The Rohingyas are a Muslim minority from the border region between Bangladesh and Rakhine State in western Myanmar (formerly Burma). Their accounts of life in Myanmar include severe human rights abuses: restrictions on movement and on marriage; forced labour; land and assets confiscation; violence and arbitrary arrest.

In 1992 more than a quarter of a million Rohingyas fled from Myanmar to Bangladesh. But two years later, without any clear change in the situation in Myanmar, the Bangladeshi authorities in cooperation with UNHCR started mass repatriations. These people are considered unwelcome economic migrants in Bangladesh but in Rakhine State they are denied the right to nationality and face continued harassment and abuses.

In Myanmar

Many Rohingya Muslims in Rakhine State have great difficulty getting any sort of health care. Travel restrictions imposed on them mean they are often effectively forced to remain confined in their own villages, or have to pay a small fee to get permission to travel prevented from seeking treatment in the towns and the provincial capital. Moreover healthcare services are often unaffordable for them.

MSF supports 30 clinics in Rakhine; about 15 of them are located in Northern Rakhine State where the majority of the population is Rohingya. These clinics focus primarily on the diagnosis and treatment of malaria. In addition, MSF runs seven 7 clinics in Rakhine (6 in Northern Rakhine State) where we provide various health services.

The teams, largely made up of Burmese and Rohingya staff, also travel out to remote villages on a regular basis to bring treatment to those who are not able to travel to a clinic. Rakhine State is one of MSF’s largest malaria programmes; in 2006 over 450.000 patients were tested and 210.000 treated for malaria. Malnutrition, tuberculosis and HIV/AIDS care and treatment are also provided for free in the clinics.

Bill Baylis worked in the MSF clinic in Sittwe, Rakhine State’s provincial capital, in 2006 and 2007: “During my time we expanded from one building to four. This expansion was due to increasing numbers of severely and acutely malnourished children and an increase in malaria cases. Almost all the patients we saw were Muslims. This may be because the Muslims faced some obstructions to attending the government hospitals, but money was probably the crucial factor – the Muslims are generally poor and our clinic was free. I imagine that if MSF left, no-one would treat the Muslims”.

In Bangladesh

Today, those Rohingyas who cross the border into Bangladesh still find themselves with nowhere to go. Although the UN set up camps to accommodate the influx of refugees in 1992, all but two are now closed. Bangladesh is not a signatory to the international refugee convention and any Rohingyas arriving since 1994 have no protective status as refugees.

The two official refugee camps house about 26,000 people and MSF runs a busy 20-bed inpatient unit in each. The Rohingyas in these camps were registered before the government stopped new refugee registrations, and therefore are better off than their unregistered compatriots. Even so, their lives are confined within the camps’ boundaries and, unable to work outside the camps, they depend on aid to survive.

For the unregistered Rohingyas scattered across the southeast corner of Bangladesh, life is even harder. Some have never moved from the beach where they landed after fleeing Myanmar. MSF runs weekly visits to Shamlapur beach, reaching the converted storeroom that serves as a clinic by driving along the beach at low water to avoid bandit activity on the roads. A Rohingya woman who has survived for 14 years on the beach with her family explains her plight: “We came to Bangladesh because the Burmese army took our land, our cows and everything we had. If I go back after all this time, they will put me in jail or shoot me. Here at least they do not say anything”.

Seven thousand more Rohingyas have congregated at a place called Tal in a makeshift camp, squeezed onto a 30-meter wide sliver of land between a river and the main trunk road. Two-meter by three-meter shelters house up to twelve people, built on a base of mud that needs to be continually replaced to prevent them collapsing into the water. River water comes into many shelters at high tide and in the rainy season nearly eight out of ten shelters are flooded. Food and clean drinking water are scarce and there is an average of about 40 people sharing each latrine. These conditions have led to a need for humanitarian and medical assistance.

MSF runs a free clinic near Tal, where the most common health problems are respiratory tract infections, probably linked to overcrowding and exposure to cold and damp. The appalling sanitary conditions in the camp mean that there are also many patients suffering from diarrhoea or worms. Many Rohingya men work in the fishing industry or look for work in the Chittagong Hill Tracts district usually staying away for long periods; some never return. The women, left with no resources, often have to rely on another family, beg or engage in prostitution to keep their family alive. The children who come to MSF’s clinic suffering from malnutrition are often from such fatherless families.

The Government of Bangladesh has recently expressed the intention to move the people from Tal camp onto another piece of land; but as for most of the Rohingyas in Bangladesh, their status and their future remain uncertain.

Burmese ethnic minorities in need of help

The Rohingyas are not the only minority group in Myanmar facing hardship. All Myanmar’s five neighbouring countries have Burmese refugees. Of these countries, only one – China – is a signatory to the international refugee convention; the others are Bangladesh, India, Laos and Thailand. Like the Rohingyas in Bangladesh, many other Burmese refugees face enormous difficulties simply surviving in countries that do not recognise their status.

As is the case for many Rohingyas, the majority of these ethnic minority refugees have fled Myanmar illegally and cannot go back to their village of origin for fear of being imprisoned by the authorities. A Rohingya man tells of his two brothers who went back to Myanmar to see their parents: “Before they could see them, they were put in jail. Why? Because they were living in Bangladesh”. It is an impossible choice – return and face imprisonment or try to settle on otherwise unwanted patches of land in country that gives you no recognition.

MSF and other organisations can try to keep these groups stay alive by providing basic health care, nutritional services, safe drinking water and sanitation facilities. But such actions do not solve the problem. As Frido Herinckx, MSF’s Head of Mission in Bangaldesh, says: “Alternatives have to be offered or negotiated. Nobody should have to live like this”.