Rohingya camps on the brink of waterborne disease outbreak

The unplanned installation of tube wells in close proximity to sanitary latrines at the Rohingya camps in Ukhiya and Teknaf upazilas of Cox’s Bazar could give rise to a number of waterborne diseases like cholera and diarrhoea. Sources from the Department of Public Health Engineering (DPHE) said many foreign and local NGOs and relief workers had set up hundreds of tube wells and latrines for providing sanitation and clean water to the displaced Rohingyas living in the camps. However, the relief workers ignored one basic rule of setting up tube wells and latrines, by failing to maintain a safe distance between them. On visits to the Kutupalong and Balukhali refugee camps, at least 27 two-ring sanitary latrines were found close to tube wells of 35-40 feet in depth, while 53 tube wells which had been installed adjacent to latrines had contaminated water flowing at the bottom. Many latrines and tube wells were found to be set up in unhygienic areas. “We have noticed that the tube wells and latrines were set up around the camps in an unplanned way (and) have discussed the matter with aid agencies,” DPHE Cox’s Bazar Executive Engineer Mosleh Uddin said. According to the DPHE, a tube well with a depth of 35-40 feet must be installed at least 15-20 feet away from a latrine, which must be set up with more than two rings for sanitation purposes. For a deeper tube well, the distance should be at least 5-10 feet. If these health regulations are not followed properly, drinking water could become contaminated through human waste from the latrine. Mosleh Uddin said: “In an attempt to respond to the Rohingya crisis fast, many NGOs and aid organisations did not take technical planning into consideration. We are now setting up tube wells and sanitary latrines in a systematic way, and we have plans to remove tube wells that are adjacent to latrines.” Despite these assurances, many health experts now fear a possible outbreak of waterborne diseases among the Rohingyas, especially after a recent World Health Organisation report warned that any outbreak would also harm the local people of Ukhiya and its adjacent regions. One of the most common contaminants in water – the faecal coliform bacteria – are found in the faecal matter of humans and other warm-blooded animals. The high presence of these bacteria in drinking water could lead to various waterborne diseases such as cholera, diarrhoea, dysentery, typhoid fever, hepatitis and gastroenteritis. Although coliform bacteria are not directly responsible for causing diseases, a high presence may indicate the presence of one or more types of pathogenic organisms in the water. The contaminated water could pose a serious health risk to the people using it for drinking, cooking and bathing. According to a report by the Directorate General of Health Services (DGHS), more than 46,000 Rohingyas have so far undergone treatment for diarrhoea, which equates to roughly 16% of the total population of the camps. The DGHS report further reveals that an average of 600 diarrhoea patients were seeking medical help per day when the camps had been set up, but this number had risen to 1,200 patients per day by October 14. The actual number of diarrhoea patients could be higher as the Rohingyas are not comfortable with consulting doctors at the camps, said relief workers. In addition, Cox’s Bazar Civil Surgeon's Office said about 18,000 Rohingya patients have undergone treatment for dysentery, and about 30,000 are suffering from various skin diseases. A media cell formed by Cox’s Bazar district administration on the Rohingya affairs recently issued a press release, detailing the government’s plan to install more tube wells and latrines at the camps. According to the release, the DPHE has so far installed 2,190 tube wells and 4,735 sanitary latrines at 12 refugee camps in Ukhiya and Teknaf. The department has a target of setting up a total of 3,000 tube wells and 5,000 sanitary latrines at the camps in “a planned and systematic” way. Mosleh Uddin is optimistic that the Rohingyas living in the camps will make proper use of the tube wells and sanitary latrines. “The health department will continue to raise awareness among the Rohingyas about various infectious diseases,” he added. The media cell press release also stated that 14 mobile water treatment plants, seven 3,000-litre mobile water carriers and eleven 1,000-litre water reservoirs have been set up at the camps to ensure smooth water supply to the Rohingyas. Moreover, one million water purifying tablets have been distributed among the Rohingyas, with 1.2 million more placed in stored for future use. So far, 51 drums of bleaching powder have been sprayed to help sterilise the camps. “We are making a serious effort to keep the Rohingyas free from any disease,” Cox’s Bazar Civil Surgeon Dr Mohammad Abdus Salam told the Dhaka Tribune. “The government’s health directorate, supported by various national and international aid organisaitons, has already provided vaccination to over 682,000 Rohingyas as a preventive measure against cholera.” Under DGHS's supervision, a total of 74 Static Health Centres are providing healthcare services to the Rohingyas. Of them, 25 are being run by government, 10 by the army and 39 by NGOs. Forty-three mobile medical teams – with a fleet of 21 ambulances and 231 vaccinators – are providing treatment to the Rohingyas. “Bangladesh government is keeping the Rohingya refugees under surveillance with support from the law enforcement agencies,” Cox’s Bazar Deputy Commissioner Md Ali Hossain told the Dhaka Tribune. According to the Office of the United Nations High Commissioner for Refugees, 604,000 displaced Rohingyas have entered Bangladesh after fleeing the violence in Myanmar’s Rakhine state since August 25.