Health and Hygiene for Rohingya Refugees: Call for a Minimum Human Standard

Fatema, a 28 years old Rohingya woman was in labour pain, she was in a crying need of quick medical support but there was scarcity of medical support as the Refugee camp is located far away from the town.

Kabir, an eighteen year old boy is still in shock and in a injurious condition, as he saw the killing of his father by the Myanmar Militants before his own eyes.  He needs psychological support.

Large number of Fatema and kabir are out there in the Refugee camps, who are badly in need of medical back up of physical and mental health. Rohingya refugees are at the risk of suffering from a possible outbreak of diphtheria in the recent times. Diphtheria is a contagious bacterial infection that often causes the building of sticky grey-white membranes in the throat or nose. There have been more than 2500 cases of suspected diphtheria including 1900 children in camps accommodating Rohingya. At least 30 people have died from the disease, which causes extreme swelling of the throat making it difficult to breathe and swallow.  In the report published on December 12, 2017, World Health Organization (WHO) said, a total number of 250,607 Rohingyas have been administered with the diphtheria vaccinations at the camps. As well as, it has mentioned that 13,00,000 people in cox’s bazar are under the threat of, where prompt action by the government is a required one to safeguard its own people as well as the Rohingyas. To reduce the spread over of the disease as it is contiguous disease, the most important measure is to ensure vaccination coverage both in the camps and in the local areas.

Since 25 August 2017, an estimated amount of 655500 Rohingyas have crossed the border through Cox’s Bazar, and connected with approximately 300000 others who had fled in previous waves of displacement. Side by side, the possibility of Respiratory infection, skin disease and acute watery diarrhea is damn high with increasingly crowded living condition, inadequate water and sanitation (WASH) facilities and low vaccination coverage. Pre-existing camps and settlements as well as the new spontaneous settlements have expanded with the new inflow.

Regardless of mentioning, Cholera and watery diarrhea, they are somewhat familiar in Bangladesh, at the current huge density of population, any outbreak can kill thousands of people. The new influx is also creating immense pressure on the health system of entire district which persuades the Public health for both refugees and host communities.

With the influx, the situation of Rohigya refugees is getting worse every day, most precisely, their health condition. There are many International treaties and conventions which promote the right of maintaining​ a balanced life by balancing  good condition of both Physical and mental health.

According to the Article 25 of the Universal Declaration of Human Rights, 1984

Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family including food, clothing, housing and medical care.

Article 11 of Convention on Elimination of All forms of Discrimination against Women states that:

The right to protection of health and safety in working condition including the safeguarding of the function of reproduction should be guarded.

Article 12 says that: States parties shall take all appropriate measure to eliminate discrimination against women in the field of health care in order to ensure the basis of equality of men and women, access to health care services including those related family planning.

According to the Article 18 of ICCPR: Freedom of manifest ones religion or beliefs may be subject only to such limitation as are prescribed by law and are necessary to protect public safety, order, health or morals or the fundamental rights and freedom of others.

Article 11 of International Covenant on Economic, social and cultural rights: The state parties to the present covenant recognize the right to everyone to a adequate standard of living condition.

Article 12 states that, the state parties to the present covenant recognize the right to everyone to the enjoyment of the highest attainable standard of physical and mental health.

Those stated above are mere blackletters, which are ratified by many of the countries as conventions; whereas some other countries are practicing those. The number is less or not mention worthy. Though Bangladesh is not a signatory to the Refugee convention 1951, but those conventions bind Bangladesh with a liability of humanity and human rights. This should be reflected in respect of establishing health safety for the Rohingyas and its people also under Article 32 of its constitution for ensuring right to life.

In spite of having a good number of limitations, Bangladesh is providing generous support to meet the humanitarian need of Rohingya refugees. Bangladesh is also under a liability scrutinizing it Article 25(1)(c), which enumerates as to ensure the support for oppressed people. And from this Article, it can be inferred.

And with that liability Bangladesh government is working for the betterment of the Rohingyas. But there are impediments existing. Some of the problems are:

Service delivery planning:

Currently, 200 health care facilities are providing different types of health services all over the settlement areas. However their distribution is not satisfactory due to the limited land availability, woeful road condition and high densities of population in the areas. It should also be stated that- many health care services in different camps pays more concentration to the easily accessible areas over remote areas.

Disease surveillance:

In the period of humanitarian emergencies, where the risk of infectious disease is increasing rapidly, it is crucial to establish effective disease surveillance system there to quickly detect and respond to the areas.

Health and Wash:

Water sources are continuously contaminated as the latrines are situated near those water spots. Reserving waters in uncovered containers is also responsible for the risk of contamination, at the end. The number of soaps for hand washing is inadequate and boiling drinking water is somewhat “hard to get” concept for them. All those factors, in a whole, create an elevated possibility of water contamination.

 

Vaccines and Immunizations:

The number of routine Immunization is low. This shortage, added with populous living conditions, Inadequacy of fresh water and proper sanitation and a high level of malnutrition, creates risk of health for the refugees and at the same time, for the native people also.

Contingency planning:

The affected population is vulnerable to diarrhea disease, linked up with the poverty-stricken conditions in the camps. Moreover, the strong risk of cyclone welcomes the possibility of additional problem. These two matters provide a message to the health sector to implement contiguous measures quickly.

Sexual and reproductive health:

Although some partners are providing the minimum initial service package for sexual reproductive health, access to the essential treatment remains a major concern, especially in the new settlements and hardest to reach remote areas. There is no such standardization of the community health volunteers network programme to ensure that home visits to pregnant women, newborn and children take place routinely to support the continuous health care.

Moral and Psychological health:

The mental and psychological effect of being forcibly are limitless with the FDMNs facing daily stressors associated with reliance on humanitarian assistance for food and other lifesaving needs.

To meet the above mentioned problems in the Rohingya camps, some fruitful steps should be taken as soon as possible. Several of those mechanisms are proposed below:

  1. Many health care camps may be established in the remote areas till the repatriation following the accord between Bangladesh and Myanmar,
  2. Necessary means to combat diphtheria and such other emergency diseases may be provided through Government and at the same time, by Non-Government organizations also.
  3. Proper vaccinations shall be given to the Rohingyas and the co-inhabitants nearby the camps to protect contiguity,
  4. The UN’s official agency is a major clearing house for aiding the Rohingya and displaced people around the globe, which may inflict it work more intensely hand in hand with the Government and World Health organization along with the co-ordination of UNHCR,
  5. To prevent contagious diseases, affected people should be given proper treatment distinctively,
  6. Nonetheless, both physical and mental health should be given parallel importance by the operational organizations.

Moreover, workshops may be launched for raising awareness among the Rohingyas on health issues. It is evident that Rohingyas are suffering from lot of health issues because of their living conditions and environmental situation which is far away from the minimum standard living and side by side which is affecting the Bangladeshi nationals. To soothe situation Governmental effort and assistance from International communities should be made more operational in regard. If these desires are met, we hope to have a upgraded picture in the Rohingya camps as well in the life of Bangladeshi nationals in respect of health.

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Sribarni Chakma

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