The fate of the Rohingya refugees in India and Bangladesh depends on the unfolding of an intricately woven web of geopolitics, human rights and the threat perception to national security. While navigating this web, some existential issues are often relegated to the sidelines.
The emergency medical needs and the wellbeing of refugees are critical issues that must be addressed. Furthermore, the health and living conditions of the displaced migrants becomes a priority when considering the high risk of a public health disaster associated with outbreaks and epidemics.
According to the United Nations High Commissioner for Refugees (UNHCR), the escalation of communal tensions and violence in Myanmar’s Rakhine state has led to the creation of over 900,000 stateless people (forty-five percent of the total population).
Out of these, the UN Office for the Coordination of Humanitarian Affairs believes that more than 600,000 Rohingyas have fled since 25 August, 2017, to Bangladesh, adding to the 300,000 to 500,000 Rohingya refugees already settled in the densely-populated neighbouring country.
The hasty, and often perilous, mass-exodus of these persecuted refugees comes with its share of trials and tribulations. Physical injuries, gunshot wounds due to hostilities with security forces, burn injuries as a result of torched settlements, all forms of violence against women, hunger, malnutrition, disease and mental trauma are just a few of the health hazards that these refugees have faced during the course of their escape to resettlement camps. An example of this is the massive mental health crisis faced by Rohingya children.
In Bangladesh, there are a large number of Rohingyas who are sick or in desperate need of medical attention. Many suffer from communicable diseases or are at a high risk for falling ill. Hepatitis B, Hepatitis C, Polio, and AIDS are the four major illnesses that have been identified by experts amongst the refugees.
Along with 11 children, there are 62 Rohingyas, predominantly women, who have been confirmed with HIV/AIDS. One woman has already died of AIDS, and it is estimated that at least 5,000 more Rohingya could be HIV-positive. The spread of sexually transmitted diseases is a concern, especially with news reports of Rohingya women in Bangladesh being forced into prostitution to feed mouths and make ends meet.
In the highly populated camps at Cox’s Bazar, 905,000 refugees are living in small, poorly drained and tightly cramped spaces that lack access to safe drinking water. Non-governmental organisations have built 1,532 latrines and with 327 persons sharing one toilet; the sanitary conditions are appalling.
Last year, health professionals had detected 850 hepatitis patients, 50 measles-affected patients, 50,000 flu-infected individuals and 15,000 persons afflicted by skin diseases.
Although local health workers and the displaced migrants are being taught about the importance of hand-washing and basic toilet hygiene, the large numbers of refugees, the limited resources and inadequate manpower is barely enough to improve overall living conditions. Cholera, tuberculosis, dengue, malaria, and measles will prove challenging to control, if patients are not given immediate medical attention.
Diphtheria is ‘spreading fast’ amongst the Rohingyas, and a potential outbreak could spread to the healthy populations in the neighboring areas for lack of quarantine.
Nine months after the arrival of refugees, news reports discuss the latest health crisis amongst the Rohingya women due to the spurt of pregnancies resulting from rape and sexual violence. Already, in Cox’s Bazar, 200 Rohingya women have given birth and the UN estimates that another 40,000 are pregnant.
Out of the 300 pregnant women screened last year, Hepatitis B was found in three percent, Hepatitis C in eight percent and both Hepatitis B and C (co-infection) among one percent of the women. In a resource-poor setting where meeting the nutritional needs is a challenge, the fear of maternal and infant mortality is great due to inadequate access to doctors and trained medical staff.
The UNHCR has stated that among forcibly displaced populations in developing countries, the top five killers of children under the age of five are malaria, malnutrition, measles, diarrhea and respiratory tract infections. A UNICEF survey of children in Kutupalong refugee camp has revealed an alarming prevalence of life-threatening, acute malnutrition, and preliminary findings indicate that one in four Rohingya children are malnourished.
Consequently, these underweight and immune-compromised children are easily prone to disease and infections. During the monsoon, heavy rains, landslides and flooding further jeopardises the overall health and wellbeing of refugee children.
As far as Rohingya refugees in India are concerned, very little is known about their health status. They are spread across the country, with over 40,000 living in shanties and slum settlements akin to Cox’s Bazar.
Of the Rohingyas living in Hyderabad, Delhi-NCR, Rajasthan, Haryana, Uttar Pradesh and Jammu, only 17,500 are registered at the UNHCR offices in Delhi and have been issued a refugee card.
Presently, there are no government initiatives to house Rohingyas or provide them with basic amenities. The Government of India has refuted claims that the refugees were denied access to health services.
And, yet, news from Rohingya camps in Salehdi in Northern India, Shaheen Bagh and Kalindi Kunj in Delhi, Shahpur Nangli, Mewat; Sector 86, Faridabad; Balapur, and Chandrayangutta, outside Hyderabad, is all the same – the frightful, squalid and sub-human state of existence of Rohingyas remains similar to their brethren in Bangladesh.
India is committed to the United Nations Sustainable Development Goals and is a signatory to the Universal Declaration of Human Rights, which states that everyone has the right to the highest standards of physical and mental health.
The 1951 Refugee Convention emphasises that refugees should enjoy access to health services equivalent to that of the host population. India has signed neither the 1951 United Nations Refugee Convention nor its 1967 Protocol and, with the exception of the Foreigner’s Act of 1946, India lacks a legal or policy framework on the treatment of refugees.
Irrespective of the high demands of a burgeoning population of 1.2 billion citizens, India has graciously accommodated refugees and illegal immigrants, whether from Sri Lanka, Iran, Bangladesh, Pakistan, Afghanistan or Tibet, into its fold. However, this largess and attitude of acceptance is coming to question. In its reply to a petition filed in the Supreme Court against deportation of Rohingya refugees, the Centre has stated that “India can’t become the refugee capital of the world”. In addition, a three-judge bench of the Supreme Court denied an interim order on a plea filed to ensure education and health facilities to the foreign settlers.
Until then, the status of the Rohingya refugees in India remains in a state of limbo with their health condition left to small mercies of international agencies and the vagaries of nature. Deprived of safe food and water and with nowhere to turn, the plight of the stateless and forsaken Rohingyas is truly tragic.
The prime ministers of India and Bangladesh met recently on 25 May, 2018. Even though Prime Minister Modi did not bring up the subject of Rohingyas, Sheikh Hasina expressly asked India to lend support towards repatriation of the illegal migrants back to Myanmar. The only question that now remains is when will the Government of India finally work on addressing the Rohingya situation in the country?
Will Prime Minister Modi join hands with Bangladesh towards a strategy for the safe and efficient return of the Rohingya refugees? Will he use his considerable regional and international influence to convince the Nobel Laureate Aung San Suu Kyi to act as a humanitarian and peace-maker to resolve this crisis? Ultimately, the long-term wellbeing of the Rohingya refugees will only be guaranteed when the root cause of the conflict –their reason for fleeing their homeland – is resolved.