Featured Commentary
by Jhalok Talukdar
Lost generation: The case of Rohingya children
The Rohingya people have been living in Myanmar for generations, however, they are not recognized as citizens there. The government consider them as migrant labourers who came from India and Bangladesh during British rule. When the Myanmar government passed the Union Citizenship Act in 1948 they did not give citizenship status to Rohingya, only providing them with foreign identity cards. They were also excluded when the government passed the new citizenship laws in 1982. The government restrained their movement and limited their right to work, study or access health care services. The Myanmar military cracked-down on the Rohingya several times in the name of controlling the Arakan Rohingya Salvation Army (ARSA) terrorist group. The ARSA, however, are not exclusively seen as terrorists; they consider themselves as protector of the Rohingya community.
The situation worsened recently on August 25 in 2017, when the ARSA attacked 30 police posts resulting in the deaths of 12 police officers and 77 ARSA members. In response to this attack, the Myanmar military initiated a coordinated attack on Rohingya community, allegedly burning hundreds of Rohingya villages, killing men and raping women (1, 2). It is estimated that 6,700 Rohingya died from this military crackdown (3). Different humanitarian groups have accused the Myanmar military of ethnic cleansing and crimes against humanity (4).
Rohingya children are one of the vulnerable groups of violent crimes. It is estimated that around 58% of the Rohingya refugees fled to Bangladesh from Myanmar after August 25 (5). Children are said to have been tortured by the military and to have witnessed atrocities including parents being killed, houses being burned, and rape of their loved ones by the Myanmar militia. Some of them have become separated from their family. They have become severely traumatized, unable to forget the brutality of Myanmar military (6). There is need for psychological support and proper care to regain the ability to build relationships with other people. Providing them with a family-like environment and arrange for schooling to be with other children, make friends and lead better life are important.
There is considerable strain on the Bangladesh government who claim they do not have enough resources to support these children properly. It is reported that around 500,000 refugee children do not have the opportunity for schooling (7). There is scarcity of food, shelter and water, and humanitarian organizations are unable to provide them with diverse and nutritious food. It is estimated that around 24% children of ages 6-59 months in Kutupalong area were suffering from malnutrition as of November 2017 (8). Most of the children have also not been vaccinated because of their lack of access to the health care system in Myanmar. Moreover, living in an overcrowded camp with lack of sanitation and drinking water can pose a risk of spreading cholera and other infectious disease. Children are especially vulnerable to this condition. Their childhood health status will significantly impact their health and well-being in the later life.
Among refugees there have been a significant number of pregnant women (9). It is estimated that around 48,000 Rohingya babies will be born in Bangladesh in 2018. Most of them will be delivered in temporary shelters with limited sanitation facilities and hence a breeding ground for cholera, diphtheria and other diseases. As children are very vulnerable to these diseases (10),
plans to improve the nutritional and health status of the new born babies can only be followed with proper resources.
The Bangladesh government is leading the humanitarian response with support from different national and international humanitarian organizations. Though these humanitarian communities are providing health, education, shelter and food to the Rohingya refugees, the challenges ahead are enormous. There remains continual risk of disease outbreaks, and the concern of disrupting relief efforts during cyclone season can jeopardize the situation. The World Food Programme is facing difficulty to provide food aid as they need $20-25 million monthly to feed the Rohingya and it would seem donors are losing their interest to support this initiative.
The current healthcare facilities are overwhelmed by the overcrowded population. Proper health care settings still need to be established in the refugee camps so that the mothers and family members can access education and counselling services regarding maternal and child care. It is evident from the shortage of food supply, healthcare facilities and healthy living environment that the pregnant women, and hence their new born babies, will suffer from chronic health problem including malnutrition. The babies with malnutrition and chronic health problems will start their life from a very disadvantaged position which include learning difficulties, weak immune system, more risk of chronic disease, disabilities and death. Ultimately, this generation might be considered a lost one; less likely to contribute much economically, risking instead to become a burden for the country in which they live.
Bangladesh and Myanmar reached a deal to start repatriation of Rohingya refugees within two months in November 2017. However, the repatriation process has not yet started. Earlier repatriation processes for Rohingya refugees in Bangladesh did not work. It remains difficult to be optimistic about a quick solution of this problem. Even if repatriation is successful it does not mean the problem is solved. It depends on how the Myanmar government is going the treat the Rohingya: as citizen or refugee. If the Myanmar government do not accept them as citizen of Myanmar, then Rohingya suffering will continue. This will impact stability in Bangladesh and also other neighboring countries like India and China. There is a need for these countries to become more actively involved to solve this problem other than being a bystander. Moreover, as bilateral agreements are not going well, the international community, especially the UN Security Council, has a responsibility to come forward to aid in the safe repatriation of Rohingya refugees to their own land. In the meantime, it is necessary to ensure the healthcare needs of the vulnerable Rohingya, especially the children, women and older people, are met.
Photo credit: 062A4658, Rohingya children playing at a UNICEF child friendly space, supported by UK aid, inside Batukhali refugee camp in Bangladesh. Anna Dubuis /DFID
References:
1. Anam M. Rohingya crisis: A concern for the region. 2017 September 13.
2. Myanmar Rohingya: What you need to know about the crisis. BBC News. 2018.
3. MSF. Myanmar/Bangladesh: MSF surveys estimate that at least 6,700 Rohingya were killed during the attacks in Myanmar 2017. Available from: http://www.msf.org/en/article/myanmarbangladesh-msf-surveys-estimate-least-6700-rohingya-were-killed-during-attacks.
4. Myanmar: Who are the Rohingya? Al Jazeera. 2018 February 5.
5. UNICEF. Bangladesh: Humanitarian Situation report No.25 (Rohingya influx) 2018.
6. Doherty M, Khan F. Neglected suffering: The unmet need for palliative care in Cox’s Bazar. London, United Kingdom: 2018.
7. Ekin A. The mental health toll of the Rohingya crisis. 2017.
8. ACAPS. Rohingya crisis Situation Analysis November 2017. 2017.
9. Desmon S. Rohingya refugees: A stateless people, a public health crisis 2017. Available from: https://hub.jhu.edu/2017/10/18/rohingya-refugees-bangladesh-photo-essay/.
10. Save the Children. At Least 48,000 Rohingya Babies Set to be Born in Overcrowded Refugee Camps in Bangladesh in 2018 2017. Available from: http://www.savethechildren.org/site/apps/nlnet/content2.aspx?c=8rKLIXMGIpI4E&b=9506655&ct=15008917¬oc=1.
Humanitarian Health Ethics 