"People are in survival mode” - MSF International President on Rohingya refugees in Bangladesh

Monday, October 23, 2017 — On Monday 23 October, in Geneva, MSF President Dr Joanne Liu will speak at a Pledging Conference for the Rohingya Refugee Crisis organized by OCHA, IOM and UNHCR and co-hosted by the European Union and Kuwait. In the piece below she describes her recent visit to Cox’s Bazar, Bangladesh, where a refugee crisis is unfolding after renewed violence in Rakhine State, Myanmar.

“Almost 600,000 Rohingya refugees have sought safety in Bangladesh in the past two months. The numbers show no sign of slowing down – 40,000 people crossed the border from Myanmar in the past two weeks alone in an indication of continuing violence in Rakhine.

It’s hard to comprehend the magnitude of the crisis until you see it with your own eyes. The refugee settlements are incredibly precarious. They look like makeshift shelters made of mud and plastic sheeting, fixed together with bamboo and scattered across little hilltops. If you stop at the main entrance of Kutupalong settlement, which was home to several thousand Rohingyas even before this most recent influx, things look somewhat organized. But if you move deeper into the settlement, into the forests and areas with no roads, it’s another story. There are almost no services available and the vulnerability of people’s living conditions is shocking. Whole families are living under plastic sheeting in muddy and flood-prone terrain. They have very few belongings, are vulnerable to attacks from elephants, and have no access to clean water, latrines, food or healthcare.

It’s a very fresh displacement and people are in survival mode, which you can clearly see in everybody’s body language. People are taking each day as it comes, trying to secure the basics to get through the day. Currently, the humanitarian response is quite scattered: plastic sheeting is handed out in one location, while bags of rice or water are distributed elsewhere.

 In Kutupalong, where MSF has run a medical facility since 2009, we’ve raised our inpatient capacity from 50 beds to 70 beds and we now see between 800 to 1,000 patients every day. Our teams are treating things we shouldn’t normally see, such as adults collapsing or dying from dehydration because of a simple case of watery diarrhoea.  We’ve opened new medical, water and sanitation projects elsewhere in Cox’s Bazar, to better respond to the exponential growth in medical needs. But more action is desperately needed. The camp is a public-health time-bomb.

Let’s also not forget the root cause of the displacement of the Rohingya, which is the ongoing crisis in Myanmar. People do not flee their homes without good reason. They leave because their lives are in danger, and they have no other option.  Hundreds of thousands of them still remain trapped in Myanmar, still living that terror and now cut off from humanitarian aid.

For Bangladesh to welcome over half a million people in two months is a tremendous and extraordinarily generous act. But it comes with incredible challenges. No country in the world can meet such enormous needs alone. We urge the Government of Bangladesh to keep its borders open, and the international community to support this courageous gesture. It is the duty of donors to help prevent a public health disaster. We can only do that by ensuring we cover the vital needs of a population that has faced violence, rape and torture. We need more organisations on the ground building latrines, installing water pumps, providing healthcare, and distributing food. This can only happen if the Government of Bangladesh facilitates the presence of aid and enables a critical mass of humanitarian organisations.

This pledging conference should be a wake-up call. It is our chance to mobilise and avert a second catastrophe to restore the dignity of a population in great need.

ENDS

ABOUT MSF IN COX’S BAZAR

MSF been present in Bangladesh since 1985 but the crisis in Cox’s Bazar has forced us to massively increase our capacity to respond. We have provided medical care to more than 30,000 people since the start of the crisis, effectively five times the number of people who sought treatment at MSF facilities during the same period last year. In July, MSF was treating approximately 200 patients a day; now MSF is treating over 2,000 patients every day across its various projects. MSF has expanded its services at its largest medical facility in the region, Kutupalong, from 50 to 70 beds, with new wards and isolation areas for infectious diseases.

The organisation has also since started constructing additional temporary health posts (Balukhali, Mainnerghona) and mobile clinics to meet the needs of the new arrivals.

Outside of the medical response, in a bid to reduce the spread of disease in the settlements, MSF is improving water and sanitation at the informal settlements. This is a major part of MSF’s attempts to prevent the spread of disease. MSF has built 200 latrines, 25 boreholes and a gravity water supply system while trucking water daily to the settlements. The construction of latrines and water points is planned in the worst affected areas, in coordination with the Bangladesh Department of Public Health and Environment, and other entities.

Between now and the end of December, MSF aims to install an additional 100 deep tube wells, 300 shallow tube wells and 1,000 latrines in the Balukhali and Kutupalong makeshift settlements.

Children walk through the rain and mud at Kutupalung informal settlement in Cox’s Bazar, Bangladesh. Photographer: Amelia Freelander
(left to right) An MSF carer sits with a young girl, who’s believed to be about 15 years, and is currently being looked after at MSF’s maternity ward at Kutupalong Clinic, Cox’s Bazar. The teenager was found severely injured, and lost, after crossing the border from Myanmar. Here she meets with MSF’s Nurse Supervisor Lucky Shamsun Naher Begun, Nurse Activities Manager Jacqueline Murekezi and MSF’s President Joanne Liu, while she is taken on a tour of the facility. Photographer: Amelia Freelander
MSF’s President Dr Joanne Liu meets a ten year old girl at Kutupalong Health Facility. The child has just started making a miraculous recovery from tetanus. Doctors had not expected the young Rohingya girl to survive. 'Tetanus is a disease that has been eliminated throughout most parts of the world by vaccination.' But not in North Western Myanmar, the home of this girl's family, where they recently fled from.<br/><br/>MSF’s President Joanne Liu reflected about why she was drawn to the little girl as her father proudly helped her walk around the facility: “Tetanus can have such a high case fatality rate that seeing someone who survived and was walking, it’s always, I would say a victory, so this is why I thought it was quite amazing to see her walking around in the clinic.” <br/><br/>[Left to right: Dr Joanne Liu, MSF’s Nurse Supervisor Lucky Shamsun Naher Begun and Nurse Activities Manager Jacqueline Murekezi meet with a ten year old tetanus survivor]. Photographer: Amelia Freelander
MSF’s President Joanne Liu meets a ten year old girl at Kutupalong Health Facility, who has just started making a miraculous recovery from tetanus, after her third week in hospital. Doctors had not expected the young Rohingya girl to survive. 'Tetanus is a disease that has been eliminated throughout most parts of the world by vaccination.' But not in North Western Myanmar, the home of this girl's family, where they recently fled from.<br/><br/>MSF’s President Joanne Liu reflected about why she was drawn to the little girl, as her father proudly helped her walk around the facility: “Tetanus can have such a high case fatality rate that seeing someone who survived and was walking, it’s always, I would say a victory over so this is why I thought it was quite amazing to see her walking around in the clinic.” <br/><br/>[Left to right: Doctor Nina Goldman, MSF President Dr Joanne Liu and Nurse Activities Manager Jacqueline Murekezi meet with a tetanus survivor]. Photographer: Amelia Freelander
The construction of the Balukhali Makeshift Settlement Inpatient Department (IPD), which is next to an already existing Outpatient Department. Photographer: Amelia Freelander
Manager Karline Kleijer and MSF President Joanne Liu meet with former MSF Myanmar staff who fled from recent violence in Rakhine State, Myanmar, to Cox’s Bazar, Bangladesh. Photographer: Amelia Freelander
MSF Logistics sending a cargo via Dubaï with supplies for the Rohingya crisis in Bangladesh. Photographer: Scott Hamilton