Generating rigorous evidence is one challenge that the IRC and others working in Myanmar’s Rakhine State have been grappling with when trying to highlight the appalling conditions for internally displaced people in Sittwe’s camps and identify what isn’t working. Set up by the Government in 2013 for around 95,000 mainly Muslim people fleeing widespread rioting and clashes, these camps were meant to be temporary. This was clearly reflected in the design: with space and resources scarce, people were accommodated in communal longhouses, each designed to fit 8–10 families, separated only by woven bamboo partitions. Yet as this protracted displacement enters its 6th year, the prospect of return for many remains distant, and the conditions in these increasingly permanent-looking “temporary” camps are a source of increasing concern for the humanitarian community.
Since the IRC started working in Rakhine in 2014, the issue of overcrowding in Sittwe’s camps has been a consistent backdrop. People seeking care at our health clinics would regularly voice concerns about the hygiene and sanitation implications of living tightly packed together with so many other people. Women and girls participating in our psychosocial support programming also spoke of the stress of living without any privacy, and of the impact this has had on exacerbating tensions within their families. When we discussed these issues with our colleagues in other agencies working on other issues such as nutrition, sanitation or child protection, they reported similar experiences but there was little hard evidence we could point to.
Rakhine State is a politically sensitive, low-resource setting, frequently discussed as a “forgotten crisis” which makes e generating new data a major, time-consuming undertaking requiring both money and political will. Instead, we decided to start with something simpler: to systematically revisit our existing data, and see what it could tell us about the impact of overcrowding
The Sphere Project Humanitarian Charter and Minimum Standards in Humanitarian Response (SPHERE) is a blueprint that lays down the standards and best practices humanitarian actors should be upholding in their work across all sectors. On shelter, SPHERE lays out a number of recommendations, most notably that:
- All affected individuals have an initial minimum covered floor area of 3.5m2 per person; and
- Existing local practices in the use of covered living space, for example sleeping arrangements and the accommodation of extended family members, should inform the covered area required.
In reviewing the population data of and the floor area available in each shelter, it quickly became apparent that the first recommendation wasn’t being upheld: each individual in the camps only had an area of 2.9m2. Furthermore, comparing conditions in camps with those in Muslim villages — where people live in family houses, carefully partitioned off from their neighbours, and where privacy for women in particular is highly valued — it was clear that the camps also fell short of the second recommendation.
With this established and in line with the IRC’s approach of evaluating the extent to which existing evidence can be applied and adapted, we began reviewing almost two years’ worth of monitoring data from our health and women’s protection and empowerment programmes to look for clues.
What we found was striking. For all diseases assessed — scabies, dysentery, suspected tuberculosis, and influenza — proportion of deaths was significantly higher in camp locations compared to villages. For tuberculosis, it was over nine times as high. Our analysis also revealed several “clusters” of these diseases, largely focused on areas of the camps where population density was highest meaning that more people in the camps appeared to be getting sick, more frequently, with diseases closely associated with cramped shelter conditions, compared to those living in nearby villages.
In addition, we found shelter consistently emerging as a major source of concern for women and girls who had repeatedly highlighted the multiple ways in which cramped conditions negatively affected their lives. In a society where privacy and clear partitioning of space between genders and households is important, the stress caused by living so close to neighbouring families was extreme. So too was the loss of dignity in the absence of private spaces to wash or change. These issues were often magnified by cultural constraints in Sittwe’s Muslim communities that limit women’s movement outside the house. Worse still, they were also highlighted as a contributing factor to high levels of tension within families, linked to higher levels of intimate partner violence compared to before displacement. In nearby villages, shelter simply did not come up as an issue, with discussions on violence against women focusing more around concerns over substance abuse, or frustrations linked to a lack of job opportunities.
Through reviewing our existing data, we’ve been able to make a clear and compelling case that overcrowding in Sittwe’s camps is a major problem with major, tangible consequences for the health and wellbeing of an already highly-vulnerable population. With authorities currently estimating that it will be at least 2022 before the camps finally close, a meaningful effort to address these issues needs to start, and start now. Sittwe’s IDPs have already had to experience five years living with the consequences of “temporary” solutions. They should not be subjected to another five.
Rob Trigwell, the IRC’s former Humanitarian Response Coordinator for Rakhine, also contributed to this piece
The International Rescue Committee responds to the world’s worst humanitarian crises, helping to restore health, safety, education, economic wellbeing, and power to people devastated by conflict and disaster. Founded in 1933 at the call of Albert Einstein, the IRC is at work in over 40 countries and 26 U.S. cities helping people to survive, reclaim control of their future and strengthen their communities.