Rohingya refugee crisis
On 25 August 2017, a massive exodus of 745,000 Rohingya began to flee Myanmar into Bangladesh. Now, five years on, more than 925,000 people are stranded in vast refugee camps.
In that first month, a concerted campaign of violence was unleashed by the Myanmar authorities against the country's Rohingya ethnic minority in Rakhine State. By the end of the year, more than 660,000 people had crossed the border into Bangladesh.
"The military came to our part of town around 6 pm and said: ‘Leave the village before 8 am tomorrow. Everyone that stays will be killed.’"
Those arriving in Bangladesh shared stories with MSF about their villages being systematically raided and burnt by the Myanmar military. Mob groups also targeted the Rohingya, with reports of women and children being raped and killed.
The resulting mass displacement of people in this short period of time is one of the largest of its kind in recent history.
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The impact of COVID-19
There has been a sharp deterioration in living conditions in the refugee camps following the outbreak of the COVID-19 pandemic.
The presence of police and the military increased; at the same time, armed groups expanded their power base in the camps. As a result, our teams began hearing about more kidnappings, violence and extortion.
The arrival of COVID-19 resulted in more restrictions on the refugees’ freedom of movement and on access to the camps for international humanitarian groups.
In 2020, services inside the camps were reduced to the bare essentials and some organisations had to stop working in the camps altogether. In the early months, our teams had limited access, which led to a reduction in the quantity and range of health services we were able to provide to the Rohingya population.
Social distancing measures are unrealistic when people live in overcrowded and flimsy shelters. Basic facilities such as water points, toilets and food distributions are all communal, with people often waiting in large groups to access these vital services.
We are striving to engage the community, but we know that many people in the camps are frustrated and frightened by the situation.
Rohingya crisis: Quick guide
The Rohingya are a stateless ethnic group who have lived for centuries in northeast Myanmar, also known as Burma. They are one of the most persecuted minorities in the world. Due to ongoing violence and persecution, hundreds of thousands of Rohingya have fled to neighbouring countries either by land or boat over the course of many decades.
Since 25 August 2017, over 745,000 Rohingya refugees have fled from Myanmar into Bangladesh. Their arrival comes on top of hundreds of thousands of other Rohingya who arrived in previous years and were already living in difficult conditions.
More than 2,000 MSF staff – the majority of whom are Bangladeshi nationals – are working in 10 health posts, primary health centres and inpatient facilities in the Cox's Bazar region of Bangladesh. More than 1.4 million patients have been treated at MSF facilities since 25 August 2017.
Inside northern Rakhine State, Myanmar
Nearly all of the Rohingya in Myanmar live in the western coastal state of Rakhine and are not allowed to leave without government permission.
Rakhine is one of the poorest states in the country with ghetto-like camps in and around the town of Sittwe. These initially temporary structures were built in 2012, but are still being used and are poorly maintained. There is a lack of basic services and opportunities for the Rohingya in Myanmar, including freedom of movement, healthcare and education.
With over 700,000 Rohingya having now fled the violence in northern Rakhine, many areas have been depopulated. Yet, there are still around 600,000 stateless Rohingya across the region, including 140,000 detained in displacement camps.
Find out more about the Rohingya crisis on Everyday Emergency, the MSF podcast
MSF had provided healthcare to all communities inside northern Rakhine from 1994 until operations were suspended on 11 August 2017 – just as the violent crackdown was launched against the Rohingya.
At that point, we were operating four primary healthcare clinics – three of which were subsequently burnt down – and providing over 11,000 primary and reproductive healthcare consultations per month.
Currently, more than 140,000 Rohingya and Kaman – another Muslim minority group – are detained in displacement camps in nearby central Rakhine, where the government has been taking steps to "close" them since 2017. MSF delivers healthcare in four of these camps, as well as the Muslim ghetto in Sittwe town, Aung Mingalar.
Violence and persecution
Surveys conducted by MSF refugee camps in Bangladesh estimate that at least 9,000 Rohingya died in Myanmar between 25 August and 24 September 2017. At least 6,500 of these (by the most conservative estimations) are thought to have been killed, including at least 730 children below the age of five.
However, this is not a one-off incident. Hundreds of thousands of Rohingya have been fleeing to neighbouring countries by land and sea over the course of many decades. In October 2016, a previous outbreak of violence forced 60,000 Rohingya to flee to Bangladesh.
International humanitarian organisations are still blocked from accessing and operating in northern Rakhine. We are urging the Myanmar government for access to Rakhine State to ensure the impartial delivery of aid to those in need.
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The Rohingya in Bangladesh
The arrival of more than 745,000 Rohingya refugees in Bangladesh since August 2017 came on top of 200,000 who had fled Myanmar in previous years.
Currently, there are around 925,000 Rohingya refugees living in Bangladesh – more than the entire population of Amsterdam, and twice that of the entire country of Malta.
The vast majority of people now live in camps in the Cox's Bazar district, on the border with Myanmar.
This includes the Kutupalong-Balukhali 'mega camp' – known as the largest refugee camp in the world – which hosts more than 626,000 people. A further 100,000 people live in Nayapara camp, to the south.
EMERGENCY, OUTPATIENT, AND MOBILE CLINIC CONSULTATIONS FROM AUGUST 2017 TO JULY 2022
MENTAL HEALTH CONSULTATIONS HELD FROM AUGUST 2017 TO JUNE 2019
MSF STAFF IN BANGLADESH IN 2022
What is MSF doing to help?
Since 1985, MSF has been present in Bangladesh in both the capital Dhaka and Cox’s Bazar, the coastal border town with Myanmar.
We massively increased our capacity to respond in the area following the massive influx of Rohingya into the country and launched large emergency responses in the Cox's Bazar area.
In the first six months of the crisis alone, we treated more than 350,000 patients.
The main health issues we are seeing are respiratory infections, diarrhoeal diseases, skin diseases – all related to poor living conditions.
We are also providing maternity care and mental healthcare, including for survivors of sexual and gender-based violence.
More recently, between January and July 2022, our teams provided more than 250,000 outpatient consultations, saw 75,000 emergency room patients and helped deliver more than 2,600 babies.
Our teams are currently delivering healthcare to four remote Rohingya displacement camps in central Rakhine. This is done through health outreach work and mobile clinics.
Nearby, Malaysia also hosts an estimated 95,000 Rohingya people. Often making the dangerous journey by sea, the Rohingya have been fleeing here for over 30 years. However, they are currently denied formal legal status and are increasingly pushed into a precarious existence alongside other refugees and asylum seekers.
Unable to work legally, many Rohingya disappear into Malaysia’s urban black market economy where they are vulnerable to exploitation, debt bondage or work accidents. Walking down the street or even seeking medical care can result in refugees being sent to detention centres or extorted.
Our teams are providing medical and mental health consultations to Rohingya people in Malaysia, some of whom have been victims of human trafficking.