The Rohingya Have Fled One Crisis for Another

As the monsoon season looms, hundreds of thousands of refugees are living in overcrowded Bangladeshi refugee camps at risk of an imminent cholera outbreak.

Rohingya refugees in Balukhali camp on January 13, 2018 in Cox's Bazar, Bangladesh.

Rohingya refugees in Balukhali camp on January 13, 2018 in Cox’s Bazar, Bangladesh. (Allison Joyce/Getty Images)

KUTUPALONG-BALUKHALI REFUGEE CAMP, Bangladesh — Lukia fled Myanmar with nothing but a swollen belly. For a grueling three days and nights, she walked with her elderly mother and a nephew — her only surviving family members — across the border to Bangladesh about five months ago. “During the violence, everything was burned,” she says. “My husband, brother, and father were burned. That’s why we came here.”

Lukia, who thinks she’s in her early 20s, along with nearly 700,000 other Rohingya — mostly women and children — have fled here since last August to escape a military crackdown in Myanmar’s western coastal state of Rakhine. Hundreds of Rohingya villages were razed to the ground in addition to widespread murder and rape, which the United Nations has since described as bearing the “hallmarks of genocide.”

Most now live in refugee camps, under flimsy tarpaulin and bamboo tents in Bangladesh’s Cox’s Bazar district, a small area in the southeast corner of the country, perched on steep slopes that were once forested hills. Lukia has since had her baby, who was delivered in her family’s tent by her mother. She was at a health post when I met her inside the sprawling refugee camp because her 3-month-old had diarrhea — an indication of things to come.

The monsoon season, which begins in earnest in a few weeks’ time, is predicted to bring with it disease, landslides, flash flooding, and death.

The monsoon season, which begins in earnest in a few weeks’ time, is predicted to bring with it disease, landslides, flash flooding, and death.

The refugee camps are located in one of the most frequently flooded regions of one of the most flood- and cyclone-prone countries in the world. In 1970, Cyclone Bhola killed at least 300,000 people; in 2007, Cyclone Sidr killed 10,000. Despite their efforts, aid agencies fear that they will be unable to protect the Rohingya from yet another crisis, one that could end in utter catastrophe, further terrorizing refugees who have endured unimaginable atrocities.“What is the worst-case scenario? I have no idea,” says Didier Boissavi, a U.N. employee who monitors water, sanitation, and hygiene in the camps. Cholera and acute watery diarrhea are endemic in Bangladesh — and it gets worse during the rainy season. While two cholera vaccination campaigns have been completed in the refugee camps and host communities, there are concerns that an outbreak of the disease is inevitable because of poor sanitation and water quality, coupled with close living conditions and predicted latrine flooding.

“Why are we putting so much emphasis on a vaccine?” asks Khairul Islam, a doctor and the country director for WaterAid Bangladesh. “Maintaining water quality hasn’t been addressed with enthusiasm,” he adds. According to the joint response plan for the Rohingya crisis — a plan that brings together more than 130 partners, including dozens of international aid organizations, and outlines funding and response requirements — because of the current density of the population, “any outbreak has the potential to kill thousands.”

“This pathogen is the fastest contagious disease known to mankind,” Boissavi says, referring to the cholera bacterium Vibrio cholerae.

“This pathogen is the fastest contagious disease known to mankind,” Boissavi says, referring to the cholera bacterium Vibrio cholerae.

At a Médecins Sans Frontières health post inside Kutupalong-Balukhali refugee camp, Ibrahim Barrie, a medical team leader, shows me how they’re preparing for an outbreak: by setting up oral rehydration points and emergency treatment centers, including isolation areas equipped with beds and chairs with a distinct hole in the middle. “The highest death toll will be the elderly,” he says, due to the extreme heat, their frailty, and dehydration from diarrhea. “Most of them are just waiting to die.”On a sweltering afternoon, refugees collect sandbags, plastic, and bamboo, grabbing anything that could be used to fortify and protect their tents — and families — from being swept away. They carry the goods up steep slopes, dodging thick piles of red mud and water holes from a recent intense downpour. While work is being done to clear land to create stable ground for the thousands who are most vulnerable to monsoon damage, more than 200,000 refugees live in areas that are likely to flood or collapse.

Agencies including the International Organization for Migration (IOM) are training refugees in search and rescue and first aid, along with creating safe access routes and new drainage channels to try to limit flooding. But there’s only so much that can be done, and there’s only so much battering tents can withstand. “With the monsoon coming, we’re looking at possible multiple disasters. It’s not a one-day or one-week weather event. It’s four or five or maybe six months,” says Caroline Gluck, a spokeswoman for UNHCR.

While Bangladesh has a good early warning system for cyclones, there are no plans to evacuate refugees. Moving to higher ground is out of the question — there’s too many people and too little land — and so is doing more to make the shelters sturdier, because the authorities won’t allow it.

Building stronger or permanent structures would suggest that the refugees are here to stay, and, in an election year, that is not a signal Bangladeshi Prime Minister Sheikh Hasina wants to send

Building stronger or permanent structures would suggest that the refugees are here to stay, and, in an election year, that is not a signal Bangladeshi Prime Minister Sheikh Hasina wants to send

to voters, especially when public sentiment toward the Rohingya refugee population is starting to harden. Building concrete homes for refugees would be, in the Bangladeshi government’s view, a political liability. And they are already being branded a threat rather than fellow Muslims in need of compassion. Hasina has told local media that the longer the Rohingya stay, the likelier it is that they will create security issues because “when people remain frustrated and have no work, they could easily indulge in militancy.”

*Sophie Cousins is a health journalist based in South Asia. She is currently writing a book on women’s health in the region.

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