Racing to prevent cholera in Rohingya refugee camps

What’s the situation?

A humanitarian crisis of near biblical proportions. Since 25 August, 515,000 Rohingya have crossed from Myanmar to Cox’s Bazar in Bangladesh. They tell stories of villages being burned, family members being executed, children killed, women raped.

It’s truly a children’s emergency. A staggering 60% of new arrivals are children and 30% are children under 5 years old. Children who’ve not only witnessed unspeakable violence but risked their lives on exhausting journeys by foot through jungles and over mountains, and some across treacherous rivers and seas in flimsy boats.

Conditions in the sprawling camps are incredibly basic. Bamboo and plastic shacks sit cheek by jowl across the hillsides. The presence of the lifesaving infrastructure of sanitation – latrines, wells, water points – is patchy. It’s a breeding ground for waterborne diseases like diarrhoea – and worse: acute watery diarrhoea and cholera, which would be catastrophic for children.

What’s the risk of a cholera outbreak?

225,000 of new arrivals are living in ‘new spontaneous settlements’, extension camps where conditions are often dire. “Planning of the extension camps is largely absent,” says UNICEF Bangladesh Chief of Health Maya Vandenant. “We see that after the rains, water flushes the camps everywhere including the toilets.”

The incredibly high population density in the camps and high levels of severe malnutrition among child refugees both increase the risks associated with an outbreak of acute watery diarrhoea and cholera. In the last week, 5011 cases of diarrhoea have been reported. “We are very concerned,” says Maya.

At an unofficial camp, we met Hasina, nursing her son under plastic tarpaulin for the last three days. He’s had bad diarrhoea and fever and isn’t holding down any food. “When he wakes up he’s crying all the time. Something really bad is going on with him,” she says worriedly. Hasina looks absolutely shattered. She arrived here 20 days ago with her five sons and one daughter. She says she left her village because people were shooting and setting their houses on fire. We persuade Hasina to get medical help at the nearest clinic, putting her into a tuk-tuk with her son.

What is UNICEF doing?

UNICEF’s response is focused on prevention, treatment and reaching communities with life-saving awareness-raising messages.

Since 25 August, 140 wells and 2,000 latrines have been constructed and we’re working around the clock to install 2,625 new water points, 33,000 new latrines and 21,000 hand washing devices.

A cholera vaccination campaign targeting all children over a year will start on 10 October with 900,000 doses of the vaccine arriving in Bangladesh imminently.

At UNICEF-supported health centres in the camps, we’re getting ready to screen for possible cholera cases and stockpiling oral rehydration salts, so vital for the treatment of diarrhoea. 20 community-based health workers have also been trained to go door to door in the camps, sharing lifesaving information on the risks of acute watery diarrhoea, the cholera vaccination campaign and the importance of good hygiene practices like handwashing.

A cholera outbreak would be disastrous for Rohingya refugee children already facing immense risks and having been through so much. That’s why we’re doing all we can to protect children from this deadly but preventable threat.

Hugh Reilly is a Communications Specialist at UNICEF HQ, currently on mission in Bangladesh

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