O’Connell EM, Mitchell T, Papaiakovou M, Pilotte N, Lee D, Weinberg M, et al. Ancylostoma ceylanicum Hookworm in Myanmar Refugees, Thailand, 2012–2015. Emerg Infect Dis. 2018;24(8):1472-1481. https://dx.doi.org/10.3201/eid2408.180280

“During 2012–2015, US-bound refugees living in Myanmar–Thailand border camps (n = 1,839) were surveyed for hookworm infection and treatment response by using quantitative PCR. Samples were collected at 3 time points: after each of 2 treatments with albendazole and after resettlement in the United States. Baseline prevalence of Necator americanus hookworm was 25.4%, Ancylostoma duodenale 0%, and Ancylostoma ceylanicum (a zoonosis) 5.4%. Compared with N. americanus prevalence, A. ceylanicum hookworm prevalence peaked in younger age groups, and blood eosinophil concentrations during A. ceylanicum infection were higher than those for N. americanus infection. Female sex was associated with a lower risk for either hookworm infection. Cure rates after 1 dose of albendazole were greater for A. ceylanicum (93.3%) than N. americanus (65.9%) hookworm (p<0.001). Lower N. americanus hookworm cure rates were unrelated to β-tubulin single-nucleotide polymorphisms at codons 200 or 167. A. ceylanicum hookworm infection might be more common in humans than previously recognized.”

“…..The most serious effects of hookworm infection are the development of anemia and protein deficiency caused by blood loss at the site of the intestinal attachment of the adult worms. When children are continuously infected by many worms, the loss of iron and protein can retard growth and mental development.….”

NY Times

“……Everyone in the Rohingya refugee camps in Bangladesh knows of the rapes and how the Myanmar military has, for decades, used sexual violence as a weapon of war, particularly against ethnic groups that are not from the nation’s Buddhist majority.

Reuters

“….When Rohingya militants launched attacks across northern Rakhine State in August last year, the 33rd and 99th spearheaded the response. Their ensuing crackdown drove 700,000 Rohingya into neighboring Bangladesh…..”

“….The European Union and Canada on June 25 imposed sanctions on seven senior Myanmar military and police officers, including the commanders of the 33rd and 99th. The seven face asset freezes and are banned from traveling to EU countries. So far, the United States has sanctioned only one Myanmar general for abuses during the Rakhine campaign……”

https://www.youtube.com/watch?v=wwrhcEmZXL4

We Will Destroy Everything : Amnesty International Document

CNN

“……The report, Adolescent Girls in Crisis: Voices of the Rohingya is based on interviews with 300 refugee girls between 10 and 19 years old living in camps outside Cox’s Bazar……..”

NPR

“……a Rohingya boy….died when a mud wall of his shelter fell on top of him…..His mother also was injured in the collapse…..”

UNHCR

NYT: Multimedia

UNHCR, the UN Refugee Agency, and UNDP, the UN Development Programme, agreed today in Nay Pyi Taw with the Government of the Republic of the Union of Myanmar on the text for the tripartite Memorandum of Understanding (MoU). It is planned that the MoU will be signed in the course of the next week, the exact date of which is still to be confirmed.

This tripartite Memorandum will establish a framework for cooperation aimed at creating the conditions conducive to the voluntary, safe, dignified and sustainable repatriation of Rohingya refugees to their places of origin or of their choosing. Since the conditions are not conducive for voluntary return yet, the MoU is the first and necessary step to support the Government’s efforts to change that situation and is also intended to support recovery and resilience-based development for the benefit of all communities living in Rakhine State.

The agreement will provide a framework for UNHCR and UNDP to be given access to Rakhine State, including to refugees’ places of origin and areas of potential return that has not been permitted since violence broke out in August 2017. The access, once effective, will allow UNHCR to assess the conditions on the ground and carry out protection activities. This will also enable UNHCR to eventually provide independent information to refugees about the conditions in their places of origin, helping them to make informed decisions if the conditions are right for them to return in safety and dignity. The MoU will also allow the two UN agencies to carry out needs assessments in affected communities and strengthen the capacity of local authorities to support the voluntary repatriation process.

The MoU, once signed, will affirm the Myanmar Government’s commitment to work with UNHCR and UNDP to find a solution for the Rohingya population, in line with the recommendations of the Advisory Commission on Rakhine State. The recommendations include establishing a clear and voluntary pathway to citizenship and ensuring freedom of movement for all people in Rakhine State, irrespective of religion, ethnicity or citizenship status. The development programmes supporting livelihoods and social cohesion will benefit all communities.

The signing of the MoU is an integral part of a comprehensive approach by UNHCR and UNDP to find solutions for Rohingya refugees and supporting transition towards a peaceful, fair and prosperous future for all the people of Rakhine. On 13 April 2018, the Government of Bangladesh and UNHCR also signed a MoU relating to voluntary returns of Rohingya refugees once conditions in Myanmar are deemed conducive.

For more information on this topic, please contact:

For UNDP:

• In Yangon, Stanislav Saling, stanislav.saling@one.un.org, +95 9 42651 9871
• In New York, Christina LoNigro, christina.lonigro@undp.org, +1 212 906 5301

For UNHCR:

• In Yangon, Paul Vrieze, vrieze@unhcr.org, +95 944 803 4427
• In Bangkok, Keane Shum, shum@unhcr.org, +66 92 275 2585
• In Geneva, Andrej Mahecic, mahecic@unhcr.org, +41 79 642 9709

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).…..”

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.

NY Times

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.