Rohingya refugee crisis

The Rohingya refugee crisis

Medical Refugees and displaced persons
At least 1.2 million Rohingya people have been displaced during violent and targeted campaigns led by the Myanmar military, with most fleeing across the border to Bangladesh. Close to one million Rohingya live in camps in Cox's Bazar.

Medical Denied humanity
The Rohingya are stateless and remain one of the most persecuted minorities in the world. Durable solutions are needed to recognise their humanity and right to a future.

Healthcare Scabies outbreak
40% of the Rohingya refuges living in Cox’s Bazar are suffering from scabies. The scabies outbreak is directly linked to the living conditions in the camps, where people share small, cramped spaces and often inadequate access to water.

Since the late 1970s, the Rohingya people, considered “stateless” under international law, have faced persecution in Myanmar, with escalating targeted campaigns forcing hundreds of thousands from their homes to seek refuge in neighbouring countries.

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Violent campaigns by the Myanmar military, the largest of which was in August 2017, have forced around one million Rohingya refugees to flee Myanmar and take shelter in Cox’s Bazar, Bangladesh, in what has become the world’s largest refugee camp. Around half of those in the camps are children.

Currently there is a severe deterioration of living conditions in camps, where homes were only designed to be temporary. Finding shelter in the overcrowded camps is a challenge while barbed wire fences limit the Rohingya people’s movements within the camp and their interactions with the outside world. The situation is extremely precarious, with many people lacking access to healthcare, safe drinking water, latrines and food. Access to work and education opportunities are also severely limited.

“They have no choice but to depend on humanitarian aid. They now only have US$8 per person per month for their food and have inadequate access to water, sanitation and healthcare.”

Arunn Jegan

Head of mission in Bangladesh

Health problems continue to grow. Médecins Sans Frontières (MSF) teams have observed a steady increase in scabies amongst the community in the camps in the last six years. Now, in 2023, a large-scale scabies outbreak is affecting the Cox’s Bazar camps, with an overall prevalence close to 40 per cent. However, in some areas, there is up to 70 per cent according to a WHO survey.

MSF is also witnessing the impact of reduced global attention on the situation of Rohingya people, as international donor funding has been directed to other crises, and the overstretched humanitarian sector attempts to respond.

As well as urgent action to improve the living conditions in the camps, the international community must prioritise long-term solutions for this community that recognise their humanity. Australia has a role to play in leading on durable solutions for this group of people living in limbo in our region.

For many Rohingya refugees in Cox's Bazar, their primary concern is that their children have access to an education, and a future.

About the crisis

On 25 August 2017, a campaign of targeted violence by the Myanmar military forced more than 700,000 Rohingya from Rakhine state into Bangladesh. These refugees, along with 200,000 others who had fled earlier violence, face dire medical needs. Meanwhile accessing healthcare remains a challenge in Myanmar since the February 2021 military coup.

Nearly one million Rohingya refugees are currently situated in Bangladesh. Most of these people have been living in the world’s largest refugee camps in Cox’s Bazar for the past six years, and some for much longer.

The COVID-19 pandemic further exacerbated the situation, reducing humanitarian presence and increasing unmet needs, leading to heightened tensions.

Shelters seen from a hilltop in Jamtoli refugee camp, Cox’s Bazar, Bangladesh. © Saikat Mojumder/MSF

The Rohingya people living in the camps share stories of struggle and resilience in their lives since being forcibly displaced from Myanmar. They struggle with the increasingly precarious living situation, whilst being denied the right to move freely, access healthcare, work, or education.

Approximately 20,000 Rohingya refugees have been relocated to a man-made island off the coast of Bangladesh called Bhasan Char. MSF has concerns about the living conditions and healthcare on the island.

Who are the Rohingya?

The Rohingya are an ethnic group, the majority of whom are Muslim, currently considered “stateless” under international law. They have lived for centuries in the majority Buddhist Myanmar (formerly known as Burma). Myanmar authorities contest this, claiming that the Rohingya are Bengali immigrants who came to Myanmar in the 20th Century.

The Rohingya have been described by the United Nations as one of the most persecuted minorities in world. Prior to the military crackdown in August 2017, roughly 1.1 million Rohingya people lived in Myanmar, though they are denied citizenship under Myanmar law.

Most Rohingya people in Myanmar live in the western coastal state of Rakhine, one of the poorest states in the country, and are not allowed to leave without government permission.

Why are the Rohingya stateless?

In 1982, Myanmar introduced a Citizenship Law which arbitrarily deprived the Rohingya of their citizenship. Under this law, full citizenship is based on membership of the ‘national races.’ As the Rohingya are not considered to be part of these national races, they are regarded as foreigners.

While a citizenship verification exercise is ongoing, this process does not meet international standards. Many Rohingya are reluctant to accept the National Verification Card (NVC1), as those holding these cards still cannot move freely within Rakhine state, or Myanmar as a whole, to access services or livelihoods due to checkpoints, bureaucratic barriers, and other discriminatory practices.

What challenges do the Rohingya face?

Accessing essential services can be close to impossible for those living in the camps in Cox's Bazar. The Rohingya are banned from accessing public health facilities and are entirely reliant on health services provided by humanitarian organisations such as MSF in the refugee camps. MSF refers patients to private facilities—the only legal way avenue available for those in the camps—as a lack of capacity in public hospitals means they cannot provide adequate healthcare.

Life in the camps has progressed since the early days of the emergency, but the situation is increasingly precarious and unsafe.

Furthermore, every year , extreme weather brings risks of flooding, mudslides and loss.

Violence, extortion, kidnappings and other incidents are making the camps unsafe for people to live in. This difficult situation is why some Rohingya people take risky decisions to leave the camp by dangerous routes through Malaysia or India, and why some become vulnerable to criminal groups.

MSF’s response

MSF has been providing medical humanitarian aid for Rohingya communities in Bangladesh and Myanmar for more than 30 years. We also currently assist Rohingya migrants with no access to support services in Malaysia.

In Bangladesh, we are one of the largest providers of healthcare for Rohingya refugees in Cox's Bazar. Our teams provide a range of activities in and around the camps of Cox’s Bazar, delivering health services for both Rohingya and Bangladeshi communities.

In Cox’s Bazar, MSF manages 10 health facilities, with activities including emergency and intensive care, paediatrics, obstetrics, sexual and reproductive healthcare, and treatment for patients with non-communicable diseases.

During the COVID-19 pandemic, increased restrictions on movement in the camps further hampered access to healthcare and made it harder for patients with ‘invisible’ illnesses—such as psychiatric disorders or non-communicable diseases like diabetes—to prove that they were sick and to travel to medical facilities.

"We are struggling and surviving in a challenging situation, while the world is forgetting... We need support; we need the attention of the international community to live, at least, a human life."

Muhammad Hubaib

MSF humanitarian affairs liaison volunteer staff

Areas MSF is focused on:

Vaccination for preventable diseases: The majority of the Rohingya have extremely low immunisation coverage as a result of decades of restricted access to healthcare in Myanmar. We are supporting government initiatives to expand routine vaccinations, administering immunisation for measles, rubella, polio and tetanus according to national protocols.
Providing mental healthcare: The targeted violence that forced Rohingya refugees to flee their homes in Myanmar, combined with the hazardous journey and the daily stresses of life in the camps, means that many refugees experience flashbacks, generalized anxiety, panic attacks, recurring nightmares and insomnia, as well as illnesses such as post-traumatic stress disorder and major depression. This is further exacerbated by insecurity concerning their future and a lack of decision-making power and control over their own lives. Our teams provide group sessions and individual mental health consultations to help those in the camps process and prioritise their mental wellbeing.
Treating non-communicable diseases (NCDs): In Cox’s Bazar area, we provide healthcare for NCD patients for both Rohingya refugees and host communities. Currently, more than 2,000 patients are under treatment and in the first nine months of 2021, more than 43,000 consultations were performed at MSF facilities.
Caring for survivors: MSF teams continue to provide services for survivors of sexual and gender-based violence. Rates of intimate partner and domestic violence are high in the refugee camps in Cox’s Bazar.
Scabies outbreak: In Cox's Bazar refugee camps, hundreds of thousands of Rohingya people are experiencing a scabies outbreak. This condition, while not fatal, significantly diminishes the quality of life, especially to those who have no proper housing or ability to treat. From January to May 2023, MSF teams have treated approximately 70,000 scabies patients, almost double the number compared to the same period in 2022.

Scabies outbreak

The skin disease scabies is affecting hundreds of thousands of Rohingya people living in refugee camps in Bangladesh’s Cox’s Bazar district. Between January and May this year, MSF teams treated almost 70,000 patients for scabies – nearly double that of the same period in 2022.

Scabies is caused by a microscopic mite that burrows into the upper layer of the skin where it lives and lays its eggs. This causes intense, relentless itching, and a pimple-like rash in most people. Scabies usually affects children but if left untreated it can quickly spread to a whole family.

Scabies is easy to treat but can cause severe physical and mental effects if left untreated. The usual treatment involves drugs applied to patients’ skin, clothes and home environments to eliminate the parasite that causes the infestation. It’s also important to wash bedding, clothing and soft furnishings. However, MSF is warning that drugs will not be enough, as the outbreak is exacerbated by unsanitary living conditions in the camps—and these need to be addressed.

An MSF study in the camps in 2022 found a concerning lack of proper sanitation, and insufficient availability of water. Basic hygiene rations are also limited. These factors combined with extremely crowded conditions make it nearly impossible for people to prevent being infected. To bring the outbreak under control, the response needs to be fast and comprehensive and include improvements to water, sanitation and hygiene within the camps. Wide gaps in basic healthcare available to Rohingya refugees also must be addressed.

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