Rohingya refugees are living in overcrowded camps in Ukhiya, Cox’s Bazar, Bangladesh. © Yunus Ali Shamrat/MSF
The sounds of heavy fighting still echoing from Myanmar serve as a constant reminder of the violence we fled. Even within the camps, tensions can run high, and the fear of further violence is ever-present. I escaped the violence from Myanmar, but I can't escape the fear. My heart races at every loud sound.*Solim, a Rohingya refugee
Our teams are treating the newly displaced Rohingya in the camps, including critically ill patients and war-wounded with mortar shell injuries and gunshot wounds. "People have shared with us that they are afraid to seek assistance as this might put them at risk of being exploited or even returned to Myanmar,” says Orla Murphy, the Doctors Without Borders Country Representative in Bangladesh.
“Our mental health teams, in particular, see how people are grappling with the violence they witnessed back home and how the lack of access to available humanitarian services has created an uncertainty that is further exacerbating their trauma. We are seeing newly arrived Rohingya patients showing symptoms of stress, anxiety and depression," says Murphy.
- “Each new trauma they encounter… only deepens their psychological wounds.”
As a mental health professional working with Rohingya refugees, I have witnessed firsthand the devastating impact of trauma and violence on the mental wellbeing of people who have recently fled Myanmar. Each month, our facilities see over 30 patients who arrive with a variety of mental health complaints, including complex trauma and post-traumatic stress disorder (PTSD). Many people with mental health disorders, previously stable in Myanmar, now experience worsening conditions due to a lack of treatment during their journey.
Among the most pressing mental health issues we encounter are severe depression and anxiety, compounded by the harrowing experiences these individuals have endured. When the violence escalated in Myanmar in July and August this year, we saw a significant increase in patients seeking help. Each of these patients carry not only the weight of their mental health struggles but also physical ailments resulting from prolonged exposure to violence and neglect.
People often recount their arduous journey from Myanmar to Bangladesh, a path fraught with danger and despair. Many faced obstacles at the border, including violence and pushbacks that prevented them from crossing. Their experiences are characterised by prolonged exposure to trauma, violence, loss and the deaths of loved ones. Unfortunately, these experiences are rarely reported, leaving the emotional scars of this suffering largely unacknowledged.
Despite finally reaching the safety of Bangladesh, these refugees find their basic needs often remain unmet. They voice concerns about registration issues, inadequate shelter, and the strain of living in overcrowded conditions with minimal resources. As they struggle to rebuild their lives, their mental health continues to deteriorate. It is challenging to maintain one’s sanity in a situation where life has become so complex and uncertain.
The conditions in the camps further exacerbate their mental health struggles. Patients describe the atmosphere as increasingly precarious, with daily reports of shootings and conflicts between different groups. The fear of violence is ever-present, creating a pervasive sense of anxiety and helplessness. For new arrivals, these feelings manifest as severe trauma, depressive symptoms and heightened anxiety—conditions that are now commonplace among those seeking our help.
Women and children face unique challenges in this environment. Many report feelings of hopelessness, low mood and anxiety stemming from the ongoing trauma they have endured. The last seven years have seen little improvement in the situation in Myanmar, with extreme movement restrictions and a lack of resources. Men, feeling powerless, may project their frustrations onto vulnerable family members, further compounding the trauma experienced within households.
The horrors of forced recruitment in the camps add another layer of complexity to the distress these families face. Imagine being a parent with a 17-year-old son and facing pressure to send him away to engage in violence, knowing the chances of survival are slim. This is a reality for many families, both in Myanmar and now in Bangladesh. Each new trauma they encounter—loss of belongings, family members, and their sense of safety—only deepens their psychological wounds. The ongoing violence in the camps serves as a constant reminder of their past traumas, leading to re-traumatisation and a cyclical pattern of suffering.
In response to these pressing needs, Doctors Without Borders provides vital support for vulnerable groups. When patients visit our facilities, our counsellors prioritise their safety, dignity and confidentiality. We create a supportive environment where they can share their experiences and express their suffering. For women, this often involves specific psychiatric consultations tailored to their unique circumstances.
Our approach includes a thorough assessment to evaluate their mental state, followed by counselling to normalise their experiences and provide mental health education. We focus on enhancing positive coping strategies and strengthening social support networks through communication with family, community members and other organisations. For those in need of psychiatric care, our mental health doctors evaluate their conditions and prescribe psychotropic medications as necessary.
We understand that every individual’s needs are unique, and we invite patients to return for weekly follow-ups. Our social workers play a crucial role in ensuring they are supported and doing well in their homes.
- Shariful Islam, Doctors Without Borders mental health activity manager at Kutupalong and Balukhali Clinic
While Bangladeshi authorities have recently committed to addressing the most urgent needs of the Rohingya refugees in the camps, more must be done immediately so that all people arriving in the country can access essential services such as food, water, shelter, healthcare, education and protection.
Doctors Without Borders calls for unhindered access to humanitarian assistance, care and protection for all Rohingya refugees in Bangladesh. Doctors Without Borders also urges all relevant authorities to ensure that no-one is returned to a place where they face serious harm. The principle of ‘non-refoulement’ is enshrined in international law, prohibiting the return of individuals to a country where they may face persecution, torture or other serious human rights abuses.
- "I ran from the violence, but I can’t escape the fear."
My name is *Solim. I am 21 years old, and I came to Bangladesh in July. I was born in Myanmar and grew up with my parents and a large family—six brothers and three sisters. Now, as I speak, one brother is here in Bangladesh, another is in Yangon, and I have no idea where the others are. One of my brothers and two of my sisters are missing. Communication between villages in Myanmar became impossible and, even now, I have no way of knowing if they are safe.
Before I left Myanmar, I was repeatedly pressured to join either the Myanmar military or the Arakan Army. Both sides expected young Rohingya men to fight, as they lacked people for their ranks, but I didn’t want to be part of that violence. One night, when our village was surrounded by the army, I escaped with my younger brother, moving through streams and across hilly areas to take shelter in a different neighborhood. There was no escaping the conflict though; there was gunfire, shelling. We went from village to village, always trying to avoid the crossfire.
Eventually, my brother and I hid in the woods for two days, hoping to stay out of sight. We moved only at night, trying to reach the border. One night, when a boat was close by, we made a desperate attempt to cross the sea. But as soon as we reached the border, the Myanmar Border Guard Police found us, suspecting we were part of the Arakan Army. We tried to explain we were just students who wanted no part in the fighting. They didn’t listen and kept interrogating us. They even tried to pressure us to join the military, but we managed to escape while they were questioning others.
After several days of escaping violence, we managed to find a boat that could take us to Bangladesh. Crossing into Bangladesh brought some relief, but my body was weak. I had been injured along the way; my legs cut and bleeding from sharp shells on the beach. I had nearly drowned when I fell into the water, I didn’t know how to swim. I can still feel the pain from my injuries, both physical and mental. I try to tell myself that I’m safe now, but I can’t shake off the fear. The gunfire and violence in Myanmar haunt me every day.
Now that I’m in Bangladesh, I spend most of my time indoors. There are so many people crowded together here—families of seven or more in small spaces, with more people coming in every day. We share what little we have, but it’s hard. I can’t work, I have no family nearby, and there’s no way for me to contact those who are still in Myanmar. My father has a distant relative who was living in the camp. He is kind and lets us stay, sharing his food with us, even though there’s little to go around.
When I hear loud noises, it’s like I’m back in Myanmar. The sounds bring back all the fear… the fear that someone will come; that I’ll be taken or worse. My heart races every time. I can’t sleep well. I want to feel safe, but it’s hard.
*Name has been changed for privacy
- “Some days, we only have one meal, and I have to look into my children’s hungry eyes.”
Teknaf is a sub-district of Cox’s Bazar District in Chittagong Division, Bangladesh. The Rohingya refugees living in camps in Teknaf are facing dire conditions. The camps are overcrowded, with inadequate sanitation facilities, limited access to clean water, and poor healthcare. Many refugees live in makeshift shelters made of bamboo and tarpaulin, which are vulnerable to the harsh weather conditions. The situation has worsened due to the recent arrivals of new refugees. Doctors Without Borders does not currently have any health facilities in Teknaf. Our team visited the area a few weeks ago, and spoke to one of the newly arrived Rohingya refugees, Zahir.
“I am Zahir, a Rohingya refugee from Myanmar. I arrived in Bangladesh in July and currently living in Teknaf, Bangladesh, with my sister-in-law's family. Before the violence, I lived a simple life with my family in a small village. We had a small farm and a modest income, but we were happy. However, in recent years, violence and instability have become a devastating part of our lives.
In July, the violence reached our village. I was sitting outside with a neighbor when gunfire suddenly erupted. A bullet struck him, killing him instantly, and I was hit in the back. With no medical help available (in Myanmar) and fearing for our lives, we made the heartbreaking decision to leave everything behind. In the chaos of fleeing, our three-year-old son was lost in the crowd. Though we searched desperately, the worsening danger forced us to move on with our remaining children.
I reached out to a boatman I knew, hoping he could help us escape. He agreed but demanded a steep price—around 250 US dollars per person. We had no other choice. We waded through waist-deep water to reach the boat and set off in the middle of the night. By dawn, we arrived on the shore in Bangladesh. I was exhausted and in pain from my injury.
Just when we thought we were safe, the boatman detained my eldest son, insisting on full payment. Helpless, we spent the entire day in Teknaf, reaching out to family members and friends to gather the money. My injury was worsening, but I couldn’t think about that while my son was still being held. Finally, we were able to pay, and he was released to us.
We then made our way to the refugee camp (Teknaf), where my sister-in-law and I tried to find medical help for my wound. The first facility we visited was too costly, so we continued looking,
moving from place to place, trying to find somewhere that could treat me. Each
place gave us only temporary relief, but my condition kept deteriorating. Eventually, I was referred to a larger facility, where I underwent surgery.
After 45 days, I was discharged, but I was told I’d need follow-up care. By then, we were trying to secure tokens as new arrivals and missing this would mean even more suffering. My wound has only worsened, and I know I need to go back for more treatment, but I can’t bring myself to leave my family in this vulnerable state. I’m exhausted, uncertain and struggling to keep us together in these conditions.
We are nine people packed into a small shelter meant for just four, sharing the space with my wife’s grandmother’s family. Food is scarce, and we survive on the few rations given by the Majhee [community leader] but it’s never enough. Some days, we only have one meal, and I have to look into my children’s hungry eyes, unable to offer them anything more. Water is limited, too; we each make do with a single jar a day.
Our future here feels bleak. We have no home, no income and no certainty about what lies ahead. My children’s lives feel overshadowed by hardship, and now I’ve heard that the token distribution has been postponed again. Without proper documentation, we are denied access to essential services, including healthcare. My ongoing medical needs are unmet, and I fear for my health and the wellbeing of my family.
Each delay only adds to our fear, knowing we may soon have no support at all. We’ve borrowed from every relative willing to help, but even their patience is wearing thin. Soon, we may truly have nowhere to turn."
* Name has been changed
