1
|
Rahman A, Strong J, Mondal PP, Maynard A, Haque T, Moore AM, Afsana K. Perceptions and attitudes of Rohingya community stakeholders to pregnancy termination services: a qualitative study in camps of Cox's Bazar, Bangladesh. Confl Health 2024; 18:19. [PMID: 38433199 PMCID: PMC10910813 DOI: 10.1186/s13031-024-00574-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 01/28/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Rohingya women suffer from inaccessibility to sexual and reproductive health services in Myanmar. After the forcible displacement of the Rohingya from Myanmar to Bangladesh in 2017, pregnancy termination services have been increasingly important and desired, while knowledge gaps and obstacles to access services still exist. The role of community stakeholders is critical as gatekeepers and decision-makers to improve and strengthen pregnancy termination services for women in camps. However, there is paucity of evidence on their perspectives about pregnancy termination. This qualitative study aims to understand the perception and attitudes of Rohingya community stakeholders to pregnancy termination in the camps of Cox's Bazar. METHODS We used purposive sampling to select 48 participants from the community stakeholders, 12 from each group: majhis (Rohingya leaders), imams (religious leaders), school teachers, and married men. We conducted in-depth interviews of all the participants between May-June 2022 and October-November 2022. Data were coded on Atlas.ti and analysed using a thematic content analysis approach. RESULTS Multiple socio-cultural and religious factors, gendered norms and stigma associated with pregnancy termination acted as barriers to women seeking services for it. From a religious stance, there was greater acceptance of pregnancy termination in the earlier period than in the later period of pregnancy. We observed that pregnancy termination among community stakeholders in earlier stages of pregnancy than later. However, circumstances, such as a woman's marital status, whether she sought her husband's permission or her ability of childcare capacity, were often framed by community stakeholders as 'acceptable' for pregnancy termination. Health concerns and social and contextual factors can influence community stakeholders supporting pregnancy termination. CONCLUSIONS The community stakeholders perspectives on barriers and enablers of pregnancy termination were variable with the context. These perspectives may support or impede women's ability to choice to seek pregnancy termination services. To improve women's choice to pregnancy termination, it is critical to consider roles of community stakeholders in creating their supporting attitudes to women's choice and access, and to designing targeted culturally appropriate interventions with communities support and engagement.
Collapse
Affiliation(s)
- Atiya Rahman
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.
| | - Joe Strong
- London School of Economics and Political Science, London, UK
| | | | | | - Tasnima Haque
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | | | - Kaosar Afsana
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| |
Collapse
|
2
|
Jubayer F, Kayshar S, Arifin S, Parven A, Khan SI, Meftaul IM. Nutritional health of the Rohingya refugees in Bangladesh: Conceptualizing a multilevel action framework focusing the COVID-19. Nutr Health 2024; 30:21-25. [PMID: 37041738 PMCID: PMC10186131 DOI: 10.1177/02601060231169372] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
The Rohingya refugees are among the most vulnerable victims of COVID-19 pandemic in Bangladesh. In refugee camps, they frequently lack access to safe and nutritious foods, drinking water, and a healthy environment. Despite the fact that numerous national and international organizations are sincerely collaborating to meet their nutritional and medical needs, the pace of work has slowed due to COVID-19. Combating COVID-19 demands a robust immune system, which relies heavily on a nutritious diet. The development of strong immunity to protect Rohingya refugees, particularly children and women, through the provision of nutrient-dense foods is thus highly necessary. Consequently, the current commentary focused on the nutritional health status of Rohingya refugees in Bangladesh during COVID-19. In addition, we provided a multilevel implementation framework that could assist stakeholders and policymakers in taking effective measures to recover their nutritional health.
Collapse
Affiliation(s)
- Fahad Jubayer
- Department of Food Engineering and
Technology, Sylhet Agricultural University, Sylhet, Bangladesh
| | - Shahidullah Kayshar
- Department of Food Engineering and
Technology, Sylhet Agricultural University, Sylhet, Bangladesh
| | - Shoaib Arifin
- Department of Agricultural Chemistry, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Aney Parven
- Department of Agricultural Chemistry, Sher-e-Bangla Agricultural University, Dhaka, Bangladesh
- Global Centre for Environmental Remediation
(GCER), College of Engineering, Science and Environment, The University of Newcastle, Callaghan, NSW, Australia
| | - Sirajul Islam Khan
- Department of Agricultural Chemistry, Sher-e-Bangla Agricultural University, Dhaka, Bangladesh
| | - Islam Md Meftaul
- Department of Agricultural Chemistry, Sher-e-Bangla Agricultural University, Dhaka, Bangladesh
- Global Centre for Environmental Remediation
(GCER), College of Engineering, Science and Environment, The University of Newcastle, Callaghan, NSW, Australia
| |
Collapse
|
3
|
Kamruzzaman P, Siddiqi B, Ahmed K. Navigating the shift in Bangladeshi host community's perceptions towards the Rohingya refugees: a declining sympathy. Front Sociol 2024; 9:1346011. [PMID: 38375152 PMCID: PMC10875995 DOI: 10.3389/fsoc.2024.1346011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/16/2024] [Indexed: 02/21/2024]
Abstract
Generosity and selflessness from the host community in Cox's Bazar were deemed to be instrumental in supporting Rohingyas who sought refuge in Bangladesh in 2017. Thousands of Rohingyas had to flee from their own country to save lives due to state-supported military violence. Initially, Bangladeshi media and civil society were largely supportive of the Rohingyas. However, the initial sympathy later withered away and may have turned into frustration and hostility. Based on 39 in-depth interviews with hot community members and humanitarian professionals, this paper argues that protraction of the crisis, inability to access natural resources due to the refugee camps, some Rohingyas' involvement in various unlawful activities, a perceived sense of neglect from the international community, and disruption in local labour market/trade affecting cost of living conditions for low-income people seem to have played important roles in creating widespread tensions between the host community and Rohingya refugees. We contend that findings of this study will add to the critical scholarship of humanitarian development in deepening the understanding of host and refugee communities' relationships. This paper will also have a positive impact on future policies toward harmonious coexistence between host communities and displaced refugees and potential sustainable solutions to the crisis.
Collapse
Affiliation(s)
- Palash Kamruzzaman
- South Wales Business School, University of South Wales, Wales, United Kingdom
| | - Bulbul Siddiqi
- Department of Political Science and Sociology, North South University, Dhaka, Bangladesh
| | - Kajal Ahmed
- Independent Researcher, Cox’s Bazar, Bangladesh
| |
Collapse
|
4
|
Tsichlis JT, Trisha IH, Aghagoli G, Flora MS, Abid MR. Prevalence of non-communicable disease among displaced Rohingya in southern Bangladesh: a first look at a persecuted ethnic minority from Myanmar. Int Health 2023:ihad106. [PMID: 37930814 DOI: 10.1093/inthealth/ihad106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/31/2023] [Accepted: 10/23/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND In Cox's Bazar, Bangladesh, 860 356 Rohingya living in refugee camps have experienced decades of persecution. Little is known about disease burden in this population. METHODS A retrospective review of deidentified electronic health records (EHR) of 51 270 Rohingya attending two primary health clinics in Kutupalong and Balukahli from October 2017 to October 2019 was performed. A novel EHR system named NIROG was used for patients' medical records'. RESULTS Females comprised 53.8% of patients. The median age of females was 25 y and for males it was 19 y. Prevalence of adult hypertension and diabetes was 14.1% and 11.0%, respectively. Also, 16.6% of children aged <5 y had moderate or severe acute malnutrition, while 36.6% were at risk of malnutrition. Body mass index (BMI) analysis showed that 34.4% of adults were underweight. Females were more likely to be hypertensive, diabetic, overweight/obese and malnourished. BMI had a statistically significant positive correlation with fasting blood glucose levels and systolic blood pressure. CONCLUSIONS The use of a portable EHR system was highly effective at providing longitudinal care in a humanitarian setting. Significant proportions of the adult population appear to have hypertension or diabetes, pointing to a critical need for management of chronic non-communicable diseases (NCDs). The findings of the current study will help stakeholders to plan effective prevention and management of NCDs among displaced Rohingya and other displaced populations.
Collapse
Affiliation(s)
- Jason T Tsichlis
- T he W arren Alpert Medical School of Brown University, 1 Hoppin st, Providence, RI 02903, USA
| | - Ipsita Hamid Trisha
- Health and Education for All, H 31, R 16, Sector 13, Uttrara, Dhaka 1230, Bangladesh
| | - Ghazal Aghagoli
- T he W arren Alpert Medical School of Brown University, 1 Hoppin st, Providence, RI 02903, USA
| | - Meerjady Sabrina Flora
- Directorate General of Health Services, Ministry of Health and Family Welfare, Mohakhali, Dhaka 1200, Bangladesh
| | - M Ruhul Abid
- T he W arren Alpert Medical School of Brown University, 1 Hoppin st, Providence, RI 02903, USA
| |
Collapse
|
5
|
Fahim SM, Das S, Rasul MG, Zaman MU, Alam MA, Afrin S, Saqeeb KN, Hasan MM, Alam AFMM, Chowdhury M, Ahmed T. Nutritional status and dietary diversity of pregnant and nonpregnant reproductive-age Rohingya women. Food Sci Nutr 2023; 11:5523-5531. [PMID: 37701197 PMCID: PMC10494628 DOI: 10.1002/fsn3.3508] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 05/10/2023] [Accepted: 06/05/2023] [Indexed: 09/14/2023] Open
Abstract
There are no data on the nutritional status and dietary diversity of the pregnant and nonpregnant reproductive-age Rohingya women who have recently shifted to the Bhasan Char Relocation Camp located on an island in the Bay of Bengal. A cross-sectional survey was conducted in November-December, 2021 to assess the nutritional status and evaluate the dietary diversity of two vulnerable groups of the forcibly displaced Rohingya population: nonpregnant reproductive-age women and pregnant mothers. Multivariable logistic regression was applied to identify the factors associated with nutritional impairments. Overall, 7.6% of the nonpregnant reproductive-age women were underweight (Body Mass Index [BMI] < 18.5 kg/m2), and nearly one-third of them had a BMI ≥ 25 kg/m2. However, 26.7% of the pregnant mothers were undernourished (BMI < 20.0 kg/m2) and almost one-fourth of them were either overweight or obese (BMI ≥ 25.0 kg/m2). The prevalence of thinness (Mid Upper Arm Circumference [MUAC] < 23 cm) was 34.5% among pregnant mothers, and 10.1% of them were severely thin (MUAC < 21 cm). The mean (±SD) of the Women's Dietary Diversity Score (WDDS) was 3.3 (±1.1) for nonpregnant reproductive-age women and 3.7 (±1.3) for pregnant mothers enrolled in this study. Overall, 63.8% of the nonpregnant women of childbearing age and 46% of the pregnant mothers had a low WDDS (WDDS < 4). The WDDS was found to be protective against thinness among nonpregnant reproductive-age women (AOR = 0.61; 95% CI = 0.37, 0.93; p-value = .03) and low BMI in pregnant mothers (AOR = 0.71; 95% CI = 0.55, 0.91; p-value = .01). The results of this survey will assist in early recognition of the nutritional demands, and act as a guide to planning nutrition-based programs among Rohingya reproductive-age women relocated to the Bhasan Char Island.
Collapse
Affiliation(s)
- Shah Mohammad Fahim
- Nutrition and Clinical Services DivisionInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
- Division of Nutritional SciencesCornell UniversityIthacaNew YorkUSA
| | - Subhasish Das
- Nutrition and Clinical Services DivisionInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | - Md. Golam Rasul
- Nutrition and Clinical Services DivisionInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | - Mahabub Uz Zaman
- Nutrition and Clinical Services DivisionInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | - Md. Ashraful Alam
- Nutrition and Clinical Services DivisionInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | - Sazia Afrin
- Nutrition and Clinical Services DivisionInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | - Kazi Nazmus Saqeeb
- Nutrition and Clinical Services DivisionInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | | | | | | | - Tahmeed Ahmed
- Nutrition and Clinical Services DivisionInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
- Office of the Executive Director, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
- Department of Global HealthUniversity of WashingtonSeattleWashingtonUSA
- Department of Public Health Nutrition, James P Grant School of Public HealthBRAC UniversityDhakaBangladesh
| |
Collapse
|
6
|
Chowdhury AT, Kundu S, Sultana ZZ, Hijazi HHA, Hossain A. A formative research to explore the programmatic approach of vaccinating the Rohingya refugees and host communities against COVID-19 infection in Bangladesh. BMC Health Serv Res 2023; 23:937. [PMID: 37653364 PMCID: PMC10472616 DOI: 10.1186/s12913-023-09945-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 08/22/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND The vaccination of the Rohingya refugees and host communities against COVID-19 in Cox's Bazar started in August 2021. Government authorities and Non-Government Organisation partners implemented a project around the initial period of vaccination to improve awareness and access to target beneficiaries. We conducted formative research to understand the programmatic approach of this project and identify potential challenges and community perceptions regarding immunisation against COVID-19. METHODOLOGY This was formative research in which we used a qualitative method of data collection. Purposively chosen 12 key-informant interviews and conveniently chosen 20 in-depth interviews were conducted using semi-structured interview guidelines from August to September 2022 in the Rohingya camp and host communities of Cox's Bazar District, Bangladesh. Ethical approval was obtained from the North South University Institutional Review Board, and written informed consent was obtained from all the participants. We used a thematic analysis approach to analyse the data. RESULTS The project neither provided any promotional or tailored messages regarding the COVID-19 vaccine nor conducted any vaccine hesitancy surveys before implementing the project. The project did not provide any storage facilities for the vaccines' cold chain management but provided transport support to carry the vaccines from the district to the sub-district level. Community leaders were included in the decision-making process during local-level planning of the vaccination programme. The project supported the reporting of any adverse effects following immunisation from community members to the government health authorities. Vaccine hesitancy among participants was high in the early stages, but mass campaigns and vaccination of frontline health workers increased their acceptance. The major challenges reported by the informants were low budget and lower salaries of field staff, stacking of the registration process at the beginning, reluctance of participants, inadequate transportation and manpower, and inadequate baby feeding corners at vaccination centers. CONCLUSION The findings from our study will help policymakers from the Government, the UN, and other humanitarian agencies to adapt and better address the issue of vaccine acceptance and strengthen the vaccination programme.
Collapse
Affiliation(s)
| | - Satyajit Kundu
- Global Health Institute, North South University, Dhaka, 1229 Bangladesh
| | - Zeeba Zahra Sultana
- Global Health Institute, North South University, Dhaka, 1229 Bangladesh
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Heba Hesham Ali Hijazi
- College of Health Sciences, University of Sharjah, Sharjah, 27273 United Arab Emirates
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110 Jordan
| | - Ahmed Hossain
- Global Health Institute, North South University, Dhaka, 1229 Bangladesh
- College of Health Sciences, University of Sharjah, Sharjah, 27273 United Arab Emirates
| |
Collapse
|
7
|
Halder CE, Hasan MA, Mohamud YM, Nyawara M, Okello JC, Mizan MN, Sayum MA, Hossain A. Understanding the challenges and gaps in community engagement interventions for COVID-19 prevention strategies in Rohingya refugees: a qualitative study with frontline workers and community representatives. Front Public Health 2023; 11:1169050. [PMID: 37601208 PMCID: PMC10437112 DOI: 10.3389/fpubh.2023.1169050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 07/13/2023] [Indexed: 08/22/2023] Open
Abstract
Background Rohingya refugees in Bangladesh are vulnerable to infectious diseases such as COVID-19 due to the crowded living conditions with fragile shelters, and limited water, sanitation and hygiene facilities and practices. While risk communication and community engagement (RCCE) is the cornerstone of outbreak control, there is limited evidence available on the effectiveness of the RCCE strategies in this setting. Objectives The goal of this study is to evaluate the effectiveness of RCCE strategies and to explore the challenges and community recommendations in relation to COVID-19 preventive measures in the context of Rohingya refugee camps in Bangladesh. Materials and methods It was a qualitative study. Methods used were (a) observation of RCCE intervention by 3 clinical supervisors accompanying 25 Community Health Workers (CHWs) and (b) 5 focus group discussions engaging 60 community representatives. Data were analyzed using a thematic analysis approach, separately for observation and focus group discussions. Results The study identified a number of good practices of RCCE, including selecting CHWs from the local community, engaging female CHWs, using local dialect, and collaborating with community/religious leaders. Certain good practices need scaling up, such as utilization of multiple communication methods and interpersonal communication skills. Some areas need improvement, such as CHWs being overburdened with multiple tasks, less effort to active listening, repeated delivery of same messages, inadequate linkage to culture, context, and resources, and less effort to empower the community. Engaging the community, five critical themes were identified in relation to poor COVID-19 preventive practices: culture, religion, and language; local context and resources; community trust and interaction with aid workers; communication methods; and gender and social inclusion. Religious misinterpretation, cultural barriers, physical barriers, lack of resources, breach of trust between the community and aid workers, inconsistent/complex messages, lack of gender and social inclusion, and stigmatization are among some key factors. Some key actions were recommended to improve COVID-19 RCCE strategy. Conclusion We urge the RCCE partners to make use of the findings and recommendations to develop a robust RCCE strategy relevant to local culture and context, responsive to people's concerns and needs, and inclusive of gender, age and social vulnerabilities.
Collapse
Affiliation(s)
- Charls Erik Halder
- Migration Health Division, International Organization for Migration, Cox’s Bazar, Bangladesh
| | - Md Abeed Hasan
- Migration Health Division, International Organization for Migration, Cox’s Bazar, Bangladesh
| | - Yussuf Mohamed Mohamud
- Migration Health Division, International Organization for Migration, Cox’s Bazar, Bangladesh
| | - Marsela Nyawara
- Migration Health Division, International Organization for Migration, Cox’s Bazar, Bangladesh
| | - James Charles Okello
- Migration Health Division, International Organization for Migration, Cox’s Bazar, Bangladesh
| | - Md Nahid Mizan
- Migration Health Division, International Organization for Migration, Cox’s Bazar, Bangladesh
| | - Md Abu Sayum
- Migration Health Division, International Organization for Migration, Cox’s Bazar, Bangladesh
| | - Ahmed Hossain
- College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Global Health Institute, North South University, Dhaka, Bangladesh
| |
Collapse
|
8
|
Anwar A, Yadav UN, Huda MN, Das S, Rosenbaum S, Ali ARMM, Mondal PK, Rizwan AAM, Hossain SFA, Das Shuvo S, Mistry SK. Anxiety and Stress Related to COVID-19 Among the Community Dwelling Older Adults Residing in the Largest Refugee Camp of the World. Community Ment Health J 2023; 59:1181-1192. [PMID: 36879112 PMCID: PMC9988202 DOI: 10.1007/s10597-023-01101-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 01/07/2023] [Indexed: 03/08/2023]
Abstract
The current cross-sectional study was conducted among 864 older adults aged ≥ 60 years residing in Rohingya refugee camp through face-to-face interviews during November-December 2021. COVID-19-related anxiety was measured using the five-point Coronavirus Anxiety Scale (CAS) and perceived stress using the 10-point Perceived Stress Scale (PSS). The linear regression model identified the factors associated with COVID-19-related anxiety and perceived stress. The prevalence of COVID-19-related anxiety and perceived stress was 68% and 93%, respectively. The average COVID-19-related anxiety score expected to be significantly higher among those who were physically inactive, concerned about COVID-19, had a close friend/family member diagnosed with COVID-19, and had some difficulty in getting food and routine medical care during the COVID-19 pandemic. Meanwhile, the average perceived stress score was expected to be significantly higher among those without partners, who were feeling overwhelmed by COVID-19, and who experienced COVID-19-related anxiety during the pandemic. The findings suggest providing immediate psychosocial support to older Rohingya adults.
Collapse
Affiliation(s)
- Afsana Anwar
- Health and Nutrition, Social Assistance &Amp; Rehabilitation for the Physically Vulnerable (SARPV), SARPV Complex, Link Road, Cox's Bazar, 4700, Bangladesh
| | - Uday Narayan Yadav
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Md Nazmul Huda
- School of Medicine, Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, 2560, Australia
- ARCED Foundation, 13/1, Pallabi, Mirpur-12, Dhaka, Bangladesh
| | - Sukanta Das
- Department of Statistics, Begum Rokeya University, Rangpur, Bangladesh
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | | | - Probal Kumar Mondal
- Health and Nutrition, Social Assistance &Amp; Rehabilitation for the Physically Vulnerable (SARPV), SARPV Complex, Link Road, Cox's Bazar, 4700, Bangladesh
| | - Abu Ansar Md Rizwan
- Health and Nutrition, Social Assistance &Amp; Rehabilitation for the Physically Vulnerable (SARPV), SARPV Complex, Link Road, Cox's Bazar, 4700, Bangladesh
| | | | - Suvasish Das Shuvo
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Sabuj Kanti Mistry
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.
- ARCED Foundation, 13/1, Pallabi, Mirpur-12, Dhaka, Bangladesh.
- Department of Public Health, Daffodil International University, Dhaka, 1207, Bangladesh.
- Brain and Mind Centre, The University of Sydney, Sydney, Australia.
| |
Collapse
|
9
|
Hossain ANMZ. Educational crisis of Rohingya refugee children in Bangladesh: Access, obstacles, and prospects to formal and non-formal education. Heliyon 2023; 9:e18346. [PMID: 37539211 PMCID: PMC10395529 DOI: 10.1016/j.heliyon.2023.e18346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/09/2023] [Accepted: 07/13/2023] [Indexed: 08/05/2023] Open
Abstract
Purpose The article discusses the contemporary educational crisis of Rohingya children in Bangladesh. It aims to identify the challenges of formal and non-formal education faced by Rohingya children and their prospects. In this scholarship, the author attempts to answer the questions-what are the current formal and non-formal educational services in the Rohingya refugee camps and how and to what extent do the existing educational services intensify the other crisis in their lives, and what are the prospects for them going forwards. Method ology: This study is primarily based on secondary sources of data. It focuses on the available educational services and key obstacles that affect Rohingya children's formal and non-formal educational opportunities in Bangladesh and their prospects in Myanmar. Findings The study found the absence of formal and non-formal education for Rohingya children in refugee camps has a significant impact on their ability to become an active member of society. Although refugee children and their parents express a willingness to formal education under the Myanmar curriculum, limited educational services and various structural and legal barriers hinder their progress. Finally, the study explores the prospects of formal and non-formal education for Rohingya children in Bangladesh and concludes with recommendations to improve their educational opportunities. Limitation The study results can differ in other contexts and countries hosting refugees. Practical implications Findings of the study may be helpful for policymakers and practitioners.
Collapse
Affiliation(s)
- A. N. M. Zakir Hossain
- Bangladesh Agricultural University, Mymensingh, 2202, Bangladesh
- University of Public Service, Budapest, 1083, Hungary
| |
Collapse
|
10
|
Apolot RR, Kaddu SS, Evers ES, Debashish P, Mowla SMN, Ahmed S, Das A, Bhuiyan ATMRH, Rahman MM, Barua A, Maina AGK, Sultan M, Nyawara M, Willet V, Von Harbou K. Infection prevention and control for COVID-19 response in the Rohingya refugee camps in Bangladesh: an intra-action review. Int J Equity Health 2023; 22:111. [PMID: 37277825 PMCID: PMC10241551 DOI: 10.1186/s12939-023-01926-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 05/30/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Infection Prevention and Control (IPC) is critical in controlling the COVID-19 pandemic and is one of the pillars of the WHO COVID-19 Strategic Preparedness and Response Plan 2020. We conducted an Intra-Action Review (IAR) of IPC response efforts to the COVID-19 pandemic in Cox's Bazar, Bangladesh, to identify best practices, challenges, and recommendations for improvement of the current and future responses. METHODS We conducted two meetings with 54 participants purposively selected from different organizations and agencies involved in the frontline implementation of IPC in Cox's Bazar district, Bangladesh. We used the IPC trigger questions from the WHO country COVID-19 IAR: trigger question database to guide the discussions. Meeting notes and transcripts were then analyzed manually using content analysis, and results were presented in text and quotes. RESULTS Best practices included: assessments, a response plan, a working group, trainings, early case identification and isolation, hand hygiene in Health Facilities (HFs), monitoring and feedback, general masking in HFs, supportive supervision, design, infrastructure and environmental controls in Severe Acute Respiratory Infection Isolation and Treatment Centers (SARI ITCs) and HFs and waste management. Challenges included: frequent breakdown of incinerators, limited PPE supply, inconsistent adherence to IPC, lack of availability of uniforms for health workers, in particular cultural and gender appropriate uniforms and Personal Protective Equipment (PPE). Recommendations from the IAR were: (1) to promote the institutionalization of IPC, programs in HFs (2) establishment of IPC monitoring mechanisms in all HCFs, (3) strengthening IPC education and training in health care facilities, and (4) strengthen public health and social measures in communities. CONCLUSION Establishing IPC programmes that include monitoring and continuous training are critical in promoting consistent and adaptive IPC practices. Response to a pandemic crisis combined with concurrent emergencies, such as protracted displacement of populations with many diverse actors, can only be successful with highly coordinated planning, leadership, resource mobilization, and close supervision.
Collapse
Affiliation(s)
| | - Simon Ssentamu Kaddu
- World Health Organization, Cox’s Bazar Emergency Sub Office, Cox’s Bazar, Bangladesh
| | - Egmond Samir Evers
- World Health Organization, Cox’s Bazar Emergency Sub Office, Cox’s Bazar, Bangladesh
| | - Paul Debashish
- World Health Organization, Cox’s Bazar Emergency Sub Office, Cox’s Bazar, Bangladesh
| | - S. M. Niaz Mowla
- World Health Organization, Cox’s Bazar Emergency Sub Office, Cox’s Bazar, Bangladesh
| | - Sabbir Ahmed
- World Health Organization, Cox’s Bazar Emergency Sub Office, Cox’s Bazar, Bangladesh
| | - Aritra Das
- Food for the Hungry/Medical Teams International, Cox’s Bazar, Bangladesh
| | | | | | - Anupam Barua
- Cox’s Bazar Medical College, Cox’s Bazar, Bangladesh
| | | | - Murad Sultan
- World Health Organization, Bangladesh Country Office, Dhaka, Bangladesh
| | - Marsela Nyawara
- International Organization for Migration (IOM), Cox’s Bazar Sub Office, Cox’s Bazar, Bangladesh
| | - Victoria Willet
- World Health Organization, WHO Health Emergencies (WHE) Programme, Geneva, Switzerland
| | - Kai Von Harbou
- World Health Organization, Cox’s Bazar Emergency Sub Office, Cox’s Bazar, Bangladesh
| |
Collapse
|
11
|
Anwar A, Yadav UN, Huda MN, Rifat MA, Ali AM, Mondal PK, Rizwan AAM, Shuvo SD, Mistry SK. Prevalence and determinants of self-reported functional status among older adults residing in the largest refugee camp of the world. BMC Geriatr 2023; 23:345. [PMID: 37264327 DOI: 10.1186/s12877-023-04067-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 05/25/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND The older adults of refugee camps might be vulnerable to exhibiting limited functional abilities because of the limited resources available to create a supportive environment for older population in the camps. This study aims to explore the prevalence and determinants of self-reported functional status among the older adults residing in the Rohingya refugee camp in Bangladesh. METHODS This cross-sectional study was conducted on 864 older adults aged 60 years and above living in five selected sub-camps of Rohingya refugee camp in Cox's Bazar, Bangladesh. Data were collected through face-to-face interviews of the participants between November-December 2021. Functional status was measured using the Barthel Index. Information on participants' sociodemographic characteristics, self-reported chronic diseases and lifestyle characteristics were also collected. A multiple logistic regression model was used to assess the factors associated with self-reported functional abilities among the participants. RESULTS The overall percentage of people having limited self-reported functional ability was 26.5% (male: 22.6% and female: 31.5%) with inability most found in grooming (33.2%), bathing (31.8%), stair using (13.2%) and mobility (10.7%). In the final adjusted model, having age of 80 years or more (aOR = 2.01,95% CI: 1.08,3.75), being female (aOR = 1.44, 95% CI: 1.04,2.0), having low memory or concentration (aOR = 1.83, 95% CI: 1.30,2.56), loneliness (aOR = 2.89, 95% CI:1.74,4.80) and living with aid alone (aOR = 2.89, 95% CI: 1.74,4.80) were found to be associated with self-reported limited functional ability. CONCLUSION The findings of this study highlight the need for attention from policymakers and public health practitioners on addressing functional limitations among older adults residing in the Rohingya refugee camp. Our findings emphasize the need for the development of comprehensive interventions that can address the wider unmet needs (e.g., ensuring family/caregiver support, engaging in social and physical activities, providing nutritional support packages, etc.) to improve the health and well-being of older Rohingya adults.
Collapse
Affiliation(s)
- Afsana Anwar
- Social Assistance and Rehabilitation for the Physically Vulnerable (SARPV), SARPV Complex, Link Road, Cox's Bazar, 4700, Bangladesh
| | - Uday Narayan Yadav
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, 2601, Australia
- Centre for Primary Health Care and Equity, University of New Sotuh Wales, Kensington, New South Wales, 2052, Australia
| | - Md Nazmul Huda
- Translational Health Research Institute, School of Health Science, Western Sydney University, Campbelltown, New South Wales, 2560, Australia
| | - M A Rifat
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Arm Mehrab Ali
- ARCED Foundation, 13/1, Pallabi, Mirpur-12, Dhaka, 1216, Bangladesh
| | - Probal Kumar Mondal
- Social Assistance and Rehabilitation for the Physically Vulnerable (SARPV), SARPV Complex, Link Road, Cox's Bazar, 4700, Bangladesh
| | - Abu Ansar Md Rizwan
- Social Assistance and Rehabilitation for the Physically Vulnerable (SARPV), SARPV Complex, Link Road, Cox's Bazar, 4700, Bangladesh
| | - Suvasish Das Shuvo
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, 7408, Bangladesh
| | - Sabuj Kanti Mistry
- Centre for Primary Health Care and Equity, University of New Sotuh Wales, Kensington, New South Wales, 2052, Australia.
- ARCED Foundation, 13/1, Pallabi, Mirpur-12, Dhaka, 1216, Bangladesh.
- Department of Public Health, Daffodil International University, Dhaka, 1207, Bangladesh.
- Brain and Mind Centre, The University of Sydney, 94 Mallet St, Camperdown, New South Wales, 2050, Australia.
| |
Collapse
|
12
|
Christensen LR, Ahsan H. Of Numbers and Moods: Screening for Mental Health Issues in a Rohingya Refugee Camp in Bangladesh. Med Anthropol 2022; 41:854-865. [PMID: 36069559 DOI: 10.1080/01459740.2022.2113396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Screening refugees for mental health issues, medical assistants use a digital tool that produces a numerical score but also, importantly, attunes to the moods of their clients and the atmospheres of their homes. In this article, we propose the concept of numeration-attunement as helpful for medical anthropology. Drawing on ethnographic fieldwork conducted among medical assistants working in the Kutapalong refugee camp in Bangladesh, we explore their assessment of the mental health of the refugees: its numeration-attunement. To develop the notion of numeration-attunement, we draw on numeration research as well as phenomenology. Comprehending how medical assistants assess the mental health of refugees requires attention both to numeration and datafication by way of a screening tool as well as the revelatory character of attunement to moods.
Collapse
Affiliation(s)
| | - Hasib Ahsan
- Department of Business IT, IT-University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
13
|
Mahamud Magan I, Patankar K, Ahmed R. The educational, social, and emotional impact of COVID19 on Rohingya youth: Implications for educators and policymakers. Child Youth Serv Rev 2022; 142:106619. [PMID: 35935736 PMCID: PMC9338834 DOI: 10.1016/j.childyouth.2022.106619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 05/11/2022] [Accepted: 07/27/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has greatly impacted the lives of many around the world, particularly refugee and immigrant communities. In the United States, millions of children and youth had to quickly shift from in-person to remote learning, encountering new challenges and uncertainties in their overall educational experiences. This study explored some of the impacts of the COVID-19 pandemic on the educational, socialization, and mental and emotional health and wellbeing of Rohingya refugee youth from Myanmar resettled in the United States. Through in-depth qualitative interviews with 15 Rohingya refugees ages 12-17, we found that Rohingya youth's experiences with COVID-19 pandemic presented both challenges and opportunities. The challenges included unavailability of personal space to conduct school work, difficulties adjusting to online school due to computer literacy levels, and familial responsibilities that often conflicted with their schooling, as well as feelings of boredom and sadness that consequently impacted their emotional and mental health state. Youth also noted opportunities such as spending more time with their parents who were unable to work due to the pandemic as well as feeling helpful in acting as caregivers to their siblings and in working alongside their parents. Implications for policymakers and educators are also discussed.
Collapse
Affiliation(s)
| | | | - Rahma Ahmed
- New York University Silver School of Social Work, United States
| |
Collapse
|
14
|
Barua M, Chowdhury S, Saha A, Mia C, Sajow SH, Sarker M. Community-based referral transportation system for accessing emergency obstetric services in the Rohingya refugee camp during the COVID-19 pandemic in Bangladesh: facilitators and barriers through beneficiaries' and providers' lens using a mixed-method design. Confl Health 2022; 16:51. [PMID: 36217169 PMCID: PMC9549832 DOI: 10.1186/s13031-022-00485-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/16/2022] [Indexed: 11/14/2022] Open
Abstract
Background Delays in seeking timely maternity care from health care professionals are crucial to address among the Rohingya population where many preventable pregnancy-related deaths occur within the camps when care is not sought. To address the challenges related to the referral of emergency and routine Sexual and Reproductive Health and Rights (SRHR) cases, United Nations Population Fund, through its partners, implemented a community-based referral transportation project called Referral hub. This paper presents the barriers and facilitators to the implementation of this referral transportation system from the perspectives of the beneficiaries and providers. Methods The research adopted a sequential explanatory mixed-method design. The quantitative phase consisted of a survey among 100 women while the qualitative phase comprised of in-depth interviews with a total of 12 mothers who used the services and key informant interviews with 21 providers. Results The barriers identified for referral hub are discordant understanding of emergency, strict gender norms and practices, distrust in providers, poor roads and mobile phone networks. The facilitators are partnership with the community, within and other organizations. Conclusion The study observed that the referral hub has a high potential to increase the utilization of SRHR services. Despite the barriers, the facilitating factors show a scope of improvement for these services.
Collapse
Affiliation(s)
- Mrittika Barua
- BRAC James P. Grant School of Public Health, Dhaka, Bangladesh.
| | | | - Avijit Saha
- BRAC James P. Grant School of Public Health, Dhaka, Bangladesh
| | - Chand Mia
- BRAC James P. Grant School of Public Health, Dhaka, Bangladesh
| | | | - Malabika Sarker
- BRAC James P. Grant School of Public Health, Dhaka, Bangladesh.,Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| |
Collapse
|
15
|
Islam MM, Rahman MM, Khan MN. Barriers to male condom use in Rohingya refugee camps in Bangladesh: A qualitative study. Lancet Reg Health Southeast Asia 2022; 2:100008. [PMID: 37383296 PMCID: PMC10305886 DOI: 10.1016/j.lansea.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Background Rohingya people are often called the most persecuted minority in the world. Currently, almost 800,000 Rohingya refugees live in temporary shelters in Cox's Bazar, Bangladesh. More than one-quarter of them are women and girls of reproductive age who are at increased risk of unplanned pregnancies, unsafe abortions and related complications. However, the use of contraception remains inadequate, and particularly use of condoms and male participation is scarce. This study examines the barriers to condom use as a contraceptive method among married Rohingya couples. Methods We conducted in-depth qualitative interviews of married Rohingya men and women and thematically analysed the data. Findings Depo Provera injections and pills are the dominant forms of contraception. Men's participation in family planning and contraceptive use is rare, and so is the use of condoms. Participants identified several barriers to condom use, including contraception being the responsibility of the women, socio-cultural issues, the stigma attached to condoms, unfamiliarity with condoms, the limitations of condoms, and issues of security in conjugal life. Health workers do not promote condoms in the same way as other contraceptive methods. Interpretation Condom use and men's participation in contraception use are rare in Rohingya camps. The involvement of family planning workers who are males may help to promote the use of condoms and increase the method-mix options of contraceptives. Funding La Trobe University, Melbourne, Australia.
Collapse
Affiliation(s)
- M Mofizul Islam
- Department of Public Health, La Trobe University, Melbourne, Australia
| | | | - Md Nuruzzaman Khan
- Department of Population Sciences, Jatiya Kabi Kazi Nazrul Islam University, Bangladesh
| |
Collapse
|
16
|
Islam MM, Khan MN, Rahman MM. Intimate Partner Abuse Among Rohingya Women and Its Relationship With Their Abilities to Reject Husbands' Advances to Unwanted Sex. J Interpers Violence 2022; 37:NP11315-NP11332. [PMID: 33546563 DOI: 10.1177/0886260521991299] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Currently, around a million Rohingya refugees live in Cox's Bazar, Bangladesh. Displacement from homelands and restrictions on movement in the refugee camps may exacerbate intimate partner abuse (IPA) against refugee women and their abilities to reject husbands' advances to unwanted sex. This study examines Rohingya refugee women's attitudes toward and experience of intimate partner abuse (IPA) and their impact on the abilities to reject husbands' advances to unwanted sex. A survey was conducted among Rohingya refugee women in Cox's Bazar, Bangladesh. Women's attitudes toward IPA, and experience of IPA were the exposure variables. Women's abilities to say "no" to husbands' advances to unwanted sexual intercourse was the outcome variable. Multivariable logistic regression models were used to examine the relationships. Participants' median age was 22 years (range: 13-41). Most women perceived hitting/beatings by their husbands in certain situations as justifiable, 72% had experienced such abuse and 56.5% had to engage in unwanted sexual intercourse with their husbands. Women with increasing leniency towards hitting/beatings and those who had experienced such abuse were less likely to be able to say "no" to husbands' advances to unwanted sexual intercourse. Rohingya women's attitudes toward and experience of IPA are associated with their abilities to say "no" to husbands' advances to unwanted sex. Intervention is needed to denormalize the current practice of IPA, create awareness against IPA, and ensure formal education for girls.
Collapse
|
17
|
Haider S, Maheen A, Ansari M, Stolley M. Health Beliefs and Barriers to Healthcare of Rohingya Refugees. J Racial Ethn Health Disparities 2022:10.1007/s40615-022-01342-2. [PMID: 35689155 DOI: 10.1007/s40615-022-01342-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 05/21/2022] [Accepted: 05/31/2022] [Indexed: 11/30/2022]
Abstract
In recent years, over 1,000 Rohingya families have been resettled to Milwaukee, Wisconsin from areas where they faced trauma and health disparities. To better understand their health beliefs and barriers to healthcare, we conducted a qualitative study with ten community health workers and stakeholders serving the Milwaukee Rohingya community. Interviews were transcribed, coded, and analyzed. Themes included: 1) health is defined as being able to meet basic needs of the family/community; 2) prior and existing mistrust and fear of systems of authority impact healthcare seeking behavior; 3) past-trauma negatively impacts physical and mental health; 4) religion and spirituality influence beliefs about illness, recovery, and wellbeing; 5) linguistic, cultural, and educational barriers impact access, quality of care, and understanding of disease. These results begin to address the significant gap in our knowledge of the health beliefs and needs of the local Rohingya community and underscore the need for tailored interventions.
Collapse
Affiliation(s)
- Shabi Haider
- Department of Medicine and Cancer Center, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 53226, US
| | - Aniya Maheen
- Department of Medicine and Cancer Center, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 53226, US
| | - Moiz Ansari
- Department of Medicine and Cancer Center, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 53226, US
| | - Melinda Stolley
- Department of Medicine and Cancer Center, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 53226, US.
| |
Collapse
|
18
|
Trager S, Leigh J, Woods A, Parmar P, Petty A, Haar R, Beyrer C. Consistency of reports of violence from northern Rakhine state in August 2017. Confl Health 2022; 16:22. [PMID: 35526032 PMCID: PMC9077994 DOI: 10.1186/s13031-022-00453-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 04/20/2022] [Indexed: 11/10/2022] Open
Abstract
Background In August 2017, Myanmar’s Armed Forces, the Tatmadaw, launched an orchestrated attack on hundreds of Rohingya-majority villages in northern Rakhine state. This study seeks to validate the consistency of previous reports of violence against the Rohingya people in the region carried out by the Tatmadaw, Border Guard Police, and Rakhine villagers in the late summer and early fall of 2017. Methods Internal validation data is from a three-armed study. Data analyzed in the external triangulation was sourced through a literature review of known, publicly available surveys and interviews. Both sets of data documented instances of violence against the Rohingya people in northern Rakhine state during the late summer and early fall of 2017. Consistency was evaluated across five indicators of violence: arson, presence of mass graves, reports of sexual violence and human injuries, as well as human fatalities, across 611 locales in northern Rakhine state. Further analysis was conducted to measure consistency of reports by locale and across locales by indicator. Results Overall, an internal validation of 94 hamlets found that 98% of these locales were consistent across at least four of the five indicators (80% + consistency). Arson and reports of human injuries were the most consistent indicators across locales (100% and 99% consistency, respectively) and sexual violence was the least consistent indicator, with 84% of participating locales exhibiting consistent reports of sexual violence between the qualitative and quantitative data. Similarly, an external validation of 57 locations found that 50 of the 57 locations (88%) were consistent across indicators. Arson was the most consistent across sources (96%), whereas source agreement across locations was the least consistent for reports of sexual violence (58%). Conclusion The government of Myanmar has denied involvement in the 2017 attacks on Rohingya communities in northern Rakhine state and purports that reports of the violence and destruction are overstated. However, consistent reporting from multiple sources on the same locales clearly underscores the veracity of the evidence documented, both by investigative groups and as recounted by Rohingya survivors of violence. It is our hope that this cataloging and comparison of available data, along with this study’s assessment of its consistency, will aid ongoing accountability efforts.
Collapse
Affiliation(s)
- Sarah Trager
- Johns Hopkins Center for Public Health and Human Rights, Baltimore, MD, USA.
| | - Jennifer Leigh
- Johns Hopkins Center for Public Health and Human Rights, Baltimore, MD, USA.,Physicians for Human Rights, New York, NY, USA
| | - Andrea Woods
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Parveen Parmar
- Clinical Emergency Medicine, University of Southern California, Los Angeles, CA, USA
| | - Agnes Petty
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rohini Haar
- Physicians for Human Rights, New York, NY, USA.,School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Chris Beyrer
- Johns Hopkins Center for Public Health and Human Rights, Baltimore, MD, USA
| |
Collapse
|
19
|
Kingston LN, Seibert Hanson AE. Marginalized and Misunderstood: How Anti- Rohingya Language Policies Fuel Genocide. Hum Rights Rev 2022; 23:289-303. [PMID: 37519926 PMCID: PMC8937497 DOI: 10.1007/s12142-022-00654-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/03/2022] [Indexed: 08/01/2023]
Abstract
Language plays a role in the genocide of the Rohingya people in Myanmar and continues to shape their experiences in displacement, yet their linguistic rights are rarely discussed in relation to their human rights and humanitarian concerns. International human rights standards offer important foundations for conceptualizing the "right to language" and identifying how linguistic rights can be violated both in situ and in displacement. The Rohingya case highlights how language policies are weaponized to oppress unwanted minorities; their outsider status is reinforced by the country's language education policy and they face additional rights challenges in displacement-including obstacles to effectively accessing humanitarian aid. Moving forward, norms associated with self-determination and language rights offer a conceptual foundation for shifting attitudes and altering negative perceptions of Rohingya identity.
Collapse
|
20
|
Palit S, Yang H, Li J, Khan MAS, Hasan MJ. The impact of the COVID-19 pandemic on the mental health of Rohingya refugees with pre-existing health problems in Bangladesh. Confl Health 2022; 16:10. [PMID: 35241122 PMCID: PMC8892402 DOI: 10.1186/s13031-022-00443-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 02/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental disorders among refugees have been well explored in several studies. However, longitudinal studies on the impact of the pandemic on refugee populations are widely lacking. This study was designed to examine the impact of the current pandemic on the mental health of Rohingya refugees living in Bangladesh. METHOD This longitudinal study involved a convenience sample of 732 Rohingya people with pre-existing health problems who lived in the Kutupalong refugee camp in Cox's Bazar, Bangladesh. The first recruitment was performed on 5 July 2019 (prepandemic visit) and assessed the health status of refugees using the Refugee Health Screener-15 (RHS-15). The follow-up survey was conducted on 10 November 2020, approximately 15 months later, during the pandemic. A total of 342 Rohingya refugees who completed the initial survey participated in the follow-up survey. A newly developed COVID-19 Impact on Quality of Life (COV19-QoL) scale was used alongside the RHS-15 scale during the second survey. Ethical measures were taken in compliance with the current Declaration of Helsinki. The analysis was performed using SPSS 26. RESULT A total of 342 Rohingya refugees completed this longitudinal survey. The average age of participants was 32.25 ± 14.01 years (SD), and the predominant age group was ≤ 30 years (n = 207, 60.5%). Most of the participants were female (n = 209, 61.1%). A significant increase in stress was noted from the prepandemic to pandemic periods, as determined by the RHS-15 scale (RHS-15 Part I: 22.96 ± 8.43 vs. 46.72 ± 1.87, p < 0.001; and RHS-15 Part II: 4.43 ± 1.59 vs. 6.91 ± 1.49, p < 0.001). The mean COV19-QoL score of the participants was 4.47 ± 0.15 (out of 5), indicating a perceived negative impact of the pandemic in their lives. In the multiple regression analysis, female sex (β = 0.604, p = 0.017) and COV19-QoL score (β = 2.537, p = 0.003) were significantly associated with higher perceived distress among participants. CONCLUSION Rohingya refugees experienced a significant deterioration of mental health during the COVID-19 pandemic. Alongside other socioeconomic, environmental, and political factors, the pandemic itself might have been a crucial contributor to this negative trend.
Collapse
Affiliation(s)
- Somen Palit
- Ningxia Medical University, Yinchuan, China.
| | | | | | | | | |
Collapse
|
21
|
Leigh J, Blum A, Petty A, Woods A, Parmar P, Beyrer C. Seeking justice amidst chaos: methods to identify and document individuals implicated in crimes against the Rohingya in August 2017. Confl Health 2022; 16:9. [PMID: 35236388 PMCID: PMC8892691 DOI: 10.1186/s13031-022-00438-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 02/08/2022] [Indexed: 11/29/2022] Open
Abstract
Background Documenting perpetrators of human rights violations enables effective prosecution and can help prevent future atrocities. Doing so calls for collecting reliable data using verifiable and transparent methodology. We present methods used to document crimes and identify alleged perpetrators implicated in the 2017 attacks against Rohingya civilians in Myanmar. The findings and lessons-learned have relevance to contemporary crises with widespread atrocities. Methods A mixed-methods assessment conducted from May to July 2018 included: (1) cross-sectional quantitative surveys among leaders of affected hamlets in northern Rakhine State, (2) qualitative interviews to record hamlet-level accounts, and (3) clinical evaluations of survivors of violence. Survey respondents who reported violence and destruction in each hamlet were asked to identify perpetrators of those acts, including known role or affiliation. The reported names were reviewed for clarity and divergent spellings, repeated references were aggregated, and the names and roles were analyzed and classified by location and affiliation. Results 143 individuals were implicated in atrocities committed across three Northern Rakhine townships. Each was independently identified by at least three separate survey respondents as directly committing violence or destruction in their hamlet of origin, or as witnessed while fleeing to Bangladesh. Two-thirds (69%) of identified perpetrators were reported by four or more participants and 47% by five or more. Some form of additional identifying information, was provided for 85% of names. The most common affiliations were: Myanmar army (n = 40), Border Guard Police (n = 32), Village Tract Administrators (n = 17), and extremists (n = 25). Conclusions The methodology presented here yielded a unique record of individuals purported to have directly committed acts of violence and destruction in Rakhine State in August 2017, forming the most extensive record of individuals implicated in ground-level perpetration of those crimes. This methodology can play a key role in accountability mechanisms for the Rohingya, and in other settings in which perpetrators are many and documentation of their crimes is difficult. The use of survey methods and standardized data collection amongst affected populations to comprehensively characterize crimes committed and to identify individuals implicated in those crimes can serve as a key tool in documentation and an important component of accountability.
Collapse
Affiliation(s)
- Jennifer Leigh
- Physicians for Human Rights, New York, NY, USA. .,Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Alexander Blum
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Agnes Petty
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Andrea Woods
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Parveen Parmar
- Clinical Emergency Medicine, University of Southern California, Los Angeles, CA, USA
| | - Chris Beyrer
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
22
|
Anwar A, Mondal PK, Yadav UN, Shamim AA, Rizwan AAM, Mistry SK. Implications of updated protocol for classification of childhood malnutrition and service delivery in world's largest refugee camp amid this COVID-19 pandemic. Public Health Nutr 2022;:1-12. [PMID: 35016741 DOI: 10.1017/S1368980022000052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objectives: During the COVID-19 pandemic, the authorities made a change in the classification of malnutrition and concomitant service delivery protocol among the Rohingya children, residing in world’s largest refugee camp, located in Cox’s Bazar, Bangladesh. In this paper, we discussed the potential implications of this updated protocol on the malnutrition status among children residing in the Rohingya camps. Design: This paper reviewed relevant literature and authors’ own experience to provide a perspective of the updated protocol for the classification of malnutrition among the children in the Rohingya camps and its implication from a broader perspective. Setting: Rohingya refugee camps, Bangladesh. Participants: Children aged less than five years residing in the Rohingya camps. Results: Major adaptation during this COVID-19 was the discontinuation of using weight-for-height z-score (WHZ) and the use of only mid upper arm circumference (MUAC) and presence of oedema for admission, follow-up and discharge of malnourished children in the camps. However, evidence suggests that use of MUAC only can underestimate the prevalence of malnutrition among the children in Rohingya camps. These apparently non-malnourished children are devoid of the rations that they would otherwise receive if classified as malnourished, making them susceptible to more severe malnutrition. Conclusions: Our analysis suggests that policymakers should consider using the original protocol of using both MUAC and WHZ to classify malnutrition and retain the guided ration size. We also believe that it would not take an extra effort to adopt the original guideline as even with MUAC only guideline, certain health measures needed to adopt during this pandemic.
Collapse
|
23
|
Hossain MA, Dawson A. A Systematic review of sexual and reproductive health needs, experiences, access to services, and interventions among the rohingya and the afghan refugee women of reproductive age in Asia. WHO South East Asia J Public Health 2022; 11:42-53. [PMID: 36308272 DOI: 10.4103/who-seajph.who-seajph_144_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Approximately 9.2 million refugees live in Asia, with most originating from Afghanistan and Myanmar, and half of them are women, girls, and children. Humanitarian crises disrupt the existing health-care system, limiting access to sexual and reproductive health (SRH) services. This review explores the SRH status of Afghan and Rohingya refugee women of reproductive age in Asia and their needs and experiences in accessing these services and commodities. MATERIALS AND METHODS We used the PRISMA checklist and searched for qualitative and quantitative peer-reviewed studies from five online bibliographic databases, SCOPUS, EMBASE (Ovid), MEDLINE (Ovid), CINAHL, and PROQUEST, from January 2000 to April 2021. Content analysis was undertaken following the minimum initial service package objectives. RESULTS Fifteen studies were included in this review from four countries: Bangladesh (5), Pakistan (5), Iran (4), and Malaysia (1). Approximately 50.91% of Rohingya and 54% of Afghan refugee women used contraceptives. About 56.6% of Afghan refugee mothers experienced pregnancy-related complications, one-third received antenatal care, and low birth weight was 2.6 times higher among infants born to Afghan refugee mothers than to Pakistani-born mothers. One out of five Rohingya women received delivery-related care. Approximately 72% of Rohingya and 79.8% of Afghan refugee women had experienced gender-based violence, and 56.5% of Rohingya women engaged in unwanted sexual intercourse with their husbands. CONCLUSION Social norms, stigma, cultural values, distrust of providers, inadequate staff, and prohibition by family members limit their access to SRH services and influence their needs, knowledge, and perceptions regarding SRH.
Collapse
Affiliation(s)
- Muhammad Anwar Hossain
- Department of Sociology, Begum Rokeya University, Rangpur, Bangladesh; Western Sydney Sexual Health, Sydney Medical School, University of Sydney, Australia
| | - Angela Dawson
- Professor, School of Public Health, Faculty of Health, University of Technology, Sydney, Australia
| |
Collapse
|
24
|
Sudheer N, Banerjee D. The Rohingya refugees: a conceptual framework of their psychosocial adversities, cultural idioms of distress and social suffering. Glob Ment Health (Camb) 2021; 8:e46. [PMID: 35003755 PMCID: PMC8715339 DOI: 10.1017/gmh.2021.43] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/17/2021] [Accepted: 11/11/2021] [Indexed: 12/19/2022] Open
Abstract
Rohingya refugees, a group of religious and ethnic minorities, primarily reside in the South Asian nations. With decades of displacement, forced migration, limited freedom of movement, violence and oppression, they have been termed by the United Nations (UN) as the 'most persecuted minority group' in world history. Literature shows an increased prevalence of psychiatric disorders such as depression, anxiety, post-traumatic stress, insomnia, etc., in this population. However, beyond 'medicalisation', the psychosocial challenges of the Rohingyas need to be understood through the lens of 'social suffering', which results from a complex interplay of multiple social, political, environmental and geographical factors. Lack of essential living amenities, poverty, unemployment, overcrowding, compromised social identity, and persistent traumatic stressors lead to inequality, restricted healthcare access, human rights deprivation and social injustice in this group. Even though the United Nations High Commission for Refugees (UNHCR) has taken a renewed interest in Rohingya re-establishment with well-researched standards of care, there are several pragmatic challenges in their implementation and inclusion in policies. This paper reviews these multi-dimensional psychosocial challenges of the Rohingyas by synthesising various intersecting conceptual models including minority stress, health-stigma-discrimination framework, refugee ecological model and capability approach. Furthermore, it highlights multidisciplinary interventions to mitigate these adversities, improve their living situation and eventually foster healing via means which are culturally relevant and contextually appropriate. These interventions need to involve various stakeholders from a human rights and dignity based lens, including the voices of the Rohingyas and supported by more research in this area.
Collapse
Affiliation(s)
- Nivedita Sudheer
- Department of Psychiatry, Christian Medical College, Vellore, India
| | - Debanjan Banerjee
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| |
Collapse
|
25
|
Mistry SK, Ali ARMM, Yadav UN, Huda MN, Ghimire S, Rahman MA, Reza S, Huque R, Rahman MA. Perceived Change in Tobacco Use and Its Associated Factors among Older Adults Residing in Rohingya Refugee Camps during the COVID-19 Pandemic in Bangladesh. Int J Environ Res Public Health 2021; 18:ijerph182312349. [PMID: 34886073 PMCID: PMC8657143 DOI: 10.3390/ijerph182312349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/15/2021] [Accepted: 11/22/2021] [Indexed: 12/13/2022]
Abstract
This study explored the perceived change in tobacco use during the COVID-19 pandemic and its associated factors among older adults residing in Rohingya refugee camps, also referred to as Forcibly Displaced Myanmar Nationals in Bangladesh. The study followed a cross-sectional design and was conducted in October 2020 among 416 older adults aged 60 years and above. A purposive sampling technique was applied to identify eligible participants, and face-to-face interviews were conducted using a pre-tested semi-structured questionnaire to collect the data. Participants were asked if they noted any change in their tobacco use patterns (smoking or smokeless tobacco) during the COVID-19 pandemic compared to pre-pandemic. Binary logistic regression models determined the factors associated with the perceived change in tobacco use. More than one in five participants (22.4%) were current tobacco users, of whom 40.8% reported a perceived increase in tobacco use during the COVID-19 pandemic. Adjusted analysis revealed that participants who were concerned about COVID-19 had significantly (p < 0.05) lower odds of perceived increase in tobacco use (aOR = 0.22, 95% CI: 0.06–0.73), while older adults who were overwhelmed by COVID-19 (aOR = 0.26, 95% CI: 0.06–1.18) and communicated less frequently with others during the pandemic than before (aOR = 0.19, 95% CI: 0.03–1.20) had marginally significantly (p < 0.1) lower odds of perceived increase in tobacco use during this pandemic. Relevant stakeholders, policymakers, and practitioners need to focus on strengthening awareness-raising initiatives as part of an emergency preparedness plan to control tobacco use during such a crisis period.
Collapse
Affiliation(s)
- Sabuj Kanti Mistry
- ARCED Foundation, Dhaka 1216, Bangladesh;
- Centre for Primary Health Care and Equity, University of New South Wales, Kensington, NSW 2052, Australia;
- BRAC James P Grant School of Public Health, BRAC University, Dhaka 1213, Bangladesh
- Department of Public Health, Daffodil International University, Dhaka 1207, Bangladesh
- Correspondence: ; Tel.: +61-4068-63358
| | - ARM Mehrab Ali
- ARCED Foundation, Dhaka 1216, Bangladesh;
- Global Research and Data Support, Innovations for Poverty Action, New Haven, CT 06510, USA
| | - Uday Narayan Yadav
- Centre for Primary Health Care and Equity, University of New South Wales, Kensington, NSW 2052, Australia;
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, ACT 2600, Australia
| | - Md. Nazmul Huda
- School of Health Sciences, Western Sydney University, Sydney, NSW 2560, Australia;
- The School of Liberal Arts and Social Sciences, Independent University, Dhaka 1229, Bangladesh
| | - Saruna Ghimire
- Department of Sociology and Gerontology and Scripps Gerontology Center, Miami University, Oxford, OH 45056, USA;
| | | | - Sompa Reza
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka 1000, Bangladesh;
| | - Rumana Huque
- Department of Economics, University of Dhaka, Dhaka 1000, Bangladesh;
- ARK Foundation, Gulshan, Dhaka 1212, Bangladesh
| | - Muhammad Aziz Rahman
- School of Health, Federation University Australia, Berwick, VIC 3350, Australia;
- Department of Non-Communicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka 1216, Bangladesh
- Faculty of Public Health, Universitas Airlangga, Surabaya 60115, Indonesia
| |
Collapse
|
26
|
Rahman MS, Sakib NH. Statelessness, forced migration and the security dilemma along borders: an investigation of the foreign policy stance of Bangladesh on the Rohingya influx. SN Soc Sci 2021; 1:160. [PMID: 34693327 PMCID: PMC8241465 DOI: 10.1007/s43545-021-00173-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 06/05/2021] [Indexed: 11/27/2022]
Abstract
Statelessness not only triggers crises within the boundaries of a state, but these crises often spread along borders. The Rohingya refugee crisis, resulting from systematic state atrocities towards a stateless community, has resulted in a massive wave of forced migration to neighbouring Bangladesh. Subsequently, the large number of refugees is exerting enormous pressure on the economy of this developing nation. The crisis can be understood from the perspectives of both human concerns and Bangladesh’s traditional security concerns. Furthermore, the COVID-19 pandemic is bringing additional challenges. This study investigates and examines the nature of the dilemma faced by the Bangladesh government in its foreign policy strategy over the Rohingya refugee crisis. It is argued that Bangladesh is facing dual challenges from the national and human security perspectives, and that the regional interests of major players, such as India, China, Russia and Japan, are determining the country’s policy stance. It is also argued that the plight of the Rohingya people through their statelessness has become less decisive in the major powers’ diplomatic calculations. The findings suggest that Bangladesh should accentuate its efforts to internationalise the issue and engage in a vigilant balancing between the major players for the repatriation of refugees, while, at the same time, exerting bilateral pressure on Myanmar.
Collapse
Affiliation(s)
| | - Nurul Huda Sakib
- Department of Government and Politics, Jahangirnagar University, Savar, Dhaka, Bangladesh.,Department of Government and Politics, Jahangirnagar University, Dhaka, Bangladesh
| |
Collapse
|
27
|
Lee MJ. Media influence on humanitarian interventions: analysis of the Rohingya refugee crisis and international media coverage. J Int Humanit Action 2021; 6:20. [PMID: 38624772 PMCID: PMC8519737 DOI: 10.1186/s41018-021-00108-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/28/2021] [Indexed: 04/17/2024]
Abstract
In 2017, the long-festering discriminatory treatment to the Rohingyas in Myanmar, both in law and practice, resulted in the largest cross-border humanitarian crisis in Asia. During the 2016‑2017 Rohingya refugee crisis, the aerial shots of burnt villages and images of people trudging toward the horizon in search of refuge in neighboring nations dominated the Western media. However, for humanitarians, the question of whether the media helps with humanitarian crises remains complicated and unclear. This study examines the effects of media coverage on the Rohingya refugee crisis based on articles from two liberal, elite newspaper sources, The New York Times and The Guardian between 2010 and 2020. The study reveals that the attempts of international pressure to stop the crisis have increased through media coverage and political pressures; however, the number of Rohingya refugees fleeing Myanmar intensified due to worsening violence and human rights violations committed by the Myanmar army. Findings are discussed using the lens of cultural and ideological context. The study suggests that in Myanmar, where authoritarian military culture is pervasive, there is a limited influence of the international press on the state-sponsored ethnic cleansing of the Rohingya population and questions whether consistent international pressure could have changed the outcome.
Collapse
Affiliation(s)
- Michelle J. Lee
- Department of Population and Family Health, Columbia University, 722 W 168th St, New York, NY 10032 USA
| |
Collapse
|
28
|
Khan S, Haque S. Autobiographical memory impairment among Rohingya refugee people: roles of direct and indirect trauma exposures and PTSD symptom severity. Cogn Emot 2021; 35:1573-1587. [PMID: 34644246 DOI: 10.1080/02699931.2021.1990018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Literature indicates that trauma exposure leads to autobiographical memory (AM) impairment, but the differential effects of direct and indirect trauma on memory remain unclear. We investigated AMs of 100 Rohingya refugees (Meanage = 35.79; SDage = 15.36) recruited from camps in Bangladesh and communities in Malaysia. Each participant retrieved ten memories to word cues and rated to what extent those memories were self-defining on a 5-point scale. They also completed the PTSD-8 scale and a trauma checklist reporting the types of traumatic events they experienced. Results showed that participants with frequent exposure to direct and indirect trauma recalled more traumatic memories. Surprisingly, more direct-trauma memories appeared to be specific than indirect trauma and non-trauma memories. As expected, individuals who scored higher on the PTSD-8 scale recalled more non-specific AMs. Rohingyas in Bangladesh who migrated months before data collection, thus retaining recent trauma experiences , retrieved more non-specific memories than those in Malaysia who migrated years ago. The direct trauma memories of the Malaysian cohort were more self-defining than their counterparts. The participant's ability to recall more direct trauma memories with specificity could be attributed to the repeated recall of those memories to the relevant authorities of the host countries to justify their refugee status.
Collapse
Affiliation(s)
- Sanjida Khan
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Selangor, Malaysia.,Department of Psychology, Jagannath University, Dhaka, Bangladesh
| | - Shamsul Haque
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Selangor, Malaysia
| |
Collapse
|
29
|
Guglielmi S, Seager J, Mitu K, Baird S, Jones N. Exploring the impacts of COVID-19 on Rohingya adolescents in Cox's Bazar: A mixed-methods study. J Migr Health 2021; 1-2:100031. [PMID: 34405179 PMCID: PMC8352087 DOI: 10.1016/j.jmh.2020.100031] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/04/2020] [Accepted: 12/05/2020] [Indexed: 11/30/2022] Open
Abstract
This article explores how intersecting vulnerabilities faced by Rohingya adolescents living in Cox's Bazar, Bangladesh, have been exacerbated during the COVID-19 pandemic. Both the direct health impacts and the indirect repercussions of COVID-19 mitigation strategies have served to heighten pre-existing risks, preventing adolescents from reaching their full capabilities. This article provides empirical mixed-methods data from the Gender and Adolescence: Global Evidence (GAGE) longitudinal study, drawing on phone surveys adolescents aged 10-14 and 15-19 (1,761), qualitative interviews with adolescents aged 15-19 years (30), and key informant interviews (7) conducted between March and August 2020 with both Rohingya and Bangladeshi adolescents residing in refugee camps and host communities, respectively. While this article focuses on displaced Rohingya adolescents' experiences during COVID-19, we contextualize our findings by drawing on data collected from Bangladeshi adolescents who serve as comparators. Findings highlight that the pandemic has lead to a decline in Rohingya adolescents' reported health status, exacerbated food insecurity, educational and economic marginalization and bodily integrity risks, amongst both girls and boys. This paper concludes by reflecting on the policy implications necessary to safeguard refugee adolescent trajectories in the context of COVID-19.
Collapse
Affiliation(s)
- Silvia Guglielmi
- Gender and Adolescence: Global Evidence (GAGE), Overseas Development Institute, 203 Blackfriars Road, London SE1 8NJ, United Kingdom
| | - Jennifer Seager
- Department of Global Health, George Washington University, 950 New Hampshire Ave NW, Washington DC 20052, United States
| | - Khadija Mitu
- Department of Anthropology, University of Chittagong, Chittagong University Rd, Chittagong 4331, Bangladesh
| | - Sarah Baird
- Department of Global Health, George Washington University, 950 New Hampshire Ave NW, Washington DC 20052, United States
| | - Nicola Jones
- Gender and Adolescence: Global Evidence (GAGE), Overseas Development Institute, 203 Blackfriars Road, London SE1 8NJ, United Kingdom
| |
Collapse
|
30
|
Abstract
Currently, around a million Rohingya refugees live in Cox’s Bazar, Bangladesh. This study examines the attitudes toward physical abuse and experiences of intimate partner violence (IPV) of Rohingya refugee women who experienced child marriage. A cross-sectional survey was conducted in the Rohingya refugee settlement at Cox’s Bazar, Bangladesh. Attitudes towards physical abuse have been assessed by a set of five questions that asked the situation under which ‘hitting or beating’ one’s wife is justifiable. Multivariable logistic regressions are used to examine the associations of exposure to child marriage with (i) attitudes towards the justification of physical abuse by one’s husband and (ii) experiences of IPV in the 12 months prior to the survey. Data are available for 486 participants. Overall, 61.32% of women experienced child marriage (married before 18 years of age) and they were more likely to have strongly justified beatings/hitting one’s wife under certain circumstances (Adjusted Odds Ratio (AOR) = 2.71; 95%CI: 1.78, 4.11), and to have experienced such IPV by their husbands in the 12 months prior to the survey (AOR = 1.72; 95%CI: 1.13, 2.61). These AORs are higher for women married at ages 12–14 than those married at 15–17. Having some formal education among husband and wife is protective of abuse within a marriage. Rohingya women’s attitudes towards and experiences of IPV are associated with their exposure to child marriage. Interventions for stopping child marriage, marriage registration, social support group, and legal interventions are needed. Offering formal education to all children needs to be prioritized.
Collapse
Affiliation(s)
- M Mofizul Islam
- Department of Public Health, La Trobe University, Melbourne, Australia
| | - Md Nuruzzaman Khan
- Department of Population Sciences, Jatiya Kabi Kazi Nazrul Islam University, Dhaka, Bangladesh
| | | |
Collapse
|
31
|
Aung TS, Unruh J, Ali F. Modelling the determinants of voluntary repatriation: The role of ecosystem services in post-conflict reconstruction in Rakhine. J Environ Manage 2021; 290:112540. [PMID: 33865157 DOI: 10.1016/j.jenvman.2021.112540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/15/2021] [Accepted: 03/31/2021] [Indexed: 06/12/2023]
Abstract
Voluntary repatriation has the utmost importance in the contemporary understanding of refugee protection. Voluntary repatriation in safety and with dignity is considered to be the most desirable and durable solutions for refugees. However, voluntary repatriation represents increasingly daunting challenges to the refugees, the governments of both home and host countries, and implementing partners. The repatriation planning of Rohingya refugees is widely criticized as being profoundly premature and dangerous. Most of the refugees are set to return to destroyed villages where food and shelter are inadequate, ecosystem services overstretched, livelihood opportunities marginal and the physical environment unfit for human habitation. Investigating the view and perspectives of the refugees on the factors that influence their intention to return can inform the implementing actors to secure those conditions and ensure a durable solution. Here, we identify the conditions that influence the decisions by Rohingya refugees in protracted displacement regarding return to Myanmar. This research also addresses the dual challenges of repatriation and sustainable post-conflict reconstruction, and, more specifically, provides a framework on how to integrate ecosystem services in the repatriation process.
Collapse
Affiliation(s)
- Thiri Shwesin Aung
- Asia Center, Faculty of Arts and Sciences, Harvard University, Cgis South, 1730 Cambridge St, Cambridge, MA, 02138, USA.
| | - Jon Unruh
- Department of Geography, McGill University, 805 Sherbrooke Street West, Montreal, QC, H3A 2K6, Canada
| | - Faizan Ali
- Muma College of Business, University of South Florida, USA
| |
Collapse
|
32
|
Mair L, Relan P, Hamilton DO, Al-Noman A, O'Dempsey T. Lessons learned from an under-reported mumps epidemic among Rohingya refugees in Cox's Bazar District, Bangladesh. Trans R Soc Trop Med Hyg 2021; 114:635-638. [PMID: 32585031 PMCID: PMC7456598 DOI: 10.1093/trstmh/traa048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/24/2020] [Accepted: 06/04/2020] [Indexed: 11/29/2022] Open
Abstract
Background In 2018, a large mumps epidemic coincided with an outbreak of diphtheria in refugee camps established in Bangladesh for the Rohingya people. These refugees did not receive a mumps-containing vaccine. Methods Cases of mumps were reported to the WHO's Early Warning, Alert and Response System (EWARS) during the Rohingya refugee crisis. The authors present amalgamated epidemiological data of a major, previously under-reported, mumps epidemic. Results In total, 19 215 mumps cases across a total of 218 facilities were reported to EWARS during 2018. The attack rate was 2.1% of the whole population. Of these cases, 7687 (40%) were in children aged <5 y. Mumps was more commonly seen among males than females. Conclusion Detailed reporting of outbreaks of all vaccine-preventable diseases is essential to ensure appropriate vaccination decisions can be made in future humanitarian crises.
Collapse
Affiliation(s)
- Luke Mair
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.,Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.,Infectious Diseases Department, Sheffield Teaching Hospitals, Sheffield, UK
| | - Pryanka Relan
- Department of Emergency Medicine, Mount Sinai Health System, New York, NY, USA
| | - David Oliver Hamilton
- Critical Care Department, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Abdullah Al-Noman
- Department of Maternal & Child Health, National Institute of Preventive and Social Medicine (NIPSOM), Dhaka, Bangladesh
| | - Timothy O'Dempsey
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| |
Collapse
|
33
|
O’Connor K, Seager J. Displacement, Violence, and Mental Health: Evidence from Rohingya Adolescents in Cox's Bazar, Bangladesh. Int J Environ Res Public Health 2021; 18:5318. [PMID: 34067724 PMCID: PMC8156348 DOI: 10.3390/ijerph18105318] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/23/2021] [Accepted: 05/14/2021] [Indexed: 11/17/2022]
Abstract
The Rohingya have endured generations of trauma through displacement and targeted violence in Myanmar. Hundreds of thousands have been forced out of the country, with a large proportion settling in refugee camps in Cox's Bazar, Bangladesh. This study examines the impacts of exposure to trauma on mental health outcomes among Rohingya adolescents living in Bangladesh. Post-traumatic stress disorder (PTSD) and depression are examined as outcomes. The main explanatory variable is a measure of exposure to trauma at two levels of proximity (experiencing and witnessing). Resilience is investigated as a potential effect modifier. Experiencing and witnessing traumatic events are positively and significantly associated with PTSD and depression. However, this effect is only seen for PTSD as a continuous measure, reflecting high rates of low-level PTSD in this population. Resilience is found to reduce the effects of trauma on depression, indicating an effect modification of this relationship.
Collapse
Affiliation(s)
| | - Jennifer Seager
- Department of Global Health, George Washington University, 950 New Hampshire Ave, Washington, DC 20052, USA;
| |
Collapse
|
34
|
Al Azdi Z, Islam K, Khan MA, Khan N, Ejaz A, Khan MA, Warraitch A, Jahan I, Huque R. Effectiveness of an Integrated Care Package for Refugee Mothers and Children: Protocol for a Cluster Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e25047. [PMID: 33944793 PMCID: PMC8132976 DOI: 10.2196/25047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/26/2021] [Accepted: 03/09/2021] [Indexed: 11/17/2022] Open
Abstract
Background Thousands of Rohingya refugee mothers at the world’s largest refugee camp located in Bangladesh are at risk of poor mental health. Accordingly, their children are also vulnerable to delayed cognitive and physical development. Objective The aim of this study is to evaluate the effectiveness of an integrated care package in reducing the prevalence of developmental delays among children aged 1 year and improving their mothers’ mental health status. Methods This is a parallel, two-arm, single-blind, cluster randomized controlled trial (cRCT). A total of 704 mother-child dyads residing at the Kutupalong refugee camp in Cox’s Bazar, Bangladesh, will be recruited from 22 clusters with 32 mother-child dyads per cluster. In the intervention arm, an integrated early childhood development and maternal mental health package will be delivered every quarter to mothers of newborns by trained community health workers until the child is 1 year old. Our primary outcome is a reduction in the prevalence of two or more childhood developmental delays of infants aged 1 year compared to the usual treatment. The secondary outcomes include reduced stunting among children and the prevalence of maternal depression. We will also assess the cost-effectiveness of the integrated intervention, and will further explore the intervention’s acceptability and feasibility. Results At the time of submission, the study was at the stage of endpoint assessment. The data analysis started in December 2020, and the results are expected to be published after the first quarter of 2021. Conclusions This study will address the burden of childhood developmental delays and poor maternal mental health in a low-resource setting. If proven effective, the delivery of the intervention through community health workers will ensure the proposed intervention’s sustainability. Trial Registration ISRCTN Registry ISRCTN10892553; https://www.isrctn.com/ISRCTN10892553 International Registered Report Identifier (IRRID) DERR1-10.2196/25047
Collapse
Affiliation(s)
| | | | | | - Nida Khan
- Association for Social Development, Lahore, Pakistan
| | - Amna Ejaz
- Association for Social Development, Lahore, Pakistan
| | | | | | | | | |
Collapse
|
35
|
Khaled AFM. Do No Harm in refugee humanitarian aid: the case of the Rohingya humanitarian response. J Int Humanit Action 2021; 6:7. [PMID: 38624853 PMCID: PMC7938038 DOI: 10.1186/s41018-021-00093-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 02/28/2021] [Indexed: 06/18/2023]
Abstract
The article broadly examines how humanitarian aid for Rohingya refugees inadvertently harmed poorer hosts and adversely affected local capacities for peace. The article also discusses possible ways of easing tension and improving social cohesion in the refugee-hosting areas, while also highlighting how policy- and mandate-related constraints hinder a humanitarian response anchored in the "Do No Harm" principle. Finally, the article concludes with the argument that the humanitarian agencies should not just limit themselves to identifying the unintended consequences and lapses in the intervention. Instead, the Do No Harm principle should lead humanitarian aid agencies to make an active effort to accept responsibility for the harm while taking all necessary steps to mitigate or avoid harming in future interventions.
Collapse
Affiliation(s)
- Abu Faisal Md. Khaled
- Dept. of International Relations, Bangladesh University of professionals (BUP), Dhaka, Bangladesh
| |
Collapse
|
36
|
Persson M, Larsson EC, Islam NP, Gemzell-Danielsson K, Klingberg-Allvin M. A qualitative study on health care providers' experiences of providing comprehensive abortion care in Cox's Bazar, Bangladesh. Confl Health 2021; 15:6. [PMID: 33441171 DOI: 10.1186/s13031-021-00338-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 01/02/2021] [Indexed: 12/03/2022] Open
Abstract
Background Humanitarian settings are characterised by limited access to comprehensive abortion care. At the same time, humanitarian settings can increase the vulnerability of women and girls to unintended pregnancies and unsafe abortions. Humanitarian actors and health care providers can play important roles in ensuring the availability and accessibility of abortion-related care. This study explores health care providers’ perceptions and experiences of providing comprehensive abortion care in a humanitarian setting in Cox’s Bazar, Bangladesh and identifies barriers and facilitators in service provision. Method In-depth interviews (n = 24) were conducted with health care providers (n = 19) providing comprehensive abortion care to Rohingya refugee women and with key informants (n = 5), who were employed by an organisation involved in the humanitarian response. Data were analysed using an inductive content analysis approach. Results The national menstrual regulation policy provided a favourable legal environment and facilitated the provision of comprehensive abortion care, while the Mexico City policy created organisational barriers since it made organisations unable or unwilling to provide the full comprehensive abortion care package. Supplies were available, but a lack of space created a barrier to service provision. Although training from organisations had made the health care providers confident and competent and had facilitated the provision of services, their knowledge of the national abortion law and menstrual regulation policy was limited and created a barrier to comprehensive abortion services. Even though the health care providers were willing to provide comprehensive abortion care and had acquired skills and applied strategies to communicate with and provide care to Rohingya women, their personal beliefs and their perceptions of Rohingya women influenced their provision of care. Conclusion The availability and accessibility of comprehensive abortion care was limited by unfavourable abortion policies, a lack of privacy, a lack of knowledge of abortion laws and policies, health care providers’ personal beliefs and a lack of cultural safety. To ensure the accessibility and availability of quality services, a comprehensive approach to sexual and reproductive health and rights is needed. Organisations must ensure that health care providers have knowledge of abortion policies and the ability to provide quality care that is woman-centred and non-judgmental. Supplementary Information The online version contains supplementary material available at 10.1186/s13031-021-00338-9.
Collapse
|
37
|
Rashid R, Uddin AMS, Nu PC, Salam A, Barua S, Mannan A, Shahjahan M, Ahmed MU, Rahman R, Dondorp A, Maude RJ, Deen J, von Seidlein L, Faiz MA. A descriptive study of Forcefully Displaced Myanmar Nationals (FDMN) presenting for care at public health sector hospitals in Bangladesh. Glob Health Action 2021; 14:1968124. [PMID: 34493163 PMCID: PMC8439211 DOI: 10.1080/16549716.2021.1968124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND In 2017 hundreds of thousands of 'Rohingya' fled to camps for Forcefully Displaced Myanmar Nationals (FDMN) in Cox's Bazar, Bangladesh. OBJECTIVE To describe the FDMNs presenting for care at public health facilities in Bangladesh so as to understand the health problems faced by the FDMNs and the burden on these public health facilities. METHODS This study combined a retrospective review of existing hospital and clinic data with prospective surveillance in government health care centres. FINDINGS The retrospective data showed a 26% increase in the number of consultations at the Kutupalong community clinic, the primary health facility closest to the camps, from 19,567 in 2015 to 26,309 in 2019. There was a corresponding 11% increase in admissions to health facilities in the area, from 80,991 in 2017 to 91,424 in 2019. Prospective surveillance of 9,421 FDMNs seeking health care from July 2018 to December 2019 showed that 29% had an infectious disease, 20% nutritional problems, 12% pregnancy-related conditions and 7% trauma or injury. CONCLUSIONS Great uncertainty remains regarding the return of FDMN to their home country of Myanmar. The current on-going protests following the military coup adds further insecurity to the status of the Rohingya. The presence of a large migrant population relative to a smaller host community burdens the limited facilities and resources of the public health sector. Continued support by the international public health community and civil society organizations is needed.
Collapse
Affiliation(s)
- Rumana Rashid
- Epidemiology and Community Medicine, Bangladesh Institute of Tropical and Infectious Diseases (BITID) Faujdarhat, Chattogram, Bangladesh
| | | | - Pu Chaw Nu
- Internal Medicine, Sadar Hospital, Cox's Bazar, Bangladesh
| | - Abdus Salam
- Civil Surgeon (Former), Cox's Bazar, Bangladesh
| | - Sumon Barua
- Upazila Health and Family Planning Officer (UHFPO), Teknaf, Cox's Bazar, Bangladesh
| | - Abdul Mannan
- Upazila Health and Family Planning Officer (UHFPO), Ukhiya, Cox's Bazar, Bangladesh
| | | | - Misbah Uddin Ahmed
- Assistant Director, National Institute of Kidney Diseases, Dhaka, Bangladesh
| | - Ridwanur Rahman
- Research Centre, Universal Medical College, Dhaka, Bangladesh
| | - Arjen Dondorp
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Richard J Maude
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Harvard T.H. Chan School of Public Health, Harvard University, Boston, USA.,The Open University, Milton Keynes, UK
| | - Jaqueline Deen
- Child Health, Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines, Manila, Philippines
| | - Lorenz von Seidlein
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Mohammad Abul Faiz
- Director General of Health Services, Dhaka, Bangladesh (Retired).,Dev Care Foundation, Dhaka, Bangladesh
| |
Collapse
|
38
|
Ahmed S, Simmons WP, Chowdhury R, Huq S. The sustainability-peace nexus in crisis contexts: how the Rohingya escaped the ethnic violence in Myanmar, but are trapped into environmental challenges in Bangladesh. Sustain Sci 2021; 16:1201-1213. [PMID: 33897904 PMCID: PMC8053562 DOI: 10.1007/s11625-021-00955-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 04/07/2021] [Indexed: 05/21/2023]
Abstract
Because of ethnic and cultural violence in Myanmar, approximately a million Rohingya fled to neighboring Bangladesh starting from August 2017, in what the UN has called a "textbook example of ethnic cleansing". Those arriving in Bangladesh were able to escape decade-long ethnic violence in Myanmar, but the Rohingya's immediate destination, Cox's Bazar district is one of the most climate-vulnerable and disaster-prone areas in Bangladesh. Currently, they have been subjected to extreme rainfalls, landslides, and flashfloods. With the COVID-19 pandemic, they continue to face fear and further marginalization in resource-constrained Bangladesh, as well as increased vulnerability due to tropical cyclones, flashfloods, and landslides. The Rohingya in southeast Bangladesh are now at the epicenter of a humanitarian and sustainability crisis. However, their situation is not entirely unique. Millions of displaced, stateless or refugees around the world are facing multi-dimensional crises in various complex geopolitical, and climatic situations. Using the theoretical lens of political ecology and critical development studies, this paper analyzes the sustainability-peace nexus for millions of Rohingya in Myanmar and in Bangladesh. This paper is based on information from various sources, including three ethnographic field visits in recent years, which helped to get local insights into the current sustainability challenges in this humanitarian context. The core arguments of this paper suggest that sustainability-peace nexus will especially be compromised in climate-vulnerable resource-constrained conditions. To overcome this challenge, decolonizing Rohingya solutions would be critical, by engaging the Rohingya in the process of development and meaningful change, which can affect their lives, livelihoods, and wellbeing. Even though this paper has a specific geographical focus, the insights are relevant in parts of the world facing similar social, economic, political, and environmental challenges.
Collapse
Affiliation(s)
- Saleh Ahmed
- School of Public Service, Boise State University, Boise, ID 83725 USA
| | - William Paul Simmons
- Gender and Women’s Studies, University of Arizona, Tucson, AZ 85721 USA
- Human Rights Practice Program, University of Arizona, Tucson, AZ 85721 USA
| | - Rashed Chowdhury
- Pacific ENSO Applications Climate Center, Joint Institute for Marine and Atmospheric Research, University of Hawaii At Manoa, Honolulu, HI 96822 USA
| | - Saleemul Huq
- International Centre for Climate Change and Development (ICCCAD), Independent University, Bangladesh (IUB), Dhaka, 1229 Bangladesh
| |
Collapse
|
39
|
Mistry SK, Ali ARMM, Irfan NM, Yadav UN, Siddique RF, Peprah P, Reza S, Rahman Z, Casanelia L, O'Callaghan C. Prevalence and correlates of depressive symptoms among Rohingya (forcibly displaced Myanmar nationals or FDMNs) older adults in Bangladesh amid the COVID-19 pandemic. Glob Ment Health (Camb) 2021; 8:e23. [PMID: 34226848 DOI: 10.1017/gmh.2021.24] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 05/24/2021] [Accepted: 06/07/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Depression is globally a crucial communal psychiatric disorder, which is more common in older adults. The situation is considerably worse among millions of older (forcibly displaced Myanmar nationals or FDMNs) Rohingya adults, and the coronavirus disease-2019 (COVID-19) pandemic may exacerbate the already existing precarious situation. The present study investigated depressive symptoms and their associated factors in older adult Rohingya FDMNs in Cox Bazar, Bangladesh, during the COVID-19 pandemic. METHOD A total of 416 older adults aged 60 years and above residing in Rohingya camps situated in the South Eastern part of Bangladesh were interviewed using a 15-item Geriatric Depression Scale (GDS-15) in Bengali language. Chi-square test was performed to compare the prevalence of depressive symptoms within different categories of a variable and a binary logistic regression model was performed to determine the factors associated with depressive symptoms. RESULTS More than 41% of Rohingya older adults had depressive symptoms (DS). Socio-demographic and economic factors such as living alone, dependency on family for living, poor memory, feelings of being left out, difficulty in getting medicine and routine medical care during COVID-19, perception that older adults are at highest risk of COVID-19 and pre-existing non-communicable chronic conditions were found to be significantly associated with developing DS. Higher DS was also evident among older female Rohingya FDMNs. CONCLUSION DS are highly prevalent in older Rohingya FDMNs during COVID-19. The findings of the present study call for immediate arrangement of mental health care services and highlight policy implications to ensure the well-being of older FDMNs.
Collapse
|
40
|
Ridout B, McKay M, Amon K, Campbell A, Wiskin AJ, Seng Du PML, Mar T, Nilsen A. Social Media Use by Young People Living in Conflict-Affected Regions of Myanmar. Cyberpsychol Behav Soc Netw 2020; 23:876-888. [PMID: 33326325 DOI: 10.1089/cyber.2020.0131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Since Myanmar's transition to civilian rule in 2011, the use of smartphones has exploded. The ubiquitous use of social media, in particular Facebook, has had a well-publicized dark side as a platform for disseminating fake news and hate speech. With poor digital literacy skills, Myanmar users are susceptible to disinformation campaigns and other online dangers, particularly young people, the most prevalent users. The current study collected benchmarking data related to usage patterns and perceptions of social media among Myanmar youth living in conflict-affected areas, including internally displaced Rohingya Muslims whose voice is yet to be captured in social media research. A total of 231 participants from Rakhine and Kayah States aged 13-35 were surveyed about their use of social media and its impact on Myanmar society and their own lives. More than half of the young people sampled were heavy smartphone users, particularly Rohingya Muslims, who rely on social media for contact with society outside of their camps. Facebook was by far the most used app, however, private group chat-based platforms were also popular. A majority said that they check the accuracy of news they read on social media, however, most do so by checking other Facebook pages or asking friends or family. Overall, most young people thought that social media has both a positive impact and negative impact on their lives. This study adds to an emerging body of research into how Myanmar youth engage with social media, particularly regarding how they consume news of current events.
Collapse
Affiliation(s)
- Brad Ridout
- Cyberpsychology Research Group, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Melyn McKay
- School of Anthropology & Museum Ethnography, University of Oxford, Oxford, United Kingdom
| | - Krestina Amon
- Cyberpsychology Research Group, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Andrew Campbell
- Cyberpsychology Research Group, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | | | | | - Theh Mar
- Independent Consultant, Yangon, Myanmar
| | - Andy Nilsen
- Save The Children International, Yangon, Myanmar
| |
Collapse
|
41
|
McGowan CR, Hellman N, Baxter L, Chakma S, Nahar S, Daula AU, Rowe K, Gilday J, Kingori P, Pounds R, Cummings R. A graphic elicitation technique to represent patient rights. Confl Health 2020; 14:86. [PMID: 33317586 PMCID: PMC7734610 DOI: 10.1186/s13031-020-00331-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 11/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A patient charter is an explicit declaration of the rights of patients within a particular health care setting. In early 2020 the Save the Children Emergency Health Unit deployed to Cox's Bazar Bangladesh to support the establishment of a severe acute respiratory infection isolation and treatment centre as part of the COVID-19 response. We developed a charter of patient rights and had it translated into Bangla and Burmese; however, the charter remained inaccessible to Rohingya and members of the host community with low literacy. METHODS To both visualise and contextualise the patient charter we undertook a graphic elicitation method involving both the Rohingya and host communities. We carried out two focus group discussions during which we discussed the charter and agreed how best to illustrate the individual rights contained therein. RESULTS Logistical constraints and infection prevention and control procedures limited our ability to follow up with the original focus group participants and to engage in back-translation as we had planned; however, we were able to elicit rich descriptions of each right. Reflecting on our method we were able to identify several key learnings relating to: 1) our technique for eliciting feedback on the charter verbatim versus a broader discussion of concepts referenced within each right, 2) our decision to include both men and women in the same focus group, 3) our decision to ask focus group participants to describe specific features of each illustration and how this benefited the inclusivity of our illustrations, and 4) the potential of the focus groups to act as a means to introduce the charter to communities. CONCLUSIONS Though executing our method was operationally challenging we were able to create culturally appropriate illustrations to accompany our patient charter. In contexts of limited literacy it is possible to enable access to critical clinical governance and accountability tools.
Collapse
Affiliation(s)
- Catherine R McGowan
- Humanitarian Public Health Technical Unit, Save the Children UK, 1 St John's Lane, London, EC1M 4AR, UK. .,Department of Public Health, Environments & Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
| | - Nora Hellman
- Humanitarian Public Health Technical Unit, Save the Children UK, 1 St John's Lane, London, EC1M 4AR, UK
| | - Louisa Baxter
- Humanitarian Public Health Technical Unit, Save the Children UK, 1 St John's Lane, London, EC1M 4AR, UK
| | - Sonali Chakma
- Save the Children International, Rohingya Response, Cox's Bazaar, Bangladesh
| | - Samchun Nahar
- Save the Children International, Rohingya Response, Cox's Bazaar, Bangladesh
| | - Ahasan Ud Daula
- Save the Children International, Rohingya Response, Cox's Bazaar, Bangladesh
| | - Kelly Rowe
- Save the Children Australia, 33 Lincoln Square South, Carlton, VIC, 3053, Australia
| | - Josie Gilday
- Save the Children International, St Vincent House, 30 Orange Street, London, WC2H 7HH, UK
| | - Patricia Kingori
- Nuffield Department of Population Health, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford, OX3 7LF, UK
| | - Rachel Pounds
- Humanitarian Public Health Technical Unit, Save the Children UK, 1 St John's Lane, London, EC1M 4AR, UK
| | - Rachael Cummings
- Humanitarian Public Health Technical Unit, Save the Children UK, 1 St John's Lane, London, EC1M 4AR, UK
| |
Collapse
|
42
|
McGowan CR, Hellman N, Chowdhury S, Mannan A, Newell K, Cummings R. COVID-19 testing acceptability and uptake amongst the Rohingya and host community in Camp 21, Teknaf, Bangladesh. Confl Health 2020; 14:74. [PMID: 33292358 PMCID: PMC7656219 DOI: 10.1186/s13031-020-00322-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 11/05/2020] [Indexed: 11/10/2022] Open
Abstract
Facility-based sentinel testing for COVID-19 was implemented in May 2020 to monitor the prevalence of COVID-19 amongst the Rohingya and host community in Cox’s Bazar, Bangladesh. In response both to low uptake of testing across all camps, and rumours of an outbreak of an influenza-like illness in May/June 2020, the International Organization for Migration (in partnership with ACAPS) undertook a qualitative study to collect accounts from the Rohingya relating to testing and treatment, and to explore the possibility that what was thought to be an outbreak of influenza may have been COVID-19. The report provided rich descriptions of the apprehension around testing and offered some clear recommendations for addressing these. We developed a testing ‘script’ in response to these recommendations, deploying it alongside a survey to determine reasons for declining a test. We compared testing uptake before deploying the testing script, and after (controlling for the total number of consultations), to generate a crude measure of the impact of the script on testing uptake. We coded reasons for declining a test thematically, disaggregated by status (Rohingya and host community) and sex. Despite the small sample size our results suggest an increase in testing uptake following the implementation of the script. Reasons provided by patients for declining a test included: 1) fear, 2) the belief that COVID-19 does not exist, that Allah will prevent them from contracting it, or that their symptoms are not caused by COVID-19, 3) no permission from husband/family, and 4) a preference to return at a later time for a test. Our findings largely mirror the qualitative accounts in the International Organization for Migration/ACAPS report and suggest that further testing amongst both populations will be complicated by fear, and a lack of clarity around testing. Our data lend force to the recommendations in the International Organization for Migration/ACAPS report and emphasise that contextual factors play a key role and must be considered in designing and implementing a health response to a novel disease.
Collapse
Affiliation(s)
- Catherine R McGowan
- Humanitarian Public Health Technical Unit, Save the Children UK, 1 St John's Lane, London, EC1M 4AR, UK. .,Department of Public Health, Environments & Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
| | - Nora Hellman
- Humanitarian Public Health Technical Unit, Save the Children UK, 1 St John's Lane, London, EC1M 4AR, UK
| | - Sayem Chowdhury
- Save the Children Bangladesh, Rohingya Response, Cox's Bazar, Bangladesh
| | - Abdul Mannan
- Save the Children Bangladesh, Rohingya Response, Cox's Bazar, Bangladesh
| | - Katherine Newell
- Humanitarian Public Health Technical Unit, Save the Children UK, 1 St John's Lane, London, EC1M 4AR, UK
| | - Rachael Cummings
- Humanitarian Public Health Technical Unit, Save the Children UK, 1 St John's Lane, London, EC1M 4AR, UK
| |
Collapse
|
43
|
Zaman S, Sammonds P, Ahmed B, Rahman T. Disaster risk reduction in conflict contexts: Lessons learned from the lived experiences of Rohingya refugees in Cox's Bazar, Bangladesh. Int J Disaster Risk Reduct 2020; 50:101694. [PMID: 32518743 PMCID: PMC7263258 DOI: 10.1016/j.ijdrr.2020.101694] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 04/09/2020] [Accepted: 05/22/2020] [Indexed: 05/07/2023]
Abstract
Bangladesh is currently hosting more than one million stateless Rohingya refugees, who fled from the Rakhine State to avoid genocide and serious crimes against humanity persecuted by the Myanmar Army. The newly arrived Rohingyas were accommodated in overcrowded refugee camps in Cox's Bazar District (CBD). The camps are highly vulnerable to landslides, tropical cyclones, flash-flooding, and communicable disease outbreak. Although a number of improvement measures are ongoing, however, no study to date has addressed Rohingyas' self-adopted strategies to mitigate disaster risks. Consequently, this paper aims to explore how refugees cope with risks associated with environmental hazards in the Kutupalong Rohingya Camp in CBD. A mixed-methods research strategy incorporating both quantitative household questionnaire survey and qualitative focus group discussions (FGDs) techniques were applied. In total 250 Rohingya refugees were selected for the questionnaire survey using a stratified random sampling method from camps 17 and 19, and two FGDs (male and female-only) were carried out in camp 13 involving 21 Rohingya participants. Results derived from the study show that responding to early warning systems, storing dried food and medicine, utilising available resources, relocating to safer shelters, and keeping hopes high were some of the coping strategies practised by the respondents. Literacy level imposed a significant impact over respondents' perception to accept various measures. For instance, the probability of storing dried food in preparation for disasters was 4 times higher among literate Rohingya compared to their illiterate counterparts. Similarly, for literate respondents, the probability was 20 times higher to store medicine than for illiterate. Guaranteed distribution of shelter strengthening kits among all refugee households, the inclusion of disaster risk awareness and preparedness training, ensuring safe and dignified return in Myanmar, and global and regional cooperation to address the refugee crisis are some of the propositions recommended in this study for improving Rohingyas' future adaptation strategies in a humanitarian context.
Collapse
Affiliation(s)
- Shamrita Zaman
- Institute for Risk and Disaster Reduction, University College London (UCL), Gower Street, London, WC1E 6BT, UK
| | - Peter Sammonds
- Institute for Risk and Disaster Reduction, University College London (UCL), Gower Street, London, WC1E 6BT, UK
| | - Bayes Ahmed
- Institute for Risk and Disaster Reduction, University College London (UCL), Gower Street, London, WC1E 6BT, UK
| | - Taifur Rahman
- Health Management BD Foundation, Kutupalong Rohingya Camp, Ukhia Upazila, Cox's Bazar, Bangladesh
| |
Collapse
|
44
|
Kaur K, Sulaiman AH, Yoon CK, Hashim AH, Kaur M, Hui KO, Sabki ZA, Francis B, Singh S, Gill JS. Elucidating Mental Health Disorders among Rohingya Refugees: A Malaysian Perspective. Int J Environ Res Public Health 2020; 17:E6730. [PMID: 32942770 DOI: 10.3390/ijerph17186730] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/09/2020] [Accepted: 09/09/2020] [Indexed: 11/17/2022]
Abstract
Mental health disorders (MHDs) among refugees has been recognized as a major public health issue. However, to date, there is limited evidence on the prevalence of MHDs among Rohingya refugees in Malaysia. This study aimed to examine the prevalence and associated factors of major depressive disorder (MDD), generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD) among Rohingya refugees in Malaysia. A total of 220 refugees were randomly selected to participate in this cross-sectional study, conducted from June 2019 to November 2019. Perceived social support, religious orientation, food security, and sociodemographic characteristics were assessed as independent variables. The dependent variables assessed were MDD, GAD, and PTSD. The prevalence of GAD, PTSD, and MDD was reported at 92 (41.8%), 84 (38.2%), and 71 (32.3%). Several factors were significantly associated with MDD following multivariate analysis such as perceived low to moderate social support (AOR = 2.17; 95% CI 1.13, 4.19) and food insecurity (AOR = 2.77; 95% CI 1.19, 6.47). Exposure to violence (AOR = 38.46; 95% CI 16.27, 90.91) and food insecurity (AOR = 3.74; 95% CI 1.41, 9.91) were significantly associated with PTSD. Addressing these risk factors could be key in improving mental health outcomes among this vulnerable population.
Collapse
|
45
|
Riley A, Akther Y, Noor M, Ali R, Welton-Mitchell C. Systematic human rights violations, traumatic events, daily stressors and mental health of Rohingya refugees in Bangladesh. Confl Health 2020; 14:60. [PMID: 32843894 PMCID: PMC7441657 DOI: 10.1186/s13031-020-00306-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 08/11/2020] [Indexed: 01/01/2023] Open
Abstract
Background Almost 900,000 Rohingya refugees currently reside in refugee camps in Southeastern Bangladesh. Prior to fleeing Myanmar, Rohingya experienced years of systematic human rights violations, in addition to other historical and more recent traumatic events such as the burning of their villages and murder of family members, friends and neighbors. Currently, many Rohingya struggle to meet basic needs in refugee camps in Bangladesh and face mental health-related concerns that appear linked to such challenges. The purpose of this study is to describe systematic human rights violations, traumatic events, daily stressors, and mental health symptoms and to examine relationships between these factors. Methods Cross-sectional data was collected from a representative sample of 495 Rohingya refugee adults residing in camps in Bangladesh in July and August of 2018. Results Respondents reported high levels of systematic human rights violations in Myanmar, including restrictions related to expressing thoughts, meeting in groups, travel, religious practices, education, marriage, childbirth, healthcare, and more. Events experienced in Myanmar included exposure to gunfire (99%), destruction of their homes (93%), witnessing dead bodies (92%), torture (56%), forced labor (49%), sexual assault (33%), and other events. More than half (61%) of participants endorsed mental health symptom levels typically indicative of PTSD, and more than two thirds (84%) endorsed levels indicative of emotional distress (symptoms of anxiety and depression). Historic systematic human rights violations, traumatic events, and daily stressors were associated with symptoms of posttraumatic stress, as well as depression and anxiety. Respondents reported numerous stressors associated with current life in the camps in Bangladesh as well as previous stressors, such as harassment, encountered in Myanmar. Conclusions Findings underscore the impact of systematic human rights violations, targeted violence, and daily stressors on the mental health of Rohingya in Bangladesh. Those working with Rohingya should consider the role of such factors in contributing to poor mental health. This research has the potential to inform interventions targeting such elements. Future research should examine the relationships between mental health and human rights violations over time.
Collapse
Affiliation(s)
- Andrew Riley
- Colorado School of Public Health and Natural Hazards Center, University of Colorado, Boulder, USA
| | - Yasmin Akther
- Colorado School of Public Health and Natural Hazards Center, University of Colorado, Boulder, USA
| | - Mohammed Noor
- Colorado School of Public Health and Natural Hazards Center, University of Colorado, Boulder, USA
| | - Rahmat Ali
- Colorado School of Public Health and Natural Hazards Center, University of Colorado, Boulder, USA
| | - Courtney Welton-Mitchell
- Colorado School of Public Health and Natural Hazards Center, University of Colorado, Boulder, USA
| |
Collapse
|
46
|
Fetters T, Rubayet S, Sultana S, Nahar S, Tofigh S, Jones L, Samandari G, Powell B. Navigating the crisis landscape: engaging the ministry of health and United Nations agencies to make abortion care available to Rohingya refugees. Confl Health 2020; 14:50. [PMID: 32760438 PMCID: PMC7379756 DOI: 10.1186/s13031-020-00298-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 07/17/2020] [Indexed: 11/29/2022] Open
Abstract
Background Unintended and unwanted pregnancies likely increase during displacement, making the need for sexual and reproductive health (SRH) services, especially safe abortion, even greater. Attention is growing around barriers to safe abortion care for displaced women as donor, non-governmental and civil society actors become more convinced of this need and reports of systematic sexual violence against women are more widely documented around the world. Yet a reluctance to truly change practice remains tied to some commonly reported reasons: 1) There is no need; 2) Abortion is illegal in the setting; 3) Donors do not fund abortion services, and; 4) Abortion is too complicated during acute emergencies. While there is global progress towards acknowledging the deficit of attention and evidence on abortion services in humanitarian settings, improvements in actual services have yet to follow. Case presentation In August 2017, over 700,000 Rohingya refugees fled Myanmar for Bangladesh. Women and girls fled homes and communities - many experienced terrible violence - and arrived at camps in Bangladesh with SRH needs, including unwanted pregnancies. With funding from UNFPA and others, Ipas trained providers and established safe induced abortion (called menstrual regulation (MR) in Bangladesh) and contraception services in October 2017. Ipas Bangladesh initiated the trainings in coordination with the government’s health system and international aid agencies. Training approaches were modified so that providers could be trained quickly with minimal disruption to their ability to provide care. Within one month of the arrival of refugees, MR services had been established in eight facilities, for the first time during an acute emergency. By mid-2019, over 300 health workers from 37 health facilities had attended training in MR, postabortion care (PAC), and contraception. Over 8000 Rohingya refugees have received abortion-related care, more than three-quarters of which were MR procedures; over 26,000 women and girls have received contraception at these facilities. Conclusions This study demonstrates demand for abortion care exists among refugees. It also illustrates that these needs could have been easily overlooked in the complex environment of competing priorities during an emergency. When safe abortion services were made available, with relative ease and institutional support, women sought assistance, saving them from complications of unsafe abortions.
Collapse
Affiliation(s)
| | | | | | | | | | - Lea Jones
- Ipas, Chapel Hill, North Carolina USA
| | | | | |
Collapse
|
47
|
Rahman MR, Faiz MA, Nu MY, Hassan MR, Chakrabarty AK, Kabir I, Islam K, Jafarullah AKM, Alakabawy M, Khatami A, Rashid H. A Rapid Assessment of Health Literacy and Health Status of Rohingya Refugees Living in Cox's Bazar, Bangladesh Following the August 2017 Exodus from Myanmar: A Cross-Sectional Study. Trop Med Infect Dis 2020; 5:E110. [PMID: 32630181 DOI: 10.3390/tropicalmed5030110] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 06/22/2020] [Accepted: 06/25/2020] [Indexed: 12/21/2022] Open
Abstract
Background: A survey was conducted among Rohingya refugees to assess their overall health literacy and health status. Methods: A questionnaire was developed to conduct face to face interviews among Rohingya refugees in Cox’s Bazar, Bangladesh in November–December 2017. Families were selected using convenience sampling from four large refugee camps. Results: Primary respondents aged 10–90 (median 32) years, 56% male, representing 1634 families were interviewed and provided data of themselves and 6268 additional family members, 4163 (66.4%) of whom were children aged <18 years. Of all, only 736 (45%) primary respondents knew how to appropriately treat diarrhoea, 882 (54%) relied on unqualified village “doctors” for treatment, 547 (33.5%) reported a family member suffering injuries in the previous six months, with 8% (42/547) of injuries fatal. One hundred and ninety two (11.8%) primary respondents also reported deaths within their family in the preceding 12 months, with the majority (70% [134/192]) occurring in males, and 44% (85/192) of all deaths were claimed to be homicidal. Conclusion: This survey highlights overall poor health literacy, limited access to qualified health care, and a high rate of injuries and assaults among Rohingyas. However, these data come from an anecdotal survey that excluded some sensitive but important questions.
Collapse
|
48
|
Hossain KMA, Walton LM, Arafat SMY, Maybee N, Sarker RH, Ahmed S, Kabir F. Expulsion from the Motherland: Association between Depression & Health-Related Quality of Life for Ethnic Rohingya Living with Refugee Status in Bangladesh. Clin Pract Epidemiol Ment Health 2020; 16:46-52. [PMID: 32508969 PMCID: PMC7254817 DOI: 10.2174/1745017902016010046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 03/08/2020] [Accepted: 03/08/2020] [Indexed: 11/28/2022]
Abstract
Background: The Rohingyas are an ethnic minority group from Myanmar who have experienced severe forms of violence such as murder, rape, humanitarian defilement and forcible expellation from their motherland. Exposure to trauma has a long-lasting impact on psychological well-being and Health-related Quality of Life (HRQoL). Objective: The purpose of this study was to examine the prevalence of depression and association with HRQoL for Rohingya displaced persons. Methodology: This was a prospective, cross-sectional study in two refugee camps in Southern Bangladesh, with a structured and language validated questionnaire. Results: The study indicates the prevalence of depression was 70% (n=150 respondents), with 8.7% reporting “severe depression” in PHQ-9. WHOQOL-BREF scores were inversely associated with symptoms on the depression scale with a strong and significant correlation (r= 0.652; p<0.01) in total and physical health; psychological (r= 0.757, p<0.01), social relationship (r= 0.479, p<0.01), environment (r= 0.443, p<0.01), increasing age (r= 0.272, p<0.01), severity of depression (r= 0.489, p<0.01). Furthermore, there was a statistically significant correlation with overall quality of life with same variables subsequently (r =0.600, 0.309, 0.482, 0.170, 0.103, 0.272, 0.339; p<0.01), also correlation was observed between married individuals and severity of depression in PHQ (r= 0.346), physical state (r= 0.353), psychological state (r= 0.358), and with social relationship (r= 0.435), with statistical significance (p= <0.01).
Conclusion: There are higher incidence rates of moderate to severe depression than the population norms and low health-related quality of life than published population norms for Rohingya displaced persons living in refugee camps. Depression rates were inversely associated with HRQoL for Rohingya displaced persons living in refugee camps. Future research may consider the prevention of related medical issues for long term program implementation.
Collapse
Affiliation(s)
- K M Amran Hossain
- Department of Physiotherapy, Bangladesh Health Professions Institute (BHPI), Savar Union, Bangladesh
| | - Lori M Walton
- Departmnt of Physiotherapy, University of Sharjah, Sharjah, UAE
| | - S M Yasir Arafat
- Department of Psychiatry, Enam Medical College and Hospital, Savar Union, Bangladesh
| | - Nidiorin Maybee
- Department of Physiotherapy, Centre for the Rehabilitation of the Paralysed (CRP), Dhaka, Bangladesh
| | - Rubel Hossen Sarker
- Department of Rehabilitation, Rohingya Humanitarian Responses, Handicap International (Humanity and Inclusion), Dhaka, Bangladesh
| | - Shahoriar Ahmed
- Department of Physiotherapy, Bangladesh Physiotherapy Association (BPA), Dhaka, Bangladesh
| | - Feroz Kabir
- Department of Physiotherapy & Rehabilitation, Jashore University of Science & Technology (JUST), Jeshore, Bangladesh
| |
Collapse
|
49
|
Nelson EL, Saade DR, Gregg Greenough P. Gender-based vulnerability: combining Pareto ranking and spatial statistics to model gender-based vulnerability in Rohingya refugee settlements in Bangladesh. Int J Health Geogr 2020; 19:20. [PMID: 32471434 PMCID: PMC7257550 DOI: 10.1186/s12942-020-00215-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 05/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Rohingya refugee crisis in Bangladesh continues to outstrip humanitarian resources and undermine the health and security of over 900,000 people. Spatial, sector-specific information is required to better understand the needs of vulnerable populations, such as women and girls, and to target interventions with improved efficiency and effectiveness. This study aimed to create a gender-based vulnerability index and explore the geospatial and thematic variations in gender-based vulnerability of Rohingya refugees residing in Bangladesh by utilizing pre-existing, open source data. METHODS Data sources included remotely-sensed REACH data on humanitarian infrastructure, United Nations Population Fund resource availability data, and the Needs and Population Monitoring Survey conducted by the International Organization for Migration in October 2017. Data gaps were addressed through probabilistic interpolation. A vulnerability index was designed through a process of literature review, variable selection and thematic grouping, normalization, and scorecard creation, and Pareto ranking was employed to rank sites based on vulnerability scoring. Spatial autocorrelation of vulnerability was analyzed with the Global and Anselin Local Moran's I applied to both combined vulnerability index rank and disaggregated thematic ranking. RESULTS Of the settlements, 24.1% were ranked as 'most vulnerable,' with 30 highly vulnerable clusters identified predominantly in the northwest region of metropolitan Cox's Bazar. Five settlements in Dhokkin, Somitapara, and Pahartoli were categorized as less vulnerable outliers amongst highly vulnerable neighboring sites. Security- and health-related variables appear to be the most significant drivers of gender-specific vulnerability in Cox's Bazar. Clusters of low security and education vulnerability measures are shown near Kutupalong. CONCLUSION The humanitarian sector produces tremendous amounts of data that can be analyzed with spatial statistics to improve research targeting and programmatic intervention. The critical utilization of these data and the validation of vulnerability indexes are required to improve the international response to the global refugee crisis. This study presents a novel methodology that can be utilized to not only spatially characterize gender-based vulnerability in refugee populations, but can also be calibrated to identify and serve other vulnerable populations during crises.
Collapse
Affiliation(s)
- Erica L Nelson
- Harvard Humanitarian Initiative, Harvard University, Cambridge, MA, USA. .,Department of Emergency Medicine, Division of Global Emergency Care and Humanitarian Studies, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
| | | | - P Gregg Greenough
- Harvard Humanitarian Initiative, Harvard University, Cambridge, MA, USA.,Department of Emergency Medicine, Division of Global Emergency Care and Humanitarian Studies, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.,Harvard T.H. Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
50
|
Abstract
Background Previous research suggests that child marriage may be accelerated during times of crisis and insecurity as resources are scarce and child marriage may be a survival strategy for girls and their families. In 2017, the Rohingya experienced a mass displacement to Bangladesh in response to escalating violence in Myanmar. This displacement has resulted in an estimated population of nearly 1 million Rohingya living in Cox’s Bazar. Methods We conducted in-depth interviews (n = 48) and focus group discussions (n = 12) with Rohingya male and female adolescents and young adults (14–24 years), and program managers and service providers (n = 24) working in Cox’s Bazar to understand their experience of living or working in the camps, preferences for timing of marriage, and marriage practices in Myanmar and in the camps. We also interviewed Bangladeshis in the host community to complement our understanding of marriage in the camps and its influence in the broader community. Our primary objective was to describe how displacement influenced marriage timing and practices. Results We found that child marriage is a strong cultural phenomenon among the Rohingya, primarily rooted in socio-cultural and religious beliefs around readiness for marriage. Although child marriage was practiced by the Rohingya in Myanmar, specific state law and oppression by military forces prevented many from marrying before age 18. Now this preference is more easily practiced in the camps in Bangladesh where the displaced Rohingya experience less marriage regulation. Host community participants perceive the presence of the Rohingya as encouraging both polygamy and child marriage in their communities, leading to tension among the host community. Conclusions Our findings support evidence that conflict and displacement increase child marriage in populations already vulnerable to child marriage by exacerbating gender inequities. However, our findings also suggest group norms around religious and cultural preferences for age at marriage play a significant role in post-displacement behaviors surrounding marriage.
Collapse
Affiliation(s)
- Andrea J Melnikas
- Population Council, 1 Dag Hammarskjold Plaza, 3rd floor, New York, NY 10017 USA
| | | | | | | | - Sajeda Amin
- Population Council, 1 Dag Hammarskjold Plaza, 3rd floor, New York, NY 10017 USA
| |
Collapse
|