On August 25 five years ago, hundreds of thousands of Rohingya men, women, boys, and girls fled violence and persecution in Myanmar and sought refuge in what is now the world’s largest refugee settlement in Cox’s Bazar, Bangladesh.
Currently, over a million Rohingyas are living in 34 overcrowded camps and makeshift settlements in Teknaf and Ukhiya of the district.
In the last five years, the Bangladesh government and humanitarians collaborated to put necessary infrastructure in place for the Rohingya, but the camps remain temporary in nature and are overcrowded.
“While the fact that people’s access to better quality water has improved since 2018, which should be championed as one of the successes of the response, unfortunately people don’t have continuously available water to meet their needs and the sanitation and hygiene situation has deteriorated drastically in the last three years,” said Arunn Jegan, representative at Médecins Sans Frontières (MSF) in Cox’s Bazar.
In an exclusive interview with Dhaka Tribune, Jegan said MSF did a community feedback mechanism to see water and sanitation situation in the camps which showed that there has been real deterioration.
88% of respondents said they used inadequate sanitation facilities, 76% said toilets were overflowing and 51% of people said water was not flowing continuously.
File Photo of a Rohingya camp in Cox's Bazar Mahmud Hossain Opu/Dhaka Tribune“We are working together with the WASH sector to improve these things, but there needs to be a commitment from donor agencies who kind of lift up the stands on these activities,” he said.
MSF has treated tens of thousands of scabies cases in the last few months alone in the camps. In 2018, only 7% households reported skin infections that jumped to 31% households in 2022.
Also, the number of dengue cases has been abnormally high in the camps in recent years.
“Gaps in the proper provision of water and sanitation facilities present an ongoing, but amendable risk to the health of refugees. It’s commendable that a large and successful investment into water and sanitation infrastructure has been achieved, but significant improvements to infrastructure monitoring, maintenance and servicing are necessary in order to meet the basic needs of the Rohingya refugees,” he said.
“Crowded camp conditions don’t help the situation as this facilitates the spread of communicable diseases. We see increasingly high numbers of patients with communicable diseases like scabies, at the highest levels in over three years. The increase in patients we see with dengue is also an extension of this dynamic of poor living conditions in the camps,” he said.
Médecins Sans Frontières, which means Doctors Without Borders in English, is an international independent medical humanitarian organization. They have been providing services in the refugee camps since the latest episode of the Rohingya crisis began in August 2017.
File Photo: Bangladesh has been hosting more than a million Rohingyas in sprawling camps in Cox’s Bazar after they fled persecution in Myanmar ReutersMSF provides free-of-cost healthcare for both Bangladeshi citizens and the Rohingya population. Currently it is operating ten facilities in Cox’s Bazar including three secondary level medical facilities. One of the most famous ones is Kutupalong hospital that offers service to both hosts and refugees.
In addition to regular medical services including mother and child healthcare and mental health services, MSF is now also offering water hygiene and sanitation services as well.
“Preventative healthcare is what we do with our wash services and our community health care services where a massive group of volunteers offer community health education on proper hygiene practices so that people can also take care of them at home,” said Arunn.
Extreme hopelessness fueling mental health issues
Many Rohingyas are facing mental health issues in Rohingya camps. Traumatic memories combined with unemployment, anxiety about the future, poor living conditions and little or no access to basic services leave the Rohingya vulnerable to long-term psychological harm.
According to Arunn of MSF, in 2017, it was an acute shock for Rohingyas, but now it is an extreme hopelessness. Many of them are facing depression, and complex psychiatric problems relating to their lack of choice, lack of freedom and lack of hope.
“What’s really important for us to focus on is the hopelessness of the situation. They are prohibited from work, and there are very few or restricted educational opportunities. People feel in limbo and they feel stuck. We say, Rohingyas are alive but they are in limbo. There can be no therapeutic solution to mental health until durable solutions are put on the table for these people,” said Arunn.
International community must redouble diplomatic efforts for repatriation
File Photo of a Rohingya camp in Cox's Bazar Mahmud Hossain Opu/Dhaka TribuneIn the last five years, Bangladesh has held several talks with major global actors over the safe repatriation of the Rohingyas to their homeland, but the international community has so far failed to mount sufficient pressure on Myanmar to take back its citizens. The delays in the repatriation process are frustrating for both the Rohingya refugees and the host community.
“Almost every refugee I speak to wants to return home. Myanmar is their home, but there has been no robust indication that the talks are progressive. For us, if a safe, dignified and voluntary return is possible, we see no reasons why that cannot happen,” said Arunn.
Bangladesh has been driving this repatriation talks, but the responsibilities should not solely be on their shoulders, thinks Arunn.
“They (Bangladesh) have provided so much in hosting this population. It is time for the international community to take this responsibility on their shoulders. Regional countries like China, India, Australia and others should engage with Myanmar in a constructive diplomatic way as well as the US, UK, EU, and Canada - everyone needs to redouble their diplomatic efforts and ensure that the situation in Rakhine state changes,” said the MSF representative Arunn.
Arunn thinks there are two tracks that all need to focus on- one is improving the day to day living conditions in camps and another is finding a durable solution for them.
“All of them (Rohingyas) have a single wish- to go back home to Myanmar, to live a peaceful and safe life. And this is where we should put a focus right now,” he said.