Agencies Struggle to Deliver Aid to Congested, Inaccessible Rohingya Refugee Settlements

Some of the over 500,000 Rohingya refugees who have crossed in Bangladesh from Myanmar since 25 August. Photo: Muse Mohammed/UN Migration Agency (IOM) 2017
In Cox’s Bazar, what started as a humanitarian crisis is slowly spiraling into a catastrophe of biblical proportions. Mud, torrential monsoon rains and a hostile terrain are bogging down delivery of aid to more than half a million Rohingya refugees fleeing violence in Myanmar.

It’s now some forty days since the first of an estimated 507,000 people fled across the border to Bangladesh. While the mass exodus seen in the first few weeks has eased, Rohingya families — mostly women and children — are still coming on foot and by boat.

They arrive with the bare minimum. Exhausted, hungry, sick and often traumatized, they need a range of life saving services that aid agencies are still struggling to provide.

A man wades through the border in Cox’s Bazar. Water is one of the natural borders between Myanmar and Bangladesh especially in monsoon season. Photo: Muse Mohammed/UN Migration Agency (IOM) 2017

Their plight has touched the world. But less than half of an initial appeal for $77 million has been funded and much more will be needed to deliver the lifesaving services they will need through the next six months.

International aid agencies, local charities and volunteers are working tirelessly to provide what they can, but the numbers in need are overwhelming and the challenges daunting. In camps without clean water or sanitation, an outbreak of water borne disease seems imminent.

The biggest challenges facing the humanitarian response are the lack of access to areas where the refugees are sheltering, and the congestion surrounding the biggest sites, which has slowed deliveries of aid to tens of thousands of people.

With just one main, access road — the Cox’s Bazar-Teknaf Highway — aid groups are struggling to penetrate the teeming congestion surrounding the giant Kutupalong makeshift settlement and its satellite sites.

Their challenge: how to reach refugees in the most remote sites, where shelter, clean water, sanitation, health care and other aid are now in desperately short supply. Off the main road, muddy footpaths are the only means of reaching these settlements.

A woman sits in her shelter as the sprawling makeshift shelters covered the hills of Cox’s Bazar can be seen behind her. Photo: Muse Mohammed/UN Migration Agency (IOM) 2017

Hilly terrain, flooding and deep mud caused by torrential rain means that vehicle access is impossible. People are forced to walk for hours to reach the nearest distribution point, health post or tube well providing clean water.

Across ravines and on unstable hillsides, people have built shelters on every available patch of ground. Living under cheap plastic sheets and bamboo bought in local markets, they live at continual risk of flooding and landslides. Vast areas of what was once forest land have been stripped of timber to make way for countless hectares of flimsy huts.

In most of the new settlements, sanitation is more or less non-existent. Latrines have yet to be dug and those dug have yet to be maintained. Daily rain has flooded campsites and left pools of water. Many of these are now are contaminated with fecal matter, but are the only accessible water source for many of the refugees.

A father and son secure their shelter kit before carrying to the place with they will use it

Aid organizations have also only managed to provide some 30 percent of the 501,800 new arrivals with shelter kits comprising a tarpaulin, ropes and bamboo. Even in the best served sites, only 45 percent of the refugees have received shelter aid — currently one tarpaulin for a family of five.

In Kutupalong makeshift settlement, Jomila, 22, is one of thousands of new arrivals. She cradles her baby, who is hot from the scorching sun. Her husband had gone in search of supplies at a nearby distribution, but she is not sure when he will return or with what exactly.

The couple arrived with her parents from their village in Myanmar only 10 days ago, after walking nearly 15km. So far she’s managed to get some rice and a hygiene kit from nearby distributions. But she still needs bamboo to make a shelter.

Jomila holds her small baby as she looks at the camera. Photo: Muse Mohammed/UN Migration Agency (IOM) 2017

While Jomila says she’s grateful to have made it out of Myanmar with her family alive, she says she no longer has hope for her future and will never go back home to her village.

Instead, she says, she will just focus on surviving for now.

Poor living conditions are contributing to ever greater healthcare needs among the refugees. Crowded shelters with a lack of clean water, food and sanitation are now presenting huge public health risks and an increased likelihood of an outbreak of communicable diseases. Diarrhea, dehydration and skin diseases are already rampant, particularly among the estimated 240,000 children who make up the majority of the refugees

As the weather fluctuates in Cox’s Bazar between rains and extremely hot and humid days, many children are suffering from flu and risk pneumonia.

Health workers fear that cholera and tuberculosis may follow.

Mohamed grips a large bottle of water, unsure of where he will get his next. Photo: Muse Mohammed/UN Migration Agency (IOM) 2017

In a communal shelter in Kutapalong, Mohamed, 31, held a two-liter bottle of water tightly. It was hot and sunny and he felt lucky to have received the water from a nearby distribution organized by a local charity. But he was also very worried as he only had two more such bottles to share with 21 other people living in the same shelter.

“I have no idea if there will be more distributions of water tomorrow or the day after,” he said clutching the water.

For the last 15 days, 40 families have been living in Yunis Member Market grounds near Shamlapur Bazar field, according to Abul Fayes, 20. “We have no latrines or wash rooms. I have six family members. We are depending on the host communities’ toilets and wash room, but it is difficult especially for the women who are facing a lot of difficulties. We are asking for help (from aid agencies),” he said.

What Comes Next?

On 14 September, the Bangladesh government allocated 2,000 acres of forest land to set up a new camp in Ukhia Upazila. The land is entirely undeveloped and will require major development and support in terms of planning, decongestion of sites, roads, bridges, drainage systems, and soil protection earthworks. IOM plans to construct approximately 150 km of roads and drainage, including necessary bridges and other infrastructure to ensure access to all areas of the site.

What Has IOM Done So Far?


IOM has distributed 40,000 tarpaulins providing basic shelter for 200,000 people. It has also distributed over 15,000 umbrellas, 2,800 non food item (NFI) relief kits, 4,600 sleeping mats and 4,200 blankets. Female-headed households and families with disabled members were prioritized in the distribution of shelter and NFI. IOM has procured a further 140,000 humanitarian shelter grade plastic sheets and 435,000 NFI kits. IOM coordinates the work of 22 agencies working to provide aid to the refugees in the shelter sector.

Site Management

IOM is working closely with partners to identify and mobilize site management agencies to improve coordination of services at site level, referring critical gaps in assistance to relevant actors and sector lead agencies. Three IOM site management teams are currently working in key areas of Kutupalong, Unchipran and Balakuli, engaging humanitarian actors and providing information and referral services to the refugees. IOM has built 650 meters of brick road and 3,000 meters of pathways through cash for work schemes.


IOM has supplied 243,00 litres of water Unchiprang spontaneous settlement. On average 18,000 litres of water is being supplied daily, serving 2,400 people (7.5 litres per capita per day).

It has bored six tube wells. Some 8,480 families have received 10 liter jerry cans. A total of 4,000 emergency pit latrines and 24 mobile toilets have been installed. Some 500 families have received hygiene kits.


IOM is currently supporting 12 health facilities with both out-patient and in-patient capacity, operating six mobile medical teams, providing nine ambulances for transport of urgent and emergency cases, and scaling up health outreach and education with 350 community health workers, in collaboration with local partners. Since August 25, IOM has treated over 23,000 patients in existing and new settlements, referred over 300 cases for higher level care, and supported almost 400 newborn deliveries. It has also led health sector coordination efforts in close collaboration with WHO and the Ministry of Health and Family Welfare.

Gender-based Violence

Since August 26 IOM GBV staff have identified 6,265 extremely vulnerable individuals and referred them to different services. Another 609 cases have been referred to health care facilities. Psychological First Aid was provided to 1,599 individuals and 205 cases of GBV were received and treated. In addition, 2,135 dignity kits and 550 solar lanterns were distributed to vulnerable women. The team also supported family tracing and reunification for unaccompanied and separated children and facilitated child foster care services.

Communication with Communities

Since the outset of the crisis, IOM has responded to the information needs of affected communities through the deployment of Communication with Communities field teams. Field members are deployed to major sites, providing referrals and disseminating life-saving messages to arriving refugees.

This article was written by Hala Jaber, the UN Migration Agency’s Spokesperson in Cox’s Bazar, on the launch of the Cox’s Bazar Appeal. To donate click here (if you are based in the US click here).