19 December 2017

Arunn Jegan was working on his first field assignment as the Project Coordinator in the Kamrangirchar slum of Bangladesh for eight months before he was pulled in to respond to the Rohingya crisis in Cox’s Bazaar.

MSF, Doctors Without Borders, Bangladesh, Rohingya refugees
MSF, Project Coordinator, Arunn Jegan.
Photo: Antonio Faccilongo

In the first week of September, I was asked to get on the next available flight from Dhaka to join the team responding to the refugee influx in Cox’s Bazar. At that point, 120,000 Rohingya had crossed from Myanmar into Bangladesh. I had never seen a population of that size arriving in such a short space of time into an area that was significantly underprepared. The numbers were unimaginable and the needs were increasing by the minute. It was like the entire population of the eastern suburbs of Sydney being forcibly relocated overnight without warning; being moved to a country where they’ve never lived before; received into a very precarious situation, with little or no chance of going back.

Within two months of being in Cox’s Bazar, I was working closely with the MSF coordination team, taking the lead in emergency response for the border operations. Although more than half a million refugees had arrived by October, hundreds more were crossing over daily. We established a small response team of four medics who could be at the border within an hour, providing critical medical triage and distributing oral rehydration salts.

MSF established and maintained a strong presence at the border, not just to provide medical care, but for the ‘temoignage’ aspect. Bearing witness and speaking out has always been at the core of our values. We saw how people were moving from Point A to B; wading through neck-deep water, with children above their heads. We realised that crossing on foot was not a secure solution and we addressed this with the local authorities. Boats were used instead, and the military played a role in pulling vulnerable people out of the water and guiding them to safety. That only happened because we walked that path with them. But above all, it was the human presence that made a difference at the border. Being there with them, offered a fraction of hope.

MSF, Doctors Without Borders, Bangladesh, Rohingya refugees
Makeshift camps that have become home to hundreds of thousands of Rohingya refugees in Bangladesh,
no system has been put in place to drain or pump clean latrines that are shallow and unsanitary. Photo: Mohammad Ghannam/MSF

“It’s moments like these don’t escape you.”
We also guided new arrivals to the transit centres – and further to the settlements. And of course, we referred vulnerable patients from the border to the MSF clinic in Kutupalong. This was always difficult because patients feared being separated from their families. For the Rohingya population, family isn’t just the immediate household: it’s relatives and the extended community. They had been through so much pain and suffering that the threat of separation would cause them to think twice about accessing health services.

One of the most striking moments happened while transporting an older man to the clinic. He was to be reunited with his wife who had been referred by our border team earlier. The man described travelling from Myanmar in gruelling conditions; walking more than 60kms; to being stuck on the berm for four days in horrendous conditions, only to be faced with photographers on arrival, interested only in capturing him in that single moment of desperation. Now, he was in the ambulance driving down the only access road towards Kutupalong and seeing the camp for the first time. He broke down in tears. What got to me, was not the fact that there was an older man crying inconsolably. It was that I couldn’t place the emotion: was he mourning the loss of his home and family? Was he overwhelmed? Was he scared? Or was he thinking ‘I finally made it, this is the end of my journey?’ I did not know what he was feeling; I don’t know if he knew. I couldn’t make that human connection and that was terrifying for me. It’s moments like these that don’t escape you.

MSF, Doctors Without Borders, Bangladesh, Rohingya, refugee
At least 6,700 Rohingya were killed during the initial 31 days following the start of the violence, including at least 730 children below the age of 5 years.
Photo: Mohammad Ghannam/MSF

“It’s important to feel angry.”
Before I left Cox’s Bazar, I was walking through the camps with one of the medical coordinators and we spotted two young kids walking in front of us. To me, it looked like a scene straight out of a movie: a pair of hopelessly innocent kids laughing and holding hands, walking through a refugee camp. We wondered what life would look like for these two kids when we were no longer here. What would it look like in 10 years’ time? I had a lingering hope that one day, back in the comfort of my own home, I would turn on the TV to see a Rohingya refugee success story. It would be an incredibly pivotal moment to see even just one refugee realise their hopes and dreams, succeeding in a profession or education. If one person could come out of this with some level of success, I think it would be a remarkable achievement for humanity.

But I am sceptical of anything even close to this vision having seen the magnitude of the crisis and the flows of people still streaming in. People are still crossing the border. Families are spending 12 days on the road, to reach crowded reception centres where they are kept overnight. When you hear these stories, it’s difficult to expect that the Rohingya will ever escape ongoing struggle.

MSF, Doctors Without Borders, Bangladesh, Rohingya refugees
Children at a camp for Rohingya refugees in Bangladesh play in the mud. Conditions are dismal here, and
diseases spread extremely quickly, in part because the soil is contaminated with human faeces. Photo: Mohammad Ghannam/MSF

It’s important to feel angry. It’s important to feel sad. I don’t think I can walk away from this feeling, ‘that was that’. It’s going to be difficult to disconnect from what I’ve seen in Bangladesh. However, the resilience that the Rohingya have shown is remarkable. And the compassion of the Bangladeshi population is inspiring. With the combination of these two things, there can be a positive outlook.


MSF first worked in Bangladesh in 1985. Close to the Kutupalong makeshift settlement in Cox’s Bazar district, and since 2009, MSF has run a medical facility and a clinic offering comprehensive basic and emergency healthcare, as well as inpatient and laboratory services to Rohingya refugees and the local community. In response to the influx of refugees in Cox’s Bazar, MSF has significantly increased its presence in the area, with expanded operations covering water, sanitation and medical activities for the refugee population.

Elsewhere in Bangladesh, MSF works in Kamrangirchar slum, in the capital, Dhaka, providing mental health, reproductive healthcare, family planning and antenatal consultations, as well as an occupational health programme for factory workers.

Find out more about MSF's work in Bangladesh.