In the area bordering Myanmar (Burma), thousands of Rakhine Muslims, often referred to as
Rohingya, struggle to survive. Denied citizenship at home, many escaped persecution only to find themselves living in appalling conditions in Bangladesh, with poor healthcare and inadequate protection.
During 2008, MSF continued to deliver healthcare services to more than 7,500 Rakhine Muslims living in Tal makeshift camp, as well as to those in the neighbouring community. The camp, positioned in a flood-prone area and close to a dangerously busy road, was appallingly overcrowded and insanitary.
In the clinic, MSF staff regularly treated people who had diarrhoea, skin infections and respiratory tract infections that were due to their squalid living conditions. Services also included a therapeutic feeding centre for severely malnourished children, a mental health
programme and projects to improve supplies of drinking water and sanitation. After months of intense lobbying led by MSF, the camp was eventually moved to a new site in Lada Bazaar in July, at which point other agencies stepped in, allowing MSF to hand over activities.
Lada unofficial refugee camp lacks clean water supplies but is home to Rohingya Muslims fleeing persecution in their home country Myanmar. July 2009
Photo by Espen Rasmussen
In the isolated districts of the Chittagong Hill Tracts, the least-developed area of Bangladesh, the ethnically diverse population is especially vulnerable. Years of conflict, discrimination and marginalisation have allowed standards of healthcare in the area to fall far below that in other areas of the country.
In 2008 people faced increased food insecurity. This was worsened by a plague of
rats that badly depleted supplies of rice – the main staple of people’s diets. Tensions between established tribal groups, the more recently arrived (and arriving) Bengali settlers, the large government military presence and local opposition groups mean the area remains prone to outbreaks of violence that cause some people to flee their homes. One of the main markets in the area remained empty for much of the year as a result of fear, boycotting and intimidation.
In response to the increased levels of food insecurity and a 13 per cent incidence of acute malnutrition in children under five-years-old, MSF set up an emergency nutritional intervention programme in the Sajek Union area of Chittagong Hill Tracts. The intervention, which ran from April to December, sought to help those who were already malnourished and to prevent the situation from worsening. A mobile feeding programme was set up, as well as an inpatient
centre to treat children who needed closer medical attention.
MSF started providing essential food items such as such as oil, fishpaste and salt to around 28,000 people. Alongside the nutritional programme, MSF set up a basic health clinic and eight health outposts, which were supported by a laboratory service for tests for diseases such as malaria.
While the nutritional situation steadily improved, MSF continued to treat around 200 people a week in the clinics, largely for diarrhoea, upper respiratory tract infection and malaria.