With over 150 diseases in the Rohingya communities in Bangladesh, we see another refugee crises that is slowly turning deadly.
Since the mass influx of Forcibly Displaced Myanmar Nationals (FDMN) in Bangladesh, there have been severe concerns surrounding the lack of access to WASH facilities (water, sanitation and hygiene) including a lack of provision of clean drinking water, washing and domestic activities; the safe removal of waste (toilets & waste disposal); and the promotion of healthy behavioural practices.
Due to the increasing number of Rohingya refugees and their congested living conditions in camps, there has been an overwhelming increase in their health risks. Refugees and affected community require 9 million litres of safe water daily, and water, sanitation and hygiene (WASH) services are reaching only 30% of the Rohingya people in need.
Bangladesh, a nation already well-known to be vulnerable to natural disasters, faced the dire task to adjoin a rapid incursion of the Rohingya refugee population from the Rakhine state of Myanmar. While the government was able to provide the refugees with land, they were unable to maintain similar competency with a healthcare plan. Humanitarian services within Bangladesh had set-up emergency shallow-tube wells in Rohingya camps that were supplying the communities with unclean water, which the refugees had no choice but to use for drinking and other uses.
Moreover, due to a lack of an adequate quantity of safe water during these initial stages of the emergency, the Rohingya population accessed drinking water from surrounding highly contaminated surface water sources, including paddy fields and irrigation canals. Over the years, vast areas of Cox’s Bazar are well-known for lacking adequate water sources because of the sharp falling of water levels making pumping water too difficult along with environmental mismanagement present in the forest and hilly topography that are restraining the resident population as well as the Rohingya population from accessing an adequate quantity of safe. Cholera, typhoid, and diarrhoea, particularly Acute Watery Diarrhoea (AWD), is very common among the Rohingya refugees.
Over 64,000 cases of AWD were reported in April 2019 alone, among which over 40% involved children under five. The clean drinking water crises also causes disproportionate issues for women and girls as 57% of the Rohingya households regularly have women as the sole collectors of water while 15% have children (especially girls) bear the responsibility. The hours spent on daily water collection could be spent on childcare, informal education, voluntary work, or other productive activities.
The Rohingya health crises further extends to poor waste management and a lack of opportunities for safe toilets in their communities. Although grey literature and news articles are available on the waste and sanitary situation in refugee camps in Bangladesh, there are limited systematic studies and scientific literature on WASH issues in Rohingya refugee camps. There is a significant lack in understanding waste flows (packaging waste, bottled drinks, sachets, as well as fecal sludge and other solid and liquid waste) and recycling practices in these refugee camps. This has lead to lifestyle degradation issues for multiple Rohingya households.
"On the main road, we saw a lot of refugees were standing beside a truck crying for food and water. Praying and begging for food is still the only way for us to make sure we eat"
- Nur, living in a Rohingya refugee camp near Cox Bazaar
32 out of 100 Rohingya children have been chronically undernourished and need urgent medical care for survival.
Today, the Rohingya people still suffer from some of the worst food crises in human history with 86% of the population highly vulnerable to poverty and hunger in 2020. Coupled with the Covid 19 pandemic and a massive influx of populations in Bangladesh’s Cox Bazaar, the pressure on local farmers and merchants to supply low-cost food had immensely increased hence worsening the food security situation of Rohingya refugees and host communities in Cox’s Bazaar. Overcrowded camps and strained host families, especially in Teknaf and Ukhiya sub-districts, have led the Government of Bangladesh to relocate some 17 000 Rohingya refugees, of whom 56 percent children, to Bhasan Char. An additional 83 000 refugees from the camps in Cox’s Bazar are planned to be relocated to a remote silt island in the Bay of Bengal. Despite the challenging conditions in Bhasan Char as well as in Cox’s Bazar, supporting the livelihoods and resilience of affected people is crucial to the humanitarian response. Rehabilitating land and providing both refugee and host communities with agricultural, fisheries and livestock production assistance can equip them with the necessary means to feed themselves thereby increasing their self-reliance.
UNHCR and partners have trained and equipped volunteers to conduct water, sanitation, and hygiene activities in the camps. This includes solid waste collection, transportation and segregation, operation, and maintenance of facilities, and de-sludging. Volunteers also conduct hygiene promotion through shelter visits, group sessions, mass awareness and clean-up campaigns. Community engagement and hygiene promotion is key to ensure the continuity of access to services and facilities. The dissemination of information on good hygiene practices during COVID-19 and other disease outbreaks has been pivotal to reducing the spread. Commemoration of key days such as Global Hand-washing Day, World Water Day and World Toilet Day are opportunities to share key information and continue advocacy for better service delivery.
To assess the impact of these hygiene promotion activities and to ascertain the level of knowledge, attitudes of practices towards water, sanitation, and hygiene services, UNHCR conducts two annual Knowledge Attitude and Practices (KAP) surveys. The results of these surveys contribute to redesign, if needed, of hygiene promotion interventions, to adapt to changing environments and to target specific groups. In addition to KAP surveys, regular field monitoring, water quality campaigns and an annual comprehensive inventory of facilities are carried out by UNHCR and partners.
All in all, steps are being taking to drastically improve the current WASH conditions at Rohingya camps and direct funding to UNHCR and its partners focusing on accelerating the adoption of safe, forward-thinking hygiene practices is always encouraged.
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