Understanding the Rohingya Refugee Crisis
Rohingya crisis update
Since 25 August, over 620,000 Rohingya refugees have fled from Myanmar into Bangladesh and the influx still continues up to today. Refugee settlements are heavily congested with many shelters on top of each other and sometimes multiple families living in one shelter. They are facing a lack of clean drinkable water, and poor hygiene and sanitation conditions. What we see is still an acute emergency situation and there are huge humanitarian needs. Emergency response on shelter, water and sanitation, needs to be urgently scaled up and the living conditions need to be massively improved.
The dense population and the poor living conditions in the settlements are putting people at a higher risk of public health emergency, especially for vulnerable population like children. Although the government of Bangladesh has implemented a mass vaccination campaign for measles, there is always a risk of any infectious diseases unless the root causes are addressed. We are now seeing an increasing number of Diphtheria cases, which is another sign of vulnerable situation where people are put to. There is an urgent need for more response to the public health emergency as well as reduce the density in the settlements to mitigate the risk of further spread of disease.
As the settlements keep expanding further, there is an inequitable access among refugees to the basic needs such as healthcare services, food and water, which increases vulnerability of those groups. The military is currently working on a new road but additional improvements to access into the settlements and humanitarian services is urgently needed not only to ensure aid is reaching all the population who are in need of basic needs to limit further hardship and the risk of public health problems.
As of the end of November 2017:
- Health facilities: 19 health posts, three primary health centres and four in-patient facilities
- Staff: 2,258 national and international staff
- Patients: More than 143,000 patients have been treated at MSF outpatient facilities and more than 3,100 patients in inpatient facilities since the end of August 2017.
- Health issues: respiratory infections, diarrheal diseases, measles and an increase in diphtheria.
- Other activities: water and sanitation (water trucking, hand pump, tube well and latrine installation) and mental health services
MSF Project locations in Cox's Bazar
- Sabrang entry point
For more updates: https://www.msf.org.za/stories-news/bangladesh/all/all/all
"I fled with my whole family, but my son was shot while running away. I brought him to the hospital here in Bangladesh, but left the other family members in the forest in Myanmar, just hiding there. I haven't heard from them for days now. I don't know what to do, I feel so desperate."
MSF is supporting the government in expanding routine vaccination in the camps through initiating vaccination for children and pregnant women at MSF facilities. Staff at all MSF health facilities will have the capacity to administer immunisation for measles and rubella, oral polio and tetanus according to national protocols.
The Ministry of Health started a measles and rubella vaccination catch-up campaign from November 18th which ran for 12 days and targeted a total of more than 336,000 children between the ages of 6 months and 15 years. MSF supported this campaign with community mobilization, site identification, logistics, and transportation of vaccines. A vaccination coverage survey is planned in mid-December in order to evaluate the success of the campaign.
- Total number of sexual violence cases from 25 August – 3 December: 113
- Number of rape cases: 91
- Number of SGBV cases under 18: 37
- Number of cases of male on male sexual violence: 0
Estimating the number of survivors is not possible. However, sexual violence is often underreported due to stigma and shame, fear of reprisals, a lack of knowledge about the medical consequences of sexual violence and the need for timely medical care, and a lack of awareness about the medical and psychological support available. Given these barriers, it is likely that the number of SGBV survivors MSF has treated so far is just a fraction of reality.
MSF is starting to see more survivors seeking medical care as some of these women and girls have become pregnant as a result of rape.
MSF has specialised staff on the ground to treat survivors who are referred for treatment as a result of trauma, including sexual assault and rape. MSF’s local community outreach workers are visiting the people living in the settlements, informing them about the free services the organisation offers, including treatment for sexual violence.
Water and Sanitation (WASH)
Due to the lack of a drainage system, stagnant water is present around a quarter (26%) of all tube wells. As for sanitation, 39% of emergency latrines installed by WASH partners, mostly at the early stage of the emergency response are non-functional. And desludging and decommissioning of these latrines remains a priority to improve the inadequate sanitation environment.
MSF is targeting its water and sanitation response in the most difficult to reach areas. So far MSF has built 1247 latrines, 157 water wells and a gravity water supply system both in the settlements located in the North as well as in the ones in the South.
By the end of December, MSF aims to install a total of 400 boreholes and 1,000 latrines in the Balukhali and Kutupalong Makeshift Settlements. Considering that the shallow aquifer - the main water source, abundant in quantity and easy to access – is contaminated with fecal coliforms throughout the camps, we started drilling deep production boreholes up to 150-200 meters deep to have clean water. Four deep boreholes have been drilled so far. We plan to start a hygiene promotion to clean latrines and educate about hand washing, as well as soap and other non-food item distribution in MSF facilities. To make sure vulnerable population get clean drinking water, MSF plans to distribute water filter in our clinics in Tasnimarkhola and Balukali 2, for patients of
malnutrition, measles and pregnant women. In the southern settlements of Unchiprang and Jamtoli MSF is aiming to construct 56 more latrines and 43 wells in the coming weeks.
MSF also includes water supply and sanitation in its emergency response for new arrivals. MSF has deployed teams to arrival, transit and settlement locations to ensure that newly arrived refugees have access to safe drinking water and adequate sanitation facilities.