ill health and desperation, that figure could escalate sharply.
MSF is unlikely to reduce its presence soon. There is an urgent health need, and we will continue adapting, providing healthcare and listening to the community.
What are governments and donors getting dangerously wrong?
A long-lasting crisis still causes harm. Bangladesh has hosted over a million Rohingya and sustained the response, but it cannot manage this alone.
Donors and member states must ensure adequate support for health, water, food, sanitation, protection and education.
The community must also be included: “No decision about us without us.”
How sustainable is it for Bangladesh to continue carrying this ‘burden’?
Bangladesh showed leadership at the UN General Assembly last year by bringing countries, groups and donors together around shared responsibility.
We hope Bangladesh will show the same leadership this year as it takes on the General Assembly presidency in September.
Our message is clear: Bangladesh should not handle this crisis alone. Donor countries, regional powers and everyone else must pay attention.
A long-lasting crisis is still a crisis.