Bangladesh – The Rohingya refugee camp of Kutupalong- Balukhali, an ever-expanding camp

It is one of the newly created expansion areas to house both new Rohingya refugees who are continuing to flee Myanmar’s Rakhine state and those being relocated from other areas of the camp.

More than 5,000 people have arrived since the year began, and an estimated 693,000   Rohingya have fled mass violence and persecution since 25  August 2017 and crossed the border into Bangladesh.

Across the 120 acres of newly-prepared, hilly ground, the camp continues to grow. Not just day by day, but hour by hour; bulldozers work day and night, workers dig with spades and shovels. 

“It’s a huge effort, which sadly won’t suffice,” said Francesco Segoni, Emergency Coordinator for Médecins Sans Frontières (MSF). “There just isn’t enough land available, the camp is too crowded. Where relocation is already happening, sanitation and hygiene conditions are below the minimum standards. When the rain comes, not only do we anticipate flooding and landslides, but also an exponential increase in the risk of an outbreak. Latrines will go underwater, contamination seems inevitable. We are bracing for the worst.”

Estimates are that around 200,000 people are at risk and 15% of the camp could be flooded, according to the UNHCR. While some 680 acres more are planned to be provided by the government at an unknown point in the future, that still remains well below what would be needed: 10 acres is estimated to hold 10,000 people, according to the UNHCR.

MSF has been increasing its capacity to cope with medical emergencies and ongoing needs within the camp. Added to MSF four hospitals, three primary health centres and 10 health posts, a new 100-bed hospital on the edge of Camp 17 opened last month, equipped with a 50-bed isolation unit. Earlier in February, MSF opened a 74-bed hospital at Goyalmara and a brand new maternity was inaugurated at the Kutupalong clinic in early April. At the Rubber Garden hospital, which currently has 30 beds for patients with diphtheria, MSF is increasing the capacity of the facility to include 100 beds for patients with acute watery diarrhoea as part of the emergency preparedness plans.

There remains an urgent need to provide water for the new and existing refugees, especially in newly designated expansion areas. “The provision of clean drinking water is an absolute priority in the camp: it’s as much a life-saving activity as our medical work,” says Segoni. “We are racing against time to reach out to new areas and keep up with the ever-evolving context.”

MSF has to date provided hundreds of hand pumped wells and drilled 25 deep bore holes for motorised pumps. 

On a sultry day in late April, 25-year-old Arafat Hosen, a Water Network Distribution Supervisor for MSF, installed a motorised pump in camp 17 for a well 120-feet-deep.

The resident of Cox Bazar ventured out from MSF’s new hospital with a crew of 12 volunteers, carrying with them a generator for the installation as only two roads provide access in the whole camp.

They worked through one of the early rainy season downpours to successfully install the pump that will provide water to the existing local camp community and those to come. It is hoped that each deep well like it could supply water for up to 4,000 people, with five litres of drinkable water per person and per day.

“We were successful,” said Hosen, “but there is still much that needs to be done, like install a network and there are other boreholes that needs pumps, too.

”Coupled with the borehole drilling and water pump installation MSF is also distributing water filters to the most vulnerable patients, such as mothers with children under 5 years of age and pregnant women.

Over 600 has been given so far with thousands more of the simple devices to be distributed. 

“We train local people to instruct the recipients on use and maintenance, as well as following up after one week, one month and three months,” says Halal Uddine, MSF’s Aquafilter Supervisor, who hails from the local community near the camp. “So far people have been really pleased. They are used by families and often shared with neighbours. It’s important as there is such a shortage of safe water.”