Rohingya Refugees Struggle to Survive in Cox’s Bazar Settlements

UN Migration Agency’s Tamsin Fernandez-Cox writes from Bangladesh

Some Rohingya children in Kutupalong Makeshift Settlement use umbrellas to shield themselves from the frequent heavy rains. Photo: Tamsin Fernandez-Cox/UN Migration Agency (IOM) 2017

Over the past month an estimated 430,000 ethnic Rohingya people have made the dangerous and arduous journey from Myanmar’s North Rakhine State to Cox’s Bazar in Bangladesh to escape the ongoing violence described by the UN as “ethnic cleansing”.

They joined another 200,000 Rohingya already living in Cox’s Bazar’s vast, muddy tarpaulin and bamboo makeshift settlements. Of these, 80,000 had already arrived between October 2016 and August this year, following an earlier outbreak of violence. Bangladesh is now grappling with a humanitarian crisis triggered by this influx of desperate people.

As one drives along the Cox’s Bazar-Teknaf Highway, a bumpy “B-road” that is the only access to Kutupalong refugee camp and the adjacent Kutupalong makeshift settlement, the epicenter of this human tide, countless faces lining the road stare into the car.

A main crossing in Kutupalong Makeshift Settlement after a few hours of heavy rain. Photo: Tamsin Fernandez-Cox/UN Migration Agency (IOM) 2017

The number of Rohingya refugees hosted inside the established original refugee camp with its concrete communal buildings and tin roofs, has more than doubled. This is in addition to an estimated 100,000 living in areas adjacent to the original camp. The makeshift settlement however, is a sea of fragile bamboo structures covered in non-durable black plastic sheets that dot muddy hillsides for as far as you can see. In recent weeks, this has also seen a population explosion.

The Inter Sector Coordination Group (ISCG) believe that there are now an estimated 400,000 people huddled under plastic in order to shelter from daily monsoon downpours, that are interspersed with blazing heat. Some long-term residents have acquired the odd sheet of corrugated iron and built mud walls to protect them from the elements, or sourced sturdier tarpaulins. Many newcomers still have nothing.

Until they acquire heavier duty tarpaulins, the Rohingya people use plastic sheeting and whatever they can find around the camp to help shelter themselves. Photo: Tamsin Fernandez-Cox/UN Migration Agency (IOM) 2017

Having now been in Cox’s Bazar for eight days, it has rained every day. Yesterday morning we saw the first glimmer of sunlight.

But the rain leaves a sea of slippery, dangerous mud. What were once paths through the hills on which the settlement was built are now brown, murky canals. People wade through them waist deep in water. The rain is expected to continue for another two months.

A sign leading to the pre-established IOM primary health care centre in Kutupalong Makeshift Settlement. This site is currently being expanded to cope with the new influx. Photo: Tamsin Fernandez-Cox/UN Migration Agency (IOM) 2017

As I walked through the mud with health team colleagues to reach one of the IOM, UN Migration Agency primary health care facilities, we were approached by Amin, who said that he had been in the settlement since the end of August. He produced a hand-written list of 200 families from his pocket whom, he said, desperately needed proper tarpaulins to protect them from the relentless rain. He emphasized to us that this was currently even more important to them than food, or healthcare.

He explained that because they were among the first to arrive, the group had been forgotten, as aid agencies attempt to expand coverage to reach refugees in the farthest and most remote settings.

We saw aid agencies including IOM distributing tarpaulins, food, and other essential items. But clearly many people have not yet received what they need, and aid agencies are stretched very thin on the ground — despite considerable efforts.

Two young Rohingya children. Photo: Tamsin Fernandez-Cox/UN Migration Agency (IOM) 2017

The number of women and children in the settlement is also striking. They can be particularly vulnerable to malnutrition, gender-based violence and sexual and reproductive health problems. An estimated 24,000 women are pregnant or lactating and it is estimated that as many as 15 per cent will experience complications. Very few are anywhere near facilities that can provide help. That day, we were told of one woman who had been in labour for the past three days. She had only now managed to reach one of IOM’s clinics.

The bridge that had been constructed in less than a week at the Kutupalong Makeshift Settlement, which had previously waded across. Photo: Tamsin Fernandez-Cox/UN Migration Agency (IOM) 2017

As one walks through the mud further into the sites, there are noticeably more and more people, but fewer visible services, such as tube wells and latrines. In some areas, there are currently none. Aid agencies are trying to scale-up services as quickly as possible, but among other logistical issues, limited road access is hampering the effective distribution of aid across all sites and settlements. It is also challenging to keep track of people still on the move and get services to them in spontaneous settlements.

In the health sector, since August 25, IOM has helped an estimated 18,500 people in areas including primary health care, mental health and psychosocial support, and sexual and reproductive health services. IOM has hired an additional 155 health staff and deployed 3 mobile clinics. It now has 11 ambulances in service and community health workers are visiting those considered hardest to reach. It is also facilitating the construction of 15 new clinics across various settlements.

Every day more aid workers are arriving in Cox’s Bazar to bring in shelter, clean water, sanitation, healthcare and other services. But the needs remain huge — not just for the new arrivals.

On sunnier days, one can see shelters far in the distance that are plotted on hill sides above the flood plains. Photo: Tamsin Fernandez-Cox/UN Migration Agency (IOM) 2017

Before August 25th, there were already an estimated 200,000 Rohingyas eking out an existence in Cox’s Bazar. There were also the poor local communities who also depend on the now vastly over-stretched infrastructure, including healthcare. It is evident that huge resources will be needed to cope with this crisis and assist both the refugees and the host community.

IOM immediately launched an initial appeal for USD 26 million, including USD 5 million for health, in order to scale up its emergency response through year end. With the ongoing arrival of new people in need already exceeding projected numbers, a revised appeal is being prepared in coordination with all partners on the ground. Looking out over the sea of inaccessible mud that are the Kutupalong settlements and talking with their desperate residents, it is easy to see why considerably more will be needed.

To donate to IOM’s response in Bangladesh, click here.

This story was written by Tamsin Fernandez-Cox, Project Officer in the UN Migration Agency’s Office in Thailand. She is currently based in Cox’s Bazar, Bangladesh, as part of the migration health team’s surge humanitarian response.