One in four Rohingya children who recently fled to Bangladesh from Myanmar is now suffering from life-threatening malnutrition, with aid workers warning that refugees are “essentially starving” before they have even crossed the border.
The preliminary findings of a joint nutrition assessment conducted in late October at Kutupalong refugee camp in Cox’s Bazar show that severe acute malnutrition rates among child refugees under five have doubled since May, while nearly half of young children are also underweight and suffering from anaemia.
The figures – already above international emergency levels – are likely to increase, warned aid agencies, since the assessment surveyed only 10% of the population in need, and included families who had arrived before as well as after violence erupted in Rakhine state in August.
Once data is taken solely from new arrivals, malnutrition – and with it the risk of diarrhoea, dysentery, respiratory infections and measles – is expected to increase.
“The conditions we are seeing in Cox’s Bazar create a perfect storm for a public health crisis on an unimaginable scale,” said Cat Mahony, emergency response director in Cox’s Bazar for the International Rescue Committee.
“These shocking figures substantiate the IRC’s own findings on worrying food insecurity: three in four do not have enough food, and 95% of the population are drinking contaminated water. This is especially serious, as agencies report that two-thirds of the water in Cox’s Bazar is contaminated with faeces.”
Malnutrition rates among children in northern Rakhine state were above emergency thresholds even before the recent exodus. But severe acute malnutrition has increased tenfold since last year, according to the joint assessment by Save the Children, IRC partner Action Against Hunger and Unicef.
Conditions have worsened due to acute food and water shortages and unsanitary living quarters in Kutupalong camp, which is home to roughly 26,000 refugees.
More than 600,000 Rohingya men, women, and children have crossed the border from Myanmar to Cox’s Bazaar since August. These families joined an estimated 212,000 Rohingya previously living in Bangladesh. The IRC expects an additional 200,000 new arrivals in the weeks ahead, pushing the total refugee population to more than 1 million.
Severe acute malnutrition can affect anyone but, if left untreated, children under five are up to nine times more likely to die than a well-nourished child.
New arrivals are often forced to set up camp far from the main road where food and medical distribution centres are located, said Save the Children’s Rik Goverde, leaving many refugees facing a long walk simply to get one meal a day.
“Malnutrition is rampant here, absolutely rampant, even among the adults,” said Goverde, speaking by phone from Kutupalong camp.
“Two men just came into the clinic weighing 32kg and 34kg. This hasn’t happened overnight – they have been hungry for a very long time and they are exhausted.”
New arrivals are required to register for an identity card in order to qualify for food distribution, Goverde said, which can take a few days to arrive. Many adults and children are consequently obliged to walk for hours into the forest, where they cut firewood in order to sell it and buy food.
“There are problems here on every sector – this isn’t just about food and malnutrition,” said Goverde. “We’re sure there are children suffering from mental health issues because they’ve suffered terrible things, they’ve lost their parents in the chaos, or seen their parents being shot. It’s truly grim.”
Unicef and other humanitarian agencies are currently treating more than 2,700 acutely malnourished children at 15 treatment centres. But the agencies are overstretched andunderfunded, prompting the IRC to launch an emergency response on both sides of the Bangladesh-Myanmar border, which the agency says will require $12m (£9m) over the next year.
The response will include four 24-hour care centres to treat severe acute malnutrition, as well as six “one stop shops” that will deliver critical assistance and child protection. The aim will be to reach 80,000 refugees within the first six months.
Two more nutrition evaluations are planned for this month, including one at a makeshift settlement. The findings from the three assessments will help update the projected number of children expected to suffer severe acute malnutrition over the next few months, guiding the emergency response, said Unicef’s Jean-Jacques Simon.
“There is an urgent need to prioritise families with malnourished children and come up with a minimum package of effective interventions to safeguard the health and wellbeing of these children,” said Simon.