I joined MSF’s Bangladesh projects in January, when Rohingya refugees were still fleeing the last outbreak of violence in Rakhine State that started in October 2016. The clinic was consistently busy, with around 350 patients a day in the outpatient department and around 200 admitted patients a month. The people had run out of money and their health deteriorated.
We saw more and more people with severe malnutrition, particularly children under five years old. At one point we had 20 patients a day with severe measles in our isolation tent. We received a lot of trauma, and lots of accidents involving children, tetanus, rabies, and other cases I wasn’t used to seeing at home. At the facility we rarely see a newborn that weighs more than 2,500 grams (around five and a half pounds). The mothers are usually malnourished, so the babies don’t have a very good start.
On 25 August, when we learnt of the deteriorating situation in Rakhine, we knew we might have to prepare for a new influx of refugees. That night the first freshly wounded people arrived, and a situation that was already bad became much worse.
People arrive in torrential rain at a border crossing on the Naf river, after fleeing Myanmar. Photo: Antonio Faccilongo.
At first we mostly received young men, but in the following days we saw women and children as well. We saw patients with gunshot wounds and burns, and people with trauma and severe injuries who had somehow managed to cross the border. Then we stopped seeing people with fresh wounds and started seeing patients who were seriously injured but had somehow managed to get to Bangladesh.
People arrived in a horrific state.
Some said they had been trapped in houses that were set on fire. We treated unaccompanied children who had lost their families. One tiny newborn baby was brought in by a woman who had found it in the grass at the border. She’s now caring for the baby in addition to her own children.
We treated a young girl with a head wound; an hour later her mother was admitted with severe burns. They said they were the only survivors from their family. The girl was always bringing her mother food and helping her eat. We’re providing play sessions for the child, counselling sessions, a caretaker to help with daily needs, and treating the mother’s burns. We’re also giving them supplementary feeding so they are in a better overall state to heal, and they are steadily improving.
People have lost everything. Whole families have walked for days to reach Bangladesh. They have very few options.
The poor conditions that most Rohingyas live in have a direct impact on their health. At one point we received 13 people who had been bitten by a rabid dog that had run through the settlement. There’s no end to their suffering. When I am sitting at home and it starts raining heavily, it’s hard knowing they are trying to sleep outside under the rain. I don’t even know if it’s worse when it’s raining, or when it’s burning hot and they have no clean water.
This is not the only conflict in the world, but it's very frustrating seeing the suffering with your own eyes, and then seeing what's considered important back home. The number of Rohingya who have arrived in the past five weeks is now over 515,000: more or less the same size as the population of Nuremburg (or Fresno, CA, if you are reading from the US).
515,000 might seem like an abstract number, but as a doctor here you see what that actually means. People are in profound need of help. A tiny bit more bad luck and we’ll have an epidemic on our hands. Comprehensive vaccination campaigns need to be started, and there is an urgent need for latrines and fresh water supplies. Things were difficult enough for the people who arrived last year, but now with so many new arrivals, it’s a catastrophe.