According to the United Nations' latest approximations, almost one million persecuted Rohingya people have fled Myanmar to seek refuge in Bangladesh as of February 2018. Almost universally, all of the migrants have been living in the densely packed temporary settlements in Cox's Bazar. Even if everything goes according to the recent repatriation agreement between Bangladesh and Myanmar, it will take two years to deport all of the Rohingya people, who have fled military crackdowns in their country.
Meanwhile, one of our biggest concerns have been how to tackle the public health issues of the stranded community, which also involves the welfare of our own citizens living around them. Over the years, experts working in migration fueled by armed conflicts have dubbed refugee healthcare as the public health crisis of this century - any contagious diseases that rely on the human host have the potential to become an epidemic amongst refugees who live in densely packed camps. A few months ago, UNICEF reported that over half the Rohingya refugees in the camps have little to no access to healthcare, and 30 per cent have no access to water, resembling the cases of Yemen and South Sudan.
After a few weeks of the conflict-driven humanitarian crisis in South Sudan, which has driven its people toward Uganda, the UN refugee agency along with Ugandan officials made a shocking revelation - an outbreak of cholera was detected in reception centers and nearby settlements. A quick intervention from the UN and the Ugandan government brought the situation under control and potentially prevented a hostile reaction from citizens of the host nation.
Yemen has faced similar public health disasters as well. The poorest nation amidst the affluence of the Arab world has witnessed a drastic increase in the number of cholera cases during its civil war. The epidemic eventually turned into the largest and fastest-spreading outbreak of the disease in modern history. The spread of the outbreak, which has quickly surpassed Haiti as the biggest since modern records began in 1949, has been aggravated by hunger and malnutrition. The repercussions of armed conflicts around the world and the induced refugee crises thereof have been proven to take a great toll on the health and morbidity of the affected population.
What's more concerning is that the Rohingya community we are dealing with in Bangladesh were cut off from aid and made off-limits to humanitarian agencies, and had very little or no access to health care and vaccinations in Myanmar. A nutrition survey conducted by International Rescue Committee partner Action Contre la Faim (ACF) found shocking levels of malnutrition amongst Rohingya children, threatening an imminent public health crisis that could jeopardize the lives of refugees as well as surrounding communities.
Due to the lack of a drainage system, stagnant water is present around a quarter (26 percent) of all tube wells in the refugee camps. As for sanitation, 39 per cent of emergency latrines installed by NGOs, mostly at the early stage of the emergency response, are non-functional. Many of the arriving refugees are already carrying a number of diseases, including TB, skin diseases and HIV/AIDS etc. If spread, these diseases could overwhelm the health service resources at the camps and pose a great risk to the general population. On top of everything, there is no single data set covering the holistic health status of the refugees, which may create a huge backlash in responding to any imminent public health outbreaks and are already obstructing our way towards computation of vulnerabilities.
A proper assessment of the vulnerabilities regarding the health of Rohingya refugee is a prerequisite for the social and health security of both the refugee population and co-residing nationals. The treatment of communicable diseases should also be prioritized to prevent any potential outbreaks. Several NGOs and other humanitarian agencies are already working on their health issues and have already provided frameworks to prevent the epidemic, all of which have primarily focused on a substantial improvement in the living conditions of the camps, with a particular focus on improvements to water, sanitation and shelter, and reducing population density. These preventive measures should be taken as soon as possible to avoid an imminent crisis that could potentially threaten the lives of millions. Vaccination should also be prioritized as a preventive measure. These threats must be eliminated immediately – and this is very possible, but only with an arduous endeavour on the part of the government.
Abu Naser Rayhan is a Feature Writer, Dhaka Tribune