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Dhaka Tribune

Covid-19 will decimate the Rohingya refugee camps

They are defenseless against this pandemic

Update : 12 Apr 2020, 06:46 PM

After all that they have gone through, the Rohingya are, like the rest of us, facing a killer even deadlier than the Myanmar military: The Covid-19 epidemic. And it won’t do Bangladesh any good to allow Cox’s Bazar to become an epicentre of infectious disease.

Two metrics are important in judging the threat of Covid-19: Its infectiousness -- how easily it spreads; and its mortality -- what proportion of those it infects end up dying from the disease.

At the moment it is difficult to quantify exactly how infectious this disease is. But we know it transmits not just from droplets from coughs or sneezes, but also from aerosols, ie from people just breathing out normally. 

We know it can persist on some surfaces up to three days. And we know that virtually no one has any kind of natural immunity to it. 

Add to this that some people do not develop symptoms at all, but can still transmit the virus while they are carrying it, and you have a situation where only the most extreme measures of social isolation and societal lockdown of the kind we have seen in China have any hope of working, once the disease appears in a population. 

In conditions like those the Rohingya are living in, in Cox’s Bazar, containing the disease will be virtually impossible, once it appears. The Rohingya are living in conditions with more than 100,000 people per square mile, with virtually no space to isolate or quarantine anyone. 

No space even to limit human-to-human contact in any significant degree so as to slow down the spread of such an infectious disease. To say nothing of the limited scope for proper hygiene in the public spaces, or the very limited availability of medical supplies -- masks, disinfectant gels, etc are effectively out of the question.

For that reason alone, as heartbreaking as it was, it was the right thing to do to put Cox’s Bazar in lockdown. We do know at least from the experience of China so far that extreme measures such as this can hinder the transmission of the disease, and it is absolutely imperative that the virus is pre-empted from making its way into the Rohingya camps.

Because if it does, all hell will break loose. We have seen from the experience of Europe that even countries with advanced healthcare systems like Italy and Spain can be quickly overrun, with catastrophic consequences. 

In the best-case scenarios, scientists believe that the disease could have a mortality rate as low as under 1%. Northern Italy has seen rates of close to 10% of those infected. But 15-25% of those infected develop acute, life-threatening symptoms which need hospitalization to manage. In other words, in conditions such as those in Cox’s Bazar, mortality rates could easily reach 20%.

So Cox’s Bazar is a place where, if the virus gets in, virtually everyone in those camps is guaranteed to get it, and as many as 20% of those who get it are likely to die. We are talking 200,000 people. An order of magnitude more than those killed by the Myanmar military.

Humanitarian disaster aside, we need to also think about how human beings, like us, are likely to react in these circumstances. 

In other words, what are the odds that Rohingya families, fearing for the lives of their children or loved ones, will stay put in Cox’s Bazar and wait for the virus to get to them and decimate their families? Would you stay put in these conditions?

But if Rohingya start to flee Cox’s Bazar in numbers, what then? By the time they start fleeing, at least some of them will be carrying the virus. 

What does that mean for the rest of Bangladesh? And what do we propose to do when that happens? Will we use military force to confine them, and so kill even more? Will we become even worse than Myanmar?

The only chance to avoid this absolute calamity from happening is to take the most amount of care to quash the transmission of the virus in the country as a whole and devote every resource we have available (including resources we can request from the international community) to ensure the disease does not reach the refugee camps. 

In other words, we need to go directly to full lockdown measures as a country, and we need to do it now. We must contain the few tens of cases we have already and prevent them from becoming more than 1,000. If we get to 10,000, we will be fighting a losing battle. 

And after we get the situation under control, we will have to regulate border crossings so as to quarantine everyone coming in for at least three weeks, for the rest of this year and next. We do not have time for incremental measures. We cannot afford to wait for the situation to develop. 

We cannot approach the political tactics of this by allowing the situation to get worse so that the population gets on board with harsh measures before we go to full lockdown. Bangladesh cannot afford that. We must act now.

Azeem Ibrahim is Senior Fellow at the Centre for Global Policy and Adj Research Professor at the Strategic Studies Institute, US Army War College.

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