Rakibul Hasan. Ghirish Das, Jhuton Sen, Kanak Madok, Chandan Sarkar, Golam Rosul. Food Technology & Nutritional Science Mawlana Bhashani Science and Technology University, Tangail.

1. Photo: Rex/Shutterstock/AP/Dar Yasin
PUBLIC HEALTH
ASPECT OF
ROHINGYA
REFUGE CRISIS
IN
BANGLADESH
 Health Risk & Prevalence
 Possible Threats
 Recommendations

2. Submitted By-
Md. Rakibul Hasan FN 13042
Jhuton Sen FN 13007
Ghirish Das FN 13023
Chandan Sarkar FN 13029
Kanak Madok FN 13030
Golam Rosul FN 13045
Submitted To-
Dr. Md. Abu Zubair
Professor,
Dept. of Food Technology and Nutritional Science
Mawlana Bhashani Science and Technology University
Santosh, Tangail.
Course Title: Public Health Nutrition
Course code: FTNS 5211
Mawlana Bhashani Science and Technology University

3. Profile of Rohingya
• Ethnic name: Rohingya
• Country of origin: Rakhine State, Myanmar
• Country of residence: Myanmar, Bangladesh, India, UAE, Saudi Arabia, Malaysia,
China.
• Total Population: 1,547,778 – 2,000,000
• Language: Arakanese, Bengali
• Religion: Sunni Islam (majority), Hinduism (minority)

4. History of Rohingya Refugee Crisis

5. Rohingya
Crisis
SINCE
1784
1977-
1978
1982
1991
1992 to
1997
2012
2016
2017
?
King Bodawpaya conquered Arakan
Operation Nagamin; 200,000 Rohingya fled
New citizenship law
250,000 Rohingya refugees fled
230,000 Rohingya returned to Arakan
10000 Rohingya refugees fled
25,000 Rohingya refugees fled
605,000 Rohingya refugees fled

6. Rohingya infiltration in Bangladesh
0
100000
200000
300000
400000
500000
600000
700000
1942 1978 1991 2016 2017
Year Num. of Rohingya people

7. Rohingya influx in 2017

8. Public Health Concerns of Rohingya Refugee

9. Health
concern
Physical
Health
Communicable
Diseases
Acute watery
diarrhoeaMeasles
Acute
jaundice
syndrome
Diphtheria
Sexually
transmitted
infections
Hepatitis
Non Communicable
Diseases
Anaemia
Chronic
diseases
Crisis-
attributable
injuries
Mental
Health

10. Mental health
According to UNHCR there are a concerning number of posttraumatic stress
disorder including-
• Explosive anger
• Psychotic-like symptoms
• Suicidal ideation
• High anxiety
• Hypervigilance
• Depression
• Appetite loss
• Help seeking behavior
• Nightmares
• Flashbacks
• Dissociation and fear

11. Mental health…
The Rohingya refugees are at risk for mental health issues due to a wide variety
of factors
• Prior history of systematic dehumanization
• Persecution
• Having witnessed or experienced traumatic events
• Burning of villages
• Arrests
• Torture
• Sexual and gender-based violence
• Loss of family and livelihoods and
• Daily stressors of remaining in a refugee settlement

12. Communicable Diseases
1. Acute respiratory infection
ARI has been the most common pathology reported by EWARS since October
2017 with an average per week rate of 12% of all infectious diseases including,
• Influenza
• Respiratory syncytial virus (RSV) or
• Bacterial pathogens such as pneumococci, a leading cause of pneumonia
ARI is compounded by
- Malnutrition
- Indoor smoke
- Burning fire
- Inadequate shelter

13. Communicable Diseases….
2. Acute watery diarrhea (AWD)
Approximately 8% of morbidity among Rohingya refugees is attributable to
acute watery diarrhea.
Prevalence of AWD among individuals who seek clinical care is 22%.
63,750 Rohingya refugees suffering from AWD visited a registered camp’s
clinic between August 25 and December 2, 2017.
Also 15 reported deaths due to AWD during that time.
40% of children less than 5 years old have been infected with a diarrheal
disease.

14. Communicable Diseases….
3. Diphtheria
From 8 November 2017, there have been a total of 6687 diphtheria case
patients and 42 deaths (CFR <1%) reported through EWARS.
As of 14 April, 210 (29%) cases have been confirmed by laboratory tests.
While the number of cases has been steadily decreasing since the vaccination
campaign.
4. Measles
Measles outbreaks were reported in 2016 and continued in 2017 in Cox’s
Bazar.
During 31 December 2017–22 April 2018, a total of 1231 cases of measles
were reported through EWARS (estimated CFR 0.12%).
The under-5 age group represented 81% of the total cases.
The number of cases has decreased but transmission appears to continue

15. Communicable Diseases….
5. Acute jaundice syndrome
At least 1892 cases of acute jaundice have been reported through EWARS
since January 2018, with an average of 100–150 cases a week.
WHO report showed a large predominance (56%) of cases positive for
hepatitis A.
Among the acute jaundice syndrome cases, 34% were less than five years old.
Mortality rates for hepatitis E, for example are as low as 1% among the
general population but can increase drastically to 20-25% for pregnant
women.

16. Communicable Diseases….
6. HIV & AIDS
The total number of Rohingya people living with HIV has been estimated to
be about 5000;
WHO estimates that ~500 patients were on ART in three northern townships
of Rakhine state from where the Rohingya population has fled since 25
August 2017.
7. Fever Unexplained >101°F
Unexplained fever predominantly placed due to some distributed influenza
A/B virus.
A higher number of cases unexplained fever during 2nd and 3rd week of the
month of may 2018.
No deaths have been reported within the host community.

17. Communicable Diseases….
8. Skin Diseases
Unhygienic living conditions in and around camps and under open sky were
causing their increasing skin and various infectious diseases.
DGHS control room said that The number of patients of skin diseases was 407
on September 27, 2017; 576 on October 30, 2017; and 1,321 on December 3,
2017.
Over time situation of Rohingya camps settings get overcrowded, unhygienic,
air and water polluted, etc.

18. Non-Communicable Diseases
1. Anaemia
According to the 2015 Demographic and Health Survey, among children
under-5 in Rohingya Refugee camps, 60% have some degree of anaemia, of
which
30% have mild anaemia,
30% have moderate anaemia and
<1% have severe anaemia
Among women aged 15–49 years in Rohingya refugee camp, 57.2% have
some degree of anaemia, of which
44.4% have mild anaemia,
12.8% have moderate anaemia, and
none have severe anaemia.

19. Non-Communicable Diseases…
02. Chronic diseases
The most common NCD admissions among the Rohingya people who recently
arrived were injuries, COPD , particularly in men
 Musculoskeletal pain and joint pain in older aged people is also a common
presentation
 There are irregular presentations of heart failure and suspected angina
 Even fewer cases of cancers have been reported
 There were also patients who self-reported diabetes and hypertension
Risk factors for NCDs are observed in the Rohingya including
-tobacco use, particularly by men,
-frequent betel nut chewing by men and women and
-indoor air pollution from household cooking in the camps

20. Non-Communicable Diseases…
3. Crisis-attributable injuries
One of the leading causes of NCD consultations in Cox’s Bazar is injuries,
especially from gunshot wounds, Shooting and beating.
other type of violence reported having their
- House burnt
- Witnessing other people being shot
- Having their money taken/being extorted and
- Other types of violence including witnessing beatings or detentions.

21. Nutritional vulnerability among Rohingya Refugee
Malnutrition is a serious public health concern for Rohingya refugee children. In
the refugee camps in Bangladesh-
• Over 25% of Rohingya children are malnourished and
• Over 12% are suffering from severe stunting
• Infants under 6 months have malnutrition rates near 50%.
• Acute malnutrition in the refugees exceeds levels between 24.5%-26.5%.
• Chronic malnutrition is prevalent in around 60% of Rohingya children in
Bangladesh
• Only 6% of refugees report having acceptable food consumption scores.

22. Nutritional vulnerability among Rohingya Refugee…
factors that play a role in the alarming rates of malnutrition among Rohingya
refugee
• Food insecurity
• Starvation
• Infectious disease
• Poor sanitary conditions
• Contaminated water
• Infant malnutrition due to lack of mothers ability to provide breast milk due
to their own lack of nutrition

23. Challenges/Threats/ Impacts of Rohingya Refugee
Bangladesh will face several challenges due to the emergent Rohingya crisis
from different aspects-
1. Economic
2. Social
3. Environmental.
4. Law and Order
5. Security Threats from Militant Groups & Political security
6. Bi lateral relation with neighbouring countries

24. Challenges/Threats/ Impacts of Rohingya Refugee…
1. Economic
Pressure on employment
The language spoken by the Rohingyas and the local people of Cox’s Bazar are
almost similar which allows the Rohingyas to assimilate quickly with the locals.
Unwillingness to farming
The daily wage earners are switching to work with the aid agencies. This creates
problems for the farmers since it has now become difficult for them to find
labourers

25. Challenges/Threats/ Impacts of Rohingya Refugee…
Reduction of daily wages
This is especially true in the camps
• The existing pay is Tk. 400-500 per day; but in the camps a day-labourer earns
Tk. 150-200 per day.
• However, the camps offer regular work and hence day labourers prefer to go
there.
Low tourist turnout in Saint Martin and cox’s bazar
A large number of Rohingya refugee are resided at teknaf, ukhiya and all over
cox’s bazar. It makes the environment of tourism unfavorable for tourist causing
lowest tourist turnout.

26. Challenges/Threats/ Impacts of Rohingya Refugee…
2. Social Challenges
Rohingya
Crisis
Social
Animosity
Population
Burden
Health
Concern
Educational
Barriers

27. Challenges/Threats/ Impacts of Rohingya Refugee…
3. Law and Order
Rohingya
Crisis
Human
Trafficking
Forced
prostitution
Fake
Identity
SIM Cards
Drug Cartel

28. Challenges/Threats/ Impacts of Rohingya Refugee…
4. Security Threats from Militant Groups & Political security
 The Rohingya camps in Cox’s Bazar District are fertile ground for recruitment
by Islamic militants.
 The stateless Rohingyas are vulnerable and desperate, and likely become
militant in an effort to uphold their interests.
Rohingya Solidarity Organization (RSO) and the Arakan Rohingya Islamic Front
(ARIF) are secretly operating their recruitment process inside rohingya camps.

29. Challenges/Threats/ Impacts of Rohingya Refugee…
5. Bi lateral relation with neighbouring countries
Myanmar is making the repatriation process delayed
also giving excuse to the world community.Bangladesh want to see these two country
to make pressure on Myanmar to return the
Rohingya refugee into their country
whereas India and China are reluctant to do
so.

30. Challenges/Threats/ Impacts of Rohingya Refugee…
6. Environmental Impacts
Deforestation
 Total Forest Area in Cox’s Bazar (2016): 2,092,016 acres
Due to Rohingya influx, initial loss of forest area: 3,500 acres
Which is equivalent to 1.67% loss in Cox’s bazar forest area and 0.05% loss in
total national forest area.
The value of forest land occupied by the Rohingyas has been estimated to be
BDT 500 crore.
Waste Generation
Major shelter materials in Camp area are tarpaulin, aluminum and bamboo
which are non disposable item except bamboo.
Drinking water are supplied to the Rohingya camps through plastic container
that is another non disposable item and harmful for the environment.

31. Recommendation & Solution of
Rohingya Crisis

32. Recommendations
To the Govt. of Myanmar-
End all forms of human rights violations and abuses
Implement the recommendations of the Advisory Commission on
Rakhine State
Allow access of int. organizations, UN agencies and their partners,
to provide humanitarian assistance
Allow Int. community to supervision of the repatriation process
Allow access to international human rights investigators
Conduct impartial and independent investigations
Establish a conducive environment for the voluntary return of
Rohingya refugees

33. Recommendations…
To the Govt. of Bangladesh-
Allow outside agencies, investigators from the UN and international
human rights organizations to the refugee camps
Strengthen collaboration with UNHCR and other Int. agencies
Allow access of int. organizations, UN agencies and their partners,
to provide humanitarian assistance
Accede to the 1951 Refugee Convention and its 1967 Protocol
Ensure safe & voluntary repatriation of Rohingya refugees
Conduct impartial and independent investigations
develop sustainable medium-and long-term measures

34. Five point proposal to world community

35. Five point proposal to world community …
The Five point Proposal that the Prime Minister Placed at the 72nd UNGA session on
September 21, includes
 Myanmar must unconditionally stop the violence and the practice of ethnic
cleansing in the Rakhine State immediately and forever
 Secretary General of the United Nations should immediately send a Fact Finding
Mission to Myanmar
 All civilians irrespective of religion and ethnicity must be protected in Myanmar For
that "safe zones“ could be created inside Myanmar under UN supervision
 Ensure sustainable return of all forcibly displaced Rohingyas in Bangladesh to their
homes in Myanmar
 The recommendations of Kofi Annan Commission Report must be immediately
implemented unconditionally and in its entirety.

36. Atrocities of Myanmar Army in
Rakhine Sate

43. STOP GENOCIDE
AND
SAVE ROHINGYA &
ENSURE SAFE
REPATRIATION
THANK YOU

44. References
• https://www.hrw.org/tag/rohingya-crisis
• https://www.unocha.org/rohingya-refugee-crisis
• https://www.acaps.org/sites/acaps/files/products/files/20171211_acaps_rohing
ya_historical_review.pdf
• https://blogs.wsj.com/indiarealtime/2016/12/23/timeline-a-short-history-of-
myanmars-rohingya-minority/
• https://en.wikipedia.org/wiki/Rohingya_people
• https://en.wikipedia.org/wiki/Rohingya_refugees_in_Bangladesh
• https://edition.cnn.com/2016/12/05/opinions/rakhine-state-rohingya-genocide-
opinion/index.html

45. • https://indianexpress.com/article/world/at-least-six-buddhists-killed-in-
rising-rakhine-violence-4781908/
• https://save-rohingya.weebly.com/picture-gallery.html
• https://amcarakan.wordpress.com/2014/02/03/rohingya-muslims-have-
been-killed-in-attacks-by-buddhists-in-rakhine-state/
• https://www.thestateless.com/2012/07/amnesty-intl-deplores-genocide-of-
myanmar-muslims.html
• https://www.trtworld.com/asia/un-fears-myanmar-human-rights-abuses-in-
internet-shutdown-27768
• http://www.searo.who.int/mediacentre/emergencies/bangladesh-
myanmar/public-health-situation-analysis-may-2018.pdf?ua=1
• https://www.bbc.com/news/world-asia-41566561
References