Thousands of Rohingya refugees have arrived in Bangladesh in recent months after fleeing escalating violence in Myanmar, while others have been pushed back or detained while trying to escape.
They now face immense challenges, including overcrowding, lack of access to essential services, and deteriorating mental health conditions in camps.
Doctors Without Borders/Médecins Sans Frontières (MSF) is urging the authorities to ensure unhindered and immediate access to humanitarian assistance, care, and protection for all Rohingya refugees.
Who are the Rohingya?
The Rohingya are a predominantly Muslim ethnic minority who have lived for centuries in the majority Buddhist Myanmar, mostly in Rakhine state, but were effectively excluded from full citizenship under the 1982 Myanmar Citizenship Law, leaving them stateless. In August 2017, a concerted campaign of extreme violence and killings by the Myanmar military against the Rohingya people forced around 770,000 people to flee to Cox’s Bazar, Bangladesh. Hundreds of thousands have also fled to countries such as Malaysia, India, and Pakistan, where they remain stateless.
Those who have managed to reach Bangladesh have described to our teams their horrific journeys, which often include witnessing loved ones dying in front of them, having to sell their remaining possessions, and being forced to incur significant debts to cover the risky journey. Others told us how they desperately tried to cross the border to find safety—a feat that sometimes took them several days.
Zahir*
Before the violence, I lived a simple life with my family in a small village. We had a small farm and a modest income, but we were happy. However, in recent years, violence and instability have become a devastating part of our lives.
In July, the violence reached our village. I was sitting outside with a neighbor when gunfire suddenly erupted. A bullet struck him, killing him instantly, and I was hit in the back. With no medical help available [in Myanmar] and fearing for our lives, we made the heartbreaking decision to leave everything behind. In the chaos of fleeing, our 3-year-old son was lost in the crowd. Though we searched desperately, the worsening danger forced us to move on with our remaining children.
Risk of malnutrition in refugee camps
Access to food is a challenge in the refugee camps of Cox’s Bazar. People who were already living in the camps say that they are sharing their food rations and space with newly arrived family members, who don’t have access to services like shelter, water, and sanitation. They also lack protection from abuse, exploitation, and neglect, which particularly impacts girls, boys, and women.
Since July, MSF has seen an increase in the number of children under 5 with moderate and severe malnutrition. Access to food and health care is almost nonexistent in Myanmar, so new arrivals are particularly vulnerable to malnutrition. The persistent under-resourcing of the humanitarian response has also severely hampered the availability of essential services, making it difficult for newly arriving Rohingya refugees to access humanitarian services. Our teams are treating newly displaced Rohingya refugees in the camps, including critically ill and war-wounded patients with mortar shell injuries and gunshot wounds.
“People have shared with us that they are afraid to seek assistance as this might put them at risk of being exploited or even returned to Myanmar,” says Orla Murphy, MSF country representative in Bangladesh. “Our mental health teams, in particular, see how people are grappling with the violence they witnessed back home and how the lack of access to available humanitarian services has created uncertainty that is further exacerbating their trauma. We are seeing newly arrived Rohingya patients showing symptoms of stress, anxiety, and depression.”
Solim*
I was born in Myanmar and grew up with my parents and a large family—six brothers and three sisters. Now, as I speak, one brother is here in Bangladesh, another is in Yangon, and I have no idea where the others are. One of my brothers and two of my sisters are missing. Communication between villages in Myanmar became impossible and, even now, I have no way of knowing if they are safe.
Before I left Myanmar, I was repeatedly pressured to join either the Myanmar military or the Arakan Army [armed opposition group]. Both sides expected young Rohingya men to fight, as they lacked people for their ranks, but I didn’t want to be part of that violence.
One night, when our village was surrounded by the army, I escaped with my younger brother, moving through streams and across hilly areas to take shelter in a different neighborhood. There was no escaping the conflict though; there was gunfire, shelling. We went from village to village, always trying to avoid the crossfire. Eventually, my brother and I hid in the woods for two days, hoping to stay out of sight.
MSF mental health activity manager at Kutupalong and Balukhali Clinic
Shariful Islam
As a mental health professional working with Rohingya refugees, I have witnessed firsthand the devastating impact of trauma and violence on the mental well-being of people who have recently fled Myanmar. Each month, our facilities see over 30 patients who arrive with a variety of mental health complaints, including complex trauma and post-traumatic stress disorder (PTSD). Many people with mental health disorders, who were previously stable in Myanmar, now experience worsening conditions due to a lack of treatment during their journey.
Among the most pressing mental health issues we encounter are severe depression and anxiety, compounded by the harrowing experiences these individuals have endured. When the violence escalated in Myanmar in July and August this year, we saw a significant increase in patients seeking help. Each of these patients carry not only the weight of their mental health struggles but also physical ailments resulting from prolonged exposure to violence and neglect.
Urgent action is needed
While Bangladeshi authorities have recently committed to addressing the most urgent needs of Rohingya refugees in the camps, more must be done immediately. MSF calls for unhindered access to humanitarian assistance, care and protection for all Rohingya refugees in Bangladesh. We also urge all relevant authorities to follow international law and ensure that no one is returned to a place where they face serious harm, including persecution, torture, or other serious human rights abuses.
* Names have been changed for privacy