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বাংলা
Dhaka Tribune

'They threw many children into the fire'

Despite the scale of their trauma, the mental health of the Rohingya is a rarely broached topic

Update : 26 May 2023, 10:25 AM

Jafar, father of eight children, sells pickles outside the IOM health center at the Balukhali camp. His youngest child is just one year old. He has fathered three children since coming to this camp. His five-year-old child led us to their home, where we spoke with Jafar's wife. Their eldest son had recently gotten married and his bride was pregnant with their child. 

Another pregnant woman from the neighbouring house joined the conversation. She was due to give birth to their second child. She fled from Myanmar with her first child at the time of pregnancy.

According to the calculations of the government and the United Nations refugee agency, the number of Rohingya refugees is 9,50,000. Among them 52% are women and the average number of family members is 4.5. Although these women try to maintain their physical health, neither they nor their families know why mental health is also important.

In October and November of 2022, three focus groups discussed mental health-related issues twice in Ukhiya camp 9, camp 8I, and camp 8W, but there was no concept related to mental health among them. However, each of them spend their day tackling various types of frustration and in some cases the frustration is so deep that they even thought about suicide. Some people have survived from that attempt. In the camp, people say that even though many have committed suicide, it has not been recorded as such. No one wanted to know the exact number of pregnant women currently in the three camps. Ten out of 15 pregnant women are currently husbandless in the camps. Those interviewed can't even say whether they will come back or not. 

A 5 months pregnant woman in Camp 8 said that her husband has not come home for the last two months. "I heard that he has married another in the neighbouring camp. Before this, he left me during the Corona period when the first child was in my womb and then returned after 11 months. I don't find any meaning in my life now."

Among 15 women interviewed, almost all of them have more than three children. Among them 73% are victims of physical abuse by their husbands. Just as 100% of these women want to return to Myanmar, similarly 100% also think that they will never return. None of them had ever sought psychiatric help or knew when to seek it. 80% of the women consider the camp life to be inhumane and 86% expressed various disappointments with life.


A total of 15 people were interviewed
Number of respondents
%
Number of women with three children and above

12 People


80
Victim of physical violence by husband
11 People
73
Those who think they cannot return home
15 People100
Those who want to return to Myanmar
15 People100
Received psychiatric help
No One100
Those considered camp life is inhumane
12 People
80
Expressed disappointment about life
13 People86


Husbands either punish or leave

"I don't want children. But my husband did not want to understand my wound. He is 21 years old. I got married after coming to this camp. I am 18 now. I was raped in 2017 a few days before I escaped. There are many more rape victims. They don't all open their mouths. I could not forget that terrible time, even today. In the meantime, I have no focus on the difficult task like carrying a child. There are days when I don't feel like putting food in my child's mouth. But I'm a mother. I do the work of the family in that bad and awkward feeling. But after coming to the camp, I saw a different situation. There was no trouble in the family when living on the other side. Here, the husband tortures if there is no money and leaves after a child is conceived."

According to the data obtained in the focus groups, most of them reported being subjected to violence by their partner. 

When asked how Médecins Sans Frontiers (MSF) -- an international medical humanitarian organization -- proceeds with regard to such women and what kind of changes can be brought about in the patients, Shariful Islam, Interim Mental Health Activity manager of MSF said, “We provide health care to victims of all types of sexual violence and even victims of domestic violence. Since mental and physical treatment is provided from the same place, the victim does not have to go from one place to another and someone who is able to provide protection is presented as a link to the victim.” 

He believes that by receiving regular mental health care, their decision-making abilities and problem-solving skills will also improve. They may begin to understand the cycle of violence and learn to develop a safety plan for themselves and their children. 

When asked if he thinks separate arrangements are needed for teenage mothers, Shariful Islam said, “Teenage mothers have to adjust to their new in-laws, new relationships, and new responsibilities as mothers. They may not be mentally, physically, or socially prepared enough to take on and carry out those responsibilities. Their mental health suffers greatly due to immature cognition, lack of problem-solving skills, and weak social and emotional support systems. Opportunities to improve the mental health of teenage mothers need to be considered individually in order to improve their mental health situation.”

A crisis in its own right

Fortify Rights has released a webinar unveiling the “serious mental health crisis” among Rohingya refugees, stating that “88.7% experienced symptoms of hopelessness, 84% exhibit symptoms of psychological distress, and 61.2% experienced symptoms consistent with post-traumatic stress disorder.” The survey found that 94.7% of Rohingya refugees in Bangladesh want to return to Myanmar in the future.

The survey stated that nearly 86.2% of Rohingya have experienced the trauma of their family members or friends being killed by the security forces, 70.6% have experienced the trauma of their family members or friends' death during the time of fleeing or hiding, and 29.5% have killed a family member near them. It has also been stated that among 62.3% of Rohingya refugees in Bangladesh who experience difficulty working, they attribute these difficulties to their poor mental health.

Survey participants in Rohingya studies have highlighted the various types of high-level pressures faced by them in the current situation in Bangladesh and previously in Myanmar. The highest pressure among the participants in the refugee camps in Bangladesh is due to two factors -- lack of adequate income (94.9%) and insufficient food (78.8%).

Focus group mothers say that food is insufficient. “How does life go on with what is given in relief? We have to buy vegetables, fish, and meat separately. Where does that money come from? What about to meet medical needs or the needs of our children?” When asked for the reason that they are under pressure, 60% said that there is an obstacle to free movement. Some 86% of the mothers mentioned the inadequacy of the living space, and 92% of the mothers said that they had been tortured by their husbands due to the decrease in the quality of life.

Another 40-year-old Rohingya woman has described how the security forces have raped her daughter. She said that they took her daughter and raped her. They even burnt her house. 

Of the 15 people, 13 reported witnessing torture, murder, and other forms of sexual violence and abuse, before fleeing Myanmar. All fifteen believed that they felt haunted by gunfight and fire. They still feel traumatized if there is a fire somewhere. 

The future of the unborn child

Out of the 15 mothers interviewed, 8 have teenage children. Since 2017 these teenagers have had nothing to do. Most of them rely on the relief they get in the camp, and then gossip out in tea shops, and watch various entertainment programs online. 

The reality is different for those who are involved in politics. They regularly engage in violence to earn little money and lead socially alienated lives.

When talking about the dream of these children, a mother said, “I had a house and a regular life there. My child would live a normal life even as a farmer. He could go wherever he wants, he would have a country of his own. What more could any mother want during childbirth?” But this child remains uneducated with nothing else to do in his life. There is also the fear of losing one's life among bad company.

Dealing with the trauma

“I have seen many of my neighbours carrying dead bodies from their houses after being slaughtered. They forced many people to go inside the house and burned houses and people. A father and two sons were kept inside a house and locked the door. Then they set fire to the house. They threw many children into the fire.”

When asked about how to bring people back to a healthy life from this terrible trauma, Shariful Islam talked about MSF's treatment process. He said when they come to MSF health facilities with a referral card, the nurses refer them to the mental health department. Then MSF counselors or psychologists bring them to their confidential counseling room and assess them, their emotional situation, social status, and also look for their risk factors. 

If the information from there suggests that the person suffers from mild mental health problems, the counselor continues with individual counseling sessions with them. But if the suffering is of a moderate or severe level, then the counselor consults jointly with the trained physician and provides the necessary psychotropic medication as per their needs. It's all provided completely free of charge.

When asked what is done next, he said, after receiving treatment, regular visits to MSF and continued counseling and psychological counseling depending on the nature of their recovery is necessary. If a patient misses their follow-up appointment, MSF's community-based volunteers visit their homes and for this intervention, permission is acquired in the beginning.

Although mental health treatment is provided by international organizations, why is the matter not given much importance by the government? RRRC Mizanur Rahman responded that Rohingya refugees are kept with basic rights. They are sheltered with a minimal service. There is no chance to think critically about psychiatric treatment in isolation. But we know that among the non-governmental organizations working, they are also working on the mental health issue. But for cultural reasons it is not a very easy task. The Rohingya are very conservative, so they won't allow others to work in that mental field.

Udisa Islam is a Special Correspondent for Bangla Tribune. This story was made possible by the Medecins Sans Frontieres (MSF) Without Borders Media Fellowship. MSF, also known as Doctors Without Borders, works with journalists to encourage independent, impartial and neutral reporting on health and humanitarian crises.

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