Rohingya refugee crisis
Persecuted in Myanmar, living in containment in Bangladesh, trafficked and living as illegals in Malaysia and elsewhere
The Plight of the Rohingya
From Myanmar, Rohingya people have fled to Bangladesh, Malaysia and other countries. They remain without the most basic rights to protection, stateless and living a life full of uncertainty.
Pregnant refugee women in Malaysia have limited access to healthcare, including adequate maternal healthcare services, such as antenatal and postnatal care, skilled birth attendants, emergency obstetric care, and family planning services, which results in the high rate of maternal mortality among refugees.
Watch the video below to know the struggles of a pregnant Rohingya refugee mother in Malaysia and why there is a need for affordable, safe and inclusive healthcare for them.
Long-term solutions--durable solutions--are needed for the Rohingya. This population cannot continue to be ignored and forgotten, like pawns in a regional political stalemate.
For decades, the Rohingya people have faced persecution and abuse in Myanmar, where they were denied citizenship and basic rights. The violence against them escalated in August 2017, causing the death of at least 6,700 Rohingya, including children, and mass exodus of more than 600,000 Rohingya from Myanmar. Many of those who remain in Myanmar are forced to live in camps in Rakhine state, violently driven from their homes, their villages razed to the ground. Those who fled targeted persecution risked travelling over land and sea to seek refuge in countries such as Bangladesh, Malaysia, Cambodia, Thailand and India.
Today, nearly a million Rohingya refugees crowd into Cox's Bazar district in Bangladesh, in what has become the world’s largest displacement camp. Many Rohingya live in Penang, Malaysia, which they reach on small and overcrowded boats crossing the Andaman Sea. Four camps in Banda Aceh, Indonesia are also home to Rohingya refugees.
Five years on, the humanitarian response must transition from a minimum provision of emergency services to one better suited to a long-term resettlement reality. Nearly every Rohingya I have spoken with wants to return home to Myanmar. But the country has been at war with itself since the military seized power in February 2021, and in Rakhine, tensions between the Myanmar military and Arakan army are increasing. Our teams on the ground know firsthand the conditions for those that remain in Rakhine are unacceptable, and safe repatriation to this region is simply not a responsible option yet.Paul McPhun, MSF director, Asia Pacific
A timeline of the Rohingya crisis
Burma’s military-run government passes the Emergency Immigration Act. Under the law, Bangladesh, China, and India are perceived as "foreigners," and given fewer rights. Authorities begin confiscating Rohingyas’ national registration cards. © Willy Legrendre/MSF
Burma launches Operation Dragon King (Naga Min) to register and verify the status of citizens and people viewed as “foreigners.” Soldiers assault and terrorize Rohingya.
This led to some 200,000 Rohingya fleeing across the border to Bangladesh, where refugee camps are set up. © Bangladesh/MSF
The Rohingya in Bangladesh are repatriated to Burma. Of those remaining in Bangladesh, some 10,000 people die - the majority children - after food rations are cut. © John Vink/MAPS
The Burmese parliament passes a new law, which bases citizenship on ethnicity. The law excludes the Rohingya and other minority communities. © Bangladesh/MSF
Following the suppression of a popular uprising, Burma is renamed Myanmar.
The government requires everyone to apply for new identification cards, called Citizenship Scrutiny Cards. Rohingya never receive the new cards.
The ruling State Law and Order Restoration Council increases its military presence in northern Rakhine state, and the Rohingya are reportedly subject to compulsory labour, forced relocation, rape, summary executions, and torture. Thousands of Rohingya flee to Bangladesh. © Willy Legrendre
Myanmar military launched Operation Pyi Thaya, or “Clean and Beautiful Nation,” during which soldiers commit widespread violence. Around 250,000 Rohingyas flee to Bangladesh.
Doctors Without Borders provided medical services in nine of the 20 refugee camps established for the Rohingya in southwestern Bangladesh. Food, water, and sanitation in the camps are inadequate. © John Vink/MAPS
The governments of Bangladesh and Myanmar sign an agreement to repatriate refugees, and the camps are closed to new arrivals in the spring. By fall, forced repatriation begins, despite protests by the international community. The government creates a special border security force, called NaSaKa, to harass and persecute the Rohingya. Over the following years, some 150,000 Rohingya are sent back to Myanmar, and new refugees attempting the journey are denied entry to Bangladesh. © MSF
Myanmar begins denying birth certificates to Rohingya children. © Liba Taylor
A temporary registration card, or "white card," is issued by the government to Rohingya. It is not a form of citizenship identification. © A. Hollmann
Of the 20 camps that were built in Bangladesh in the early '90s, only two remain. Living conditions remain dire—a study finds that 58 per cent of children and 53 per cent of adults are chronically malnourished. © Johannes Abeling
Tens of thousands of Rohingya fled Myanmar by boat as a result of clashes between the Buddhist and Muslim communities in Rakhine State. © Giulio Di Sturco
Doctors Without Borders runs a medical facility in Kutupalong makeshift camp in Bangladesh. Only a small percentage of Rohingya seeking refuge in Bangladesh are officially recognised as refugees. Unrecognised Rohingya refugees are vulnerable to harassment and exploitation. © Juan Carlos Tomasi
Rohingya white cards, their only form of identification, are invalidated by the government. Instead, the Rohingya must obtain national verification cards, which incorrectly identify them as immigrants from Bangladesh. Most Rohingya reject the new cards. © Alva Simpson White
On October 9 Rohingya militant attacks on border police in Myanmar’s Rakhine state triggered reprisals against the Rohingya community, bringing a new wave of refugees across the border and an influx of patients to the Doctors Without Borders clinic in Kutupalong makeshift camp clinic, which provides comprehensive medical care to Rohingya refugees and the local community in Bangladesh. © Alva Simpson White
Following Rohingya militia attacks on several police and army posts in Myanmar on August 25, state security forces launch a campaign of horrific violence and terror targeting the Rohingya community. More than 700,000 Rohingya are driven out of Myanmar within weeks. The cycle of mass displacement begins again, this time on an unprecedented scale. Doctors Without Borders documents more than 6,700 violent deaths among the Rohingya.
Medical facilities in Bangladesh, including those run by Doctors Without Borders, are quickly overwhelmed. In September, Doctors Without Borders called for an immediate scale-up of humanitarian aid to the Rohingya in Bangladesh to avoid a public health disaster. Doctors Without Borders also urges the government of Myanmar to allow independent humanitarian organisations unfettered access to northern Rakhine state. © Madeleine Kingston/MSF
Starting in December, the Bangladeshi government begins relocating some refugees to Bhasan Char, a silt island in the Bay of Bengal that had remained uninhabited until now—due in part to its remote location and unstable environment. © Hasnat Sohan/MSF
Bangladeshi authorities impose strict lockdown measures during the COVID-19 pandemic that further restrict freedom of movement and work opportunities for Rohingya people. Amid increasingly desperate conditions, armed groups gain strength through violence and extortion. As living conditions continue to deteriorate, fires break out in the camp, including one in the Balukhali area that injures 11 people and destroys a Doctors Without Borders clinic in March. The camp is then hit with heavy rains and floods starting in July.
Many people must make impossible choices about their future. Some make the dangerous journey on trafficking boats across the Bay of Bengal to join the more than 100,000 Rohingya living in Malaysia. These boats are often caught by Malaysian authorities, but when they return to Bangladesh, they are blocked by Bangladeshi authorities and stranded at sea for weeks—sometimes months.
Miserable conditions in the camp and bleak prospects for the future fuel a mental health crisis among the Rohingya living here. © Pau Miranda
Five years after the largest campaign of targeted violence ever committed against the Rohingya in Myanmar, nearly one million people are living in the same bamboo and plastic shelters in Cox's Bazar, dependent on aid, with no better solutions in sight. © Saikat Mojumder/MSF
- Who are the Rohingya?
The Rohingya are people from Rakhine state, Myanmar, which borders Bangladesh to the north. They are mostly Muslims, who had lived in the predominantly Buddhist country for centuries. The Myanmar authorities disputed this and declared them to be illegal immigrants from Bangladesh.
Before the military crackdown in August 2017, roughly 1.1 million Rohingya people lived in the country.
Anwar Arafat, 15 years old who lives in Jamtoli Refugee Camp said to the young people around the world: “I would like to address young people like me around the world. Please use the opportunity you have and learn as much as you can. Myself and fellow Rohingya refugees do not have such an opportunity.” Bangladesh, 2022 © Saikat Mojumder/MSF
The Rohingya fled by the hundreds of thousands after the Myanmar government ramped up military action against them, in retaliation to attacks claimed by the Arakan Rohingya Salvation Army in 2017.
The Rohingya journeyed to Cox's Bazar on foot, on boats, and sometimes by wading through a river separating the Bangladesh-Myanmar border.
This led to the Rohingya people being named by the United Nations in 2013 as one of the most persecuted minorities in the world.
At least 6,700 Rohingya have died between 25 August and 24 September 2017, according to surveys conducted by Doctors Without Borders. In very conservative estimates, at least 6,500 were killed, including 730 children below the age of five. These confirm reports by international news organisations of targeted violence--which the Myanmar government continues to deny.
- Why are the Rohingya stateless?
The Rohingya are considered foreigners in Myanmar, following the introduction of a Citizenship Law in 1982. The law does not recognise them as one of the "national race."
While the Myanmar government was offering citizenship through a "verification" exercise, the Rohingya people are reluctant to accept National Verification Card (NVC1); despite holding it they are still unable to move freely within the Rakhine state or the country, and have limited access to necessary services due to checkpoints, bureaucratic barriers, and other discriminatory practices.
We are not stateless. We are from Myanmar. Our ancestors are from Myanmar.” – Abu Ahmad, 52 years old, fled to Bangladesh to seek treatment for his daughter's paralysis. Bangladesh, 2018 ©Ikram N'gadi/MSF
- What is the Rohingya refugee crisis?
A total of 745,000 Rohingya refugees fled to Bangladesh on August 25, 2017. Their arrival adds to thousands of their people who migrated to the refugee camps in previous years and are still living in difficult conditions.
Today, the Cox's Bazar district is home to nearly a million refugees, making it the world's largest refugee camp.
The temporary shelters where Rohingya live have been enduring extreme weather conditions and fire accidents since 2017. Bangladesh, 2022. © Saikat Mojumder/MSF
The Rohingya also risk their lives on boats across the Andaman Sea to flee to other countries, such as Malaysia, Thailand, Indonesia, Cambodia and Laos.
The mass displacement of people in this short period is the largest in the world of its kind in recent history.
- What is the current situation of the Rohingya?
"Spending our lives in the camps is difficult; the area is small, and there is no space for the children to play.” – Abu Siddik, Cox's Bazar, Bangladesh
It has been five years since the 2017 influx of more than 770,000 Rohingya to Cox’s Bazar. They joined more than 250,000 Rohingya already there from previous waves of violence. Now, almost 1 million people live in an approximately 25-kilometre zone south of Cox’s Bazar city.
The government of Bangladesh welcomed Rohingya refugees fleeing the violence in Myanmar and shouldered most of the burden to provide shelter and food assistance at the beginning of the influx in 2017. In collaboration with the government of Bangladesh and other actors involved in the joint response to Rohingya in camps in Cox’s Bazar, several NGOs work in the camps to respond to some of the basic needs people have, including provision of food staples (mostly rice and oil), cooking gas, water and sanitation services, basic education (up to primary school only), and primary healthcare services. However, these services barely cover the needs of the almost 1 million refugees in the camps.
Bangladeshi authorities and the host community are also increasingly frustrated by what they perceive as a lack of action at the international level to find a solution to this crisis. The authorities insist that repatriation should happen as soon as possible, and that the response in Bangladesh must remain temporary until then. This manifests itself in the nature of the refugee shelters inside the camps, as well as the facilities of all NGOs operating there. All establishments within the camp parameters are required to use only non-permanent structure materials (like bamboo and wooden boards).
“I am old now and will die soon. I wonder if I will see my motherland before I die. My wish is to breathe my last breath in Myanmar.” Mohamed Hussein, 65 years old Rohingya shared his wish with Doctors Without Borders. Bangladesh, 2022. © Saikat Mojumder/MSF
To make matters worse, humanitarian attention to the Rohingya is challenged by other crises around the world. As announced by UNOCHA, funding for the Rohingya Joint Response Plan (JRP) decreased from $629 million in 2020 to $602 million in 2021. As of August 2022, the funding stands at only $266 million.
As most conditions in the camp worsen, people who try to escape most often pay smugglers to take them to primarily Malaysia, but also Indonesia and Thailand.
Since December 2020, as an apparent measure to reduce over-crowding in the camps, the authorities started to relocate Rohingya to a 40 square kilometre flood-prone island called Bhasan Char. So far, over 27,000 people have been relocated as of July 2022.
Rohingya refugees have been going to Malaysia for more than 30 years, making the perilous journey across the Andaman Sea in search of a safe haven and hope for the future. However, in Malaysia, the life of refugees continues to be a struggle for dignity and acceptance. Malaysia is not a signatory to the 1951 UN Refugee Convention and its subsequent protocol, and the country does not recognise or protect refugees and asylum seekers in domestic law. Therefore, refugees and asylum-seekers in Malaysia are effectively criminalised, and have limited access to public services, including healthcare.
The card issued by the UN High Commissioner for Refugees (UNHCR) provides registered refugees and asylum-seekers limited protection, but they still lack legal status, which means that they are at constant risk of arrest and detention, in addition to facing barriers in access to healthcare, education and legal employment.
Many refugees, including the Rohingya, are detained in immigration detention centres nationwide. Children have also been detained. UNHCR has been denied access to these centres since August 2019. As a result, UNHCR is unable to conduct refugee status determination, and unable to seek release of the detained asylum seekers and refugees.
Doctors Without Borders has observed an increase in xenophobic sentiment against Rohingya since the start of the COVID-19 pandemic in 2020, which coincided with the change in government. Following news of several new arrivals by boat in early 2020, the government took a hardline stance against Rohingya refugees by preventing boats from reaching the coast, tightening the nation’s land and sea borders, and increasing raids by immigration authorities throughout the country, targeting areas where refugees and migrants reside and work.
Three groups of new boat arrivals were reported in May 2022. Doctors Without Borders learned that these arrivals consisted of more males than females, a deviation compared to past trends, where majority of the journeys were taken by women and girls. Reportedly, the newly arrived Rohingya refugees and asylum seekers have been charged in court and are currently in prison or immigration custody. Doctors Without Borders has attempted to access these individuals to provide medical assistance and mental health support; our attempts were unsuccessful.
Around 600,000 Rohingya remain in Rakhine state, with some 140,000 living in displacement sites, including camps where they have extremely limited freedom of movement. Those living in village settings also require costly and bureaucratic documentation to move around and have limited access to basic services.
Among the Rohingya living in Rakhine state, the military coup has not led to significant shifts in their situation – it was terrible before 1 February 2021, and it remains terrible now. Despite generations of residence in Myanmar, under the 1982 Myanmar Citizenship Law, the Rohingya are not considered to be among the “135 official indigenous races” and are therefore effectively excluded from full citizenship, leaving them stateless. This led to many infringements of their human rights. They are denied freedom of movement, and subsequently access to healthcare, education and livelihoods.
The camps remain cramped and squalid. There is no sign that people will be given permission to return to the villages they were driven from, and the reality for many is that their homes will not be there or will be occupied by other ethnicities.
Conditions in Myanmar are nowhere close to what they need to be for the safe, voluntary repatriation of Rohingya from Bangladesh. Families have been divided not only among those who fled to Bangladesh, but also when Rohingya embark on perilous journeys to countries, particularly Malaysia, in search of better opportunities. These conditions have a serious impact on the mental health of those remaining in Myanmar.
The impact of the military seizing power on the back of the pandemic has caused economic turmoil in the country, with the kyat nose-diving against the dollar, pushing up the price of imports. Fuel and food have both increased in price, particularly in Rakhine state where there is a reliance on transporting goods in from other areas of the country.
Tensions in Rakhine state between the Arakan Army and the Myanmar military are growing. While Rohingya are not directly involved in this conflict, growing insecurity may cause Rohingya to be caught up in violence and have a knock-on impact on Doctors Without Borders' movements and access to communities.
Doctors Without Borders has faced blockages at checkpoints while checks are made. Navy checkpoints on the way to our clinics in Pauktaw township are holding us for, on average, two hours, and this causes our clinic opening times to be cut in half and medical consultations fell by 30% in a week. We estimate around 200 patients a week are missing out on healthcare.