Global & Disaster Medicine

Archive for the ‘Rohingya’ Category

Diarrhea and Acute Respiratory Infection, Oral Cholera Vaccination Coverage, and Care-Seeking Behaviors of Rohingya Refugees — Cox’s Bazar, Bangladesh, October–November 2017

CDC

Summers A, Humphreys A, Leidman E, et al. Notes from the Field: Diarrhea and Acute Respiratory Infection, Oral Cholera Vaccination Coverage, and Care-Seeking Behaviors of Rohingya Refugees — Cox’s Bazar, Bangladesh, October–November 2017. MMWR Morb Mortal Wkly Rep 2018;67:533–535. DOI: http://dx.doi.org/10.15585/mmwr.mm6718a6.

“……Violence in the Rakhine State of Myanmar, which began on August 25, 2017, prompted mass displacement of Rohingya to the bordering district of Cox’s Bazar, Bangladesh. Joining the nearly 213,000 Rohingya already in the region, an estimated 45,000 persons settled in two preexisting refugee camps, Nayapara and Kutupalong, and nearly 550,000 into new makeshift settlements (1). Mass violence and displacement, accompanied by malnutrition, overcrowding, poor hygiene, and lack of access to safe water and health care increase the vulnerability of children to infectious diseases, including pneumonia and diarrhea (2).…..”

 


A massive cholera vaccination campaign begins to protect nearly one million Rohingyas and their host communities living in and around the refugee camps in Bangladesh

WHO

One million Rohingya refugees, host communities being vaccinated against cholera

Cox’s Bazar, 6 May 2018: A massive cholera vaccination campaign began today to protect nearly one million Rohingyas and their host communities living in and around the refugee camps in Bangladesh, to prevent any potential outbreak during the ongoing monsoon season.

This is a second cholera vaccination campaign being held for the Rohingyas and their host communities. Earlier 900,000 doses of oral cholera vaccine were administered to the vulnerable population in two phases in October – November last year.

“Considering the water and sanitation conditions in the overcrowded camps and the increased risk of disease outbreaks in the monsoon season, the health sector is taking all possible measures to prevent cholera and other water and vector borne diseases,” says Dr. Bardan Jung Rana, WHO Representative to Bangladesh.

As many as 245 mobile vaccination teams have been deployed to vaccinate all people over the age of one year in refugee camps and host communities in Ukhiya and Teknaf sub-districts during nearly week-long campaign led by the Ministry of Health and Family Welfare, with support of World Health Organization, UNICEF and icddr,b and other partners.

“We have managed to prevent the cholera outbreak since the first campaign in October last year, but flood water, heavy storms and landslides in the monsoon season could damage water and sanitation facilities in the camps, increasing the risk again of an outbreak of this dangerous disease. We have to take all initiatives to address the risk, including preventive measures through vaccination,” says Edouard Beigbeder, UNICEF Representative in Bangladesh.

The oral cholera vaccines have been made available through the Inter-Agency Coordinating Group with members from WHO, UNICEF, Médecins sans Frontières and International Federation of the Red Cross. The vaccines and supplies are financed by Gavi, the vaccine alliance.

“This vaccination campaign is a part of the ongoing efforts of the government and the health sector partners to protect nearly a million people, including at least 135,000 Bangladeshis, who have been affected by the influx since last year,” says Professor Dr. Abul Kalam Azad, Director General of Health Services (DGHS), Ministry of Health and Family Welfare, Government of Bangladesh.

In addition to vaccination, consistent efforts are being made to improve access to clean water and sanitation and promote hygiene. UNICEF has been scaling up interventions and communication on safe practices.

The World Health Organization has raised an early warning, alert and response emergency surveillance system, is monitoring water quality and working with the Department of Public Health Engineering to enhance local laboratory capacity.

Both WHO and UNICEF have prepositioned life-saving supplies to ensure rapid response to any outbreak.

The WHO-led Health Sector is supporting setting up of diarrhea treatment centres, including five supported by UNICEF and managed by icddr,b.

Editorial Note:

The Maternal Neonatal and Adolescent Health (MNC&AH) of Director General of Health Services (DGHS) is leading the oral cholera vaccination campaign through district and upazila level health managers and administration as well as DGHS Coordination Cell in Cox’s Bazar, Armed Forces, Refugee Relief and Repatriation Commission (RRRC), development partners, including UN agencies, and national and international non-government organizations.


Monsoon season: The world’s largest refugee camp, a temporary home to more than half a million Rohingyas that sprawls precariously across barren hills in southeastern Bangladesh may soon face landslides, flash floods, & inundation.

NY Times


The upcoming monsoon season in Bangladesh could put tens of thousands of Rohingya refugees staying at the highly congested settlements in Cox’s Bazar district at serious risk.

UNHCR

  • At least 100,000 refugees could be in grave danger from landslides and floods.
  • Up to one third of the settlement area could be flooded
  • More than 85,000 refugees could lose their shelters.
  • Another 23,000 refugees living on steep slopes within the site could be at risk of landslides.
  • key services in the settlement are also at risk of being washed away, including latrines, washrooms, tube wells, and health centers.

 

 


Reports of 5 Rohingya mass graves


Rohingya: US diplomat resigns from international advisory board because it was a “whitewash” and he did not want to be part of a “cheerleading squad for the government [Myanmar]”.

BBC

 


The rape of Rohingya women by Myanmar’s security forces

Pulitzer

“…..The AP interviewed 29 women and girls who say they were raped by Myanmar’s armed forces, and found distinct patterns in their accounts, their assailants’ uniforms and the details of the rapes themselves. The most common attack involved groups of soldiers storming into a house, beating any children inside and then beating and gang raping the women. ….”


Rohingya: From 3 November 2017 through 12 December 2017, a total of 804 suspected diphtheria cases including 15 deaths were reported among the displaced Rohingya population in Cox’s Bazar.

WHO

Diphtheria – Cox’s Bazar in Bangladesh

Disease outbreak news
13 December 2017

From 3 November 2017 through 12 December 2017, a total of 804 suspected diphtheria cases including 15 deaths were reported among the displaced Rohingya population in Cox’s Bazar (Figure 1). The first suspected case was reported on 10 November 2017 by a clinic of Médecins Sans Frontières (MSF) in Cox’s Bazar.

Figure 1: Number of diphtheria cases among the displaced Rohingya population in Cox’s Bazar, Bangladesh reported by date of illness onset from 3 November 2017 through 12 December 20171

1Date of onset information is missing for 45 (5.6%) cases.

Source: Médecins Sans Frontières

Of the suspected cases, 73% are younger than 15 years of age and 60% females (the sex for one percent cases was not reported). Fourteen of 15 deaths reported among suspected diphtheria cases were children younger than 15 years of age. To date, no cases of diphtheria have been reported from local communities.

Public health response

Since August 2017, more than 646 000 people from neighbouring Myanmar have gathered in densely populated camps and temporary settlements with poor access to clean water, sanitation and health services. A multi-agency diphtheria task force, led by the Ministry of Health Family Welfare of Bangladesh, has been providing clinical and public health services to the displaced population. WHO has mobilized US$ 3 million from its Contingency Fund for Emergencies (CFE) to support essential health services in Bangladesh.

WHO is working with health authorities to provide tetanus diphtheria (Td) vaccines for children aged seven to 15 years, as well as pentavalent vaccines (diphtheria, pertussis, tetanus, Haemophilus influenzae type b, and hepatitis B) and pneumococcal conjugate vaccines (PCV) for children aged six weeks to six years. A list of essential medicines and required supplies to support the response is being finalized by WHO and partners.The Serum Institute of India has donated 300 000 doses of pentavalent vaccines for use in the response.

WHO risk assessment

The current outbreak in Cox’s Bazar is evolving rapidly. To date, all suspected cases have occurred among the displaced Rohingya population, who are living in temporary settlements with difficult and crowded conditions. The coverage of diphtheria toxoid containing vaccines among the displaced Rohingya population is difficult to estimate, although diphtheria outbreaks are an indication of low overall population vaccination coverage. Available vaccination data for Bangladesh indicates that the coverage of diphtheria toxoid containing vaccines is high. However, spillover into the local population cannot be ruled out. WHO considers the risk at the national level to be moderate and low at the regional and global levels.

WHO advice

WHO recommends timely clinical management of suspected diphtheria cases that is consistent with WHO guidelines consisting of diphtheria antitoxin, appropriate antibiotics and implementation of infection prevention and control measures. High-risk populations such as young children, close contacts of diphtheria cases, and health workers should be vaccinated on priority basis. A coordinated response and community engagement can reduce the risk of further transmission and help to control the outbreak.

For more information on diphtheria, please see the link below:


Doctors Without Borders: At least 6,700 Rohingya were killed in attacks during the first month of a military crackdown in Myanmar in late August

CNN

“…..[ Médecins Sans Frontières ] interviewed several thousand Rohingya refugees in four camps in Bangladesh in late October and early November, asking how many members of their families had died and how, both before and after the violence began.

The survey showed that a minimum of 6,700 Rohingya — including 730 children — were killed by shooting and other violence between August 25 and September 24, and that at least 2,700 others died from disease and malnutrition…..”

 


“There is no such thing as Rohingya,” said U Kyaw San Hla, an officer in Rakhine’s state security ministry. “It is fake news.”

NY Times

  • “….human rights watchdogs warn that much of the evidence of the Rohingya’s history in Myanmar is in danger of being eradicated by a military campaign….”
  • “….Since late August, more than 620,000 Rohingya Muslims, about two-thirds of the population that lived in Myanmar in 2016, have fled to Bangladesh,……”

UN

Brutal attacks on Rohingya meant to make their return almost impossible – UN human rights report

GENEVA (11 October 2017) – Brutal attacks against Rohingya in northern Rakhine State have been well-organised, coordinated and systematic, with the intent of not only driving the population out of Myanmar but preventing them from returning to their homes, a new UN report based on interviews conducted in Bangladesh has found.

The report by a team from the UN Human Rights Office, who met with the newly arrived Rohingya in Cox’s Bazar from 14 to 24 September 2017, states that human rights violations committed against the Rohingya population were carried out by Myanmar security forces often in concert with armed Rakhine Buddhist individuals. The report, released on Wednesday, is based on some 65 interviews with individuals and groups.

It also highlights a strategy to “instil deep and widespread fear and trauma – physical, emotional and psychological” among the Rohingya population.

More than 500,000 Rohingya have fled to Bangladesh since the Myanmar security forces launched an operation in response to alleged attacks by militants on 25 August against 30 police posts and a regimental headquarters. The report states the “clearance operations” started before 25 August 2017, and as early as the beginning of August.

The UN Human Rights Office is gravely concerned for the safety of hundreds of thousands of Rohingya who remain in northern Rakhine State amid reports the violence is still ongoing, and calls on authorities to immediately allow humanitarian and human rights actors unfettered access to the stricken areas.

The report cites testimony from witnesses that security forces scorched dwellings and entire villages, were responsible for extrajudicial and summary executions, rape and other forms of sexual violence, torture and attacks on places of worship. Eyewitnesses reported numerous killings, saying some victims were deliberately targeted and others were killed through explosions, fire and stray bullets.

A 12-year old girl from Rathedaung township described how “the [Myanmar security forces and Rakhine Buddhist individuals] surrounded our house and started to shoot. It was a situation of panic – they shot my sister in front of me, she was only seven years old. She cried and told me to run. I tried to protect her and care for her, but we had no medical assistance on the hillside and she was bleeding so much that after one day she died. I buried her myself.

The report states that in some cases, before and during the attacks, megaphones were used to announce: “You do not belong here – go to Bangladesh. If you do not leave, we will torch your houses and kill you.

Credible information indicates that the Myanmar security forces purposely destroyed the property of the Rohingyas, targeting their houses, fields, food-stocks, crops, livestock and even trees, to render the possibility of the Rohingya returning to normal lives and livelihoods in the future in northern Rakhine almost impossible.

UN Human Rights chief Zeid Ra’ad Al Hussein, who has described the Government operations in northern Rakhine State as “a textbook example of ethnic cleansing,” has also urged the Government to immediately end its “cruel” security operation. By denying the Rohingya population their political, civil, economic and cultural rights, including the right to citizenship, he said, the Government’s actions appear to be “a cynical ploy to forcibly transfer large numbers of people without possibility of return.”

The report indicates that efforts were taken to effectively erase signs of memorable landmarks in the geography of the Rohingya landscape and memory in such a way that a return to their lands would yield nothing but a desolate and unrecognizable terrain.

Information received also indicates that the Myanmar security forces targeted teachers, the cultural and religious leadership, and other people of influence of the Rohingya community in an effort to diminish Rohingya history, culture and knowledge.

ENDS

To read the full report, see: http://www.ohchr.org/Documents/Countries/MM/CXBMissionSummaryFindingsOctober2017.pdf

For more information and media requests, please contact:Rupert Colville – + 41 22 917 9767 / rcolville@ohchr.orgLiz Throssell – + 41 22 917 9466  / ethrossell@ohchr.org  Jeremy Laurence – + 41 22 917 9383 / jlaurence@ohchr.org

 


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