I’ve been here for ten days now. My baby is absolutely exhausted.” – A young Rohingya refugee mother at Cox’s Bazar
At the end of August 2017, renewed violence against the Rohingya minority broke out in the State of Rakhine. The conflict forced more than 600,000 people to flee their villages and cross the frontier to seek refuge in Bangladesh, in the region of Cox’s Bazar, joining the 220,000 other refugees already installed there. The Rohingya families live here in extremely difficult conditions, with no access to basic services. Many of them have gone through traumatic experiences, making them even more vulnerable when faced with an uncertain future.
Having returned from a mission of evaluation at the beginning of October in the refugee camps at Cox’s Bazar, Pierluigi Testa, health expert in Terre des hommes’ (Tdh) humanitarian aid department, tells us what he witnessed there and comments on some of his photos.
During the assessment tour, our team visited several camps. This photo illustrates the density of the refugee population and the immense geographic expansion of the new camps: “The further we went, the more we discovered new shelters behind the hills,” says Pierluigi. The new refugee camps have no access by road and the only way to help the inhabitants is to go there by foot. During the rainy season, the paths are transformed into muddy rivers, further aggravating the refugees’ living conditions and making humanitarian aid even more difficult.
So as to fully understand the situation of the Rohingya refugees and the conditions under which they are living, our team of experts went to meet the people – marching for hours through the hills and the camps. They talked to many families and asked them about their needs, about their access to water and food, and on the physical and psychological state of their children.
The Rohingya refugees installed themselves in this zone of expansion in the Kutupalong camp in February and March this year. They have already received some aid, such as the building of this water point. However, despite their arrival having been some months ago, access to clean water is not assured. During the evaluation visit, our team recorded the lack of a water draining system and of protective barriers. Such conditions aggravate the risks of epidemics linked to the poor quality of the water. In this region where cholera is endemic, the massive influx of refugees worsens the dangers of transmission of water-borne diseases like cholera and diarrhoea.
This father has lost his wife, killed during the violent clashes endured in Myanmar, and is now left alone with his four children. Without work, this young man cannot meet the needs of his children, who suffer from malnutrition. When we visited him, not one of the little ones had been taken into care or admitted to a nutritional programme, although the family had arrived five months ago.
“The first time we came to Burma Para, the hills behind the camp were still empty. But when we came back, the camp had doubled in size,” says Pierluigi. “Here, the Rohingyas who arrived at least two weeks ago can be found,” he adds. These latest refugees build their shelters with bamboo, straw and refuse bags to protect themselves from the rain. There is nothing at all on the ground, not even a mattress. The living conditions of these new refugees are desperate. Not a single international actor was on the spot at the time of our evaluation.
This photo shows the shelter of a recently arrived family: the wife is alone with her three children, aged five, three and one-and-a-half. A few sacks of food containing maize and flour, a kit of hygienic products and a bucket for drawing water are the sole assistance she has received since she arrived at the camp. She told us how difficult it is for her to go to fetch water and food, as she is quite alone with her very young children.
A new-born baby, barely 24 hours old. The mother gave birth here, alone in her shelter. When Pierluigi met her, she had not had any postnatal consultation, either for herself or for her baby. When he asked her if she had been able to breastfeed the baby, the young woman replied: “I don’t have any milk”. When a mother has an insufficient food intake, her body cannot produce milk. “This is a part of our project. We will provide all the care required to pregnant and breastfeeding women as well as to children from 0 to 5 years of age, or older if needed,” he assured us.
A large number of malnourished children were identified by our experts. Talking to the women, one of them said: “I’ve been here for 10 days. I can only give my children some food once a day.” The child held in her arms is not yet two years old. She admitted that her child is “exhausted”. The child is, in fact, suffering from malnutrition.
Here, one of our doctors palpates a child’s foot. This is a quick test to establish a child’s nutritional condition through signs of pitting: a gesture that serves to demonstrate oedema in the lower limbs, a potential sign of malnutrition.
What we do for the Rohingya families
An operational emergency team is presently on the spot to roll out the projects aimed at saving lives. We are drawing upon our long experience in Bangladesh – we have been running healthcare projects for the past 30 years in northern and southern regions of that country – by setting up activities for peri- and postnatal healthcare, for prevention and treatment of malnutrition, for hygiene and sanitation, and finally psychosocial activities for the children and their parents.
The strength of our activities lies in their multi-sectoral approach: all visits and medical care are coupled with a component of protection. This means that our co-workers assess the state of a child’s health and treat it whilst informing themselves of the family’s living conditions and the psychological state of the children. In this way we aim to reduce both child and mother mortality, and the vulnerability of the Rohingya refugees most affected by the conflict.
We need supplementary funding to be able to help even more Rohingya children:
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