When Mohammad*, a Rohingya father of four living at a refugee camp in Cox’s Bazar in Bangladesh , was diagnosed with the coronavirus disease, he was not prepared for the challenges his family would face. As he was being treated at the Kutupalong field hospital, Mohammad’s relatives began facing pressure and threats from the community for wanting to quarantine in their home. “I started receiving phone calls from the camp majis [community leaders] who were pushing to send my family to a quarantine centre,” he said. “My family said everyone in our block was starting to think badly about them. People were saying that I was Covid-19 positive because I was a bad person.” Mohammad, who is in his 30s, said some people even threatened to physically hurt his family. “People surrounded my house with sticks … saying they would burn our house down if my family didn’t go into quarantine,” he said. “It was so shameful for my family. They felt extremely frightened.” Aid workers and experts say many Rohingya refugees – who grapple with poverty, long-term health issues and unsanitary conditions at overcrowded refugee camps in Bangladesh – have struggled in recent months with fear and stigma about the coronavirus disease. Some worry that the number of infections among this community is higher than reported, and warn that a spike could have major consequences. Our refugee patients are afraid of going to the health centre because of stigmatisation from the community A doctor from Médecins Sans Frontières Last month marked three years since scores of minority Rohingya Muslims and other communities from Myanmar’s Rakhine state were displaced from their homes. There are about 860,000 Rohingya refugees currently housed in Bangladesh camps. Experts have said the crowded conditions, which sees up to 10 people sharing a room, lack of access to clean water, and flooding caused by heavy rains during monsoon season make Rohingya particularly vulnerable to illness. Tarikul Islam*, a Bangladesh doctor with Médecins Sans Frontières (MSF) and a team leader at the Balukhali hospital, said before the Covid-19 outbreak, he saw adults and children mostly with respiratory infections, diarrhoea diseases and skin infections, as well as patients experiencing psychiatric illnesses. But the pandemic has brought further pressure to an already fragile health system. As Covid-19 started hitting Bangladesh and the first case in the camps was confirmed in May, Dr Islam said some health care providers scaled down their activities because of issues such as reduced staffing and restricted movements. At the same time, health workers have struggled to encourage refugees to be open about their symptoms. “One of the issues is stigma and fear about Covid-19,” Dr Islam said. “Our refugee patients are afraid of going to the health centre. We have even seen some patients not disclosing Covid-related symptoms because they thought they would be treated differently after that.” The World Health Organisation (WHO) reported that as of the end of August, about 4,000 coronavirus cases had been recorded in the host community in Cox’s Bazar, while some 100 refugees in the camps tested positive. Among the refugee population, six have died of Covid-19. Coronavirus: first Rohingya refugee dies in Bangladesh camps Pablo Percelsi, who heads the International Committee of the Red Cross (ICRC) delegation in Bangladesh, said before the pandemic, the ICRC staff would see about 150 to 200 displaced people a day at the emergency room of Sadar Hospital in Cox’s Bazar. After March, the figures dropped to half. “Given the size of the camps, [the number of confirmed Covid-19 cases] seem too little,” said Percelsi, adding there were concerns about undetected infections. “We might also see a spike, like it is happening in other parts of the world.” Percelsi noted that the current scenario was unprecedented. “The combination of the size of the camps and a pandemic is something completely new. Both aid agencies and the state are facing challenges,” he said. “If something goes wrong, it could lead to very bad consequences because of the sheer number.” Across the border, Myanmar’s health ministry on Tuesday said that 92 new coronavirus infections had been confirmed, with most of them recorded in Rakhine state. As Malaysia battles Covid-19, its Rohingya refugees face a torrent of hate Jean-François Quéguiner, deputy resident representative of the ICRC in Myanmar, said that “Covid-19 has affected states across Myanmar to varying degrees, yet Rakhine is particularly concerning given the recent outbreak of the virus in mid-August”. Thousands remain displaced in camps across central and northern Rakhine, where they have limited access to water and sanitation. The pandemic “only compounds an already vulnerable situation given the active conflict that is ongoing”, Quéguiner said. “Our main concern remains being able to support families who are most vulnerable, trying to ensure they have enough food rations, essentials, access to drinkable water, basic health care services and the right Covid-19 prevention information,” he said. LOOKING FOR SAFETY After decades of ethnic tension, violence broke out again in Buddhist-majority Myanmar in August 2017, when a military offensive destroyed entire villages in Rakhine, forcing hundreds of thousands to flee. Myanmar officials said the military action was a response to attacks by Rohingya armed groups in the western state. Most of those who fled crossed the border into Bangladesh, where they now live in refugee camps. United Nations investigators have meanwhile said the campaign had been executed with “genocidal intent”. This week, two news organisations and a rights group reported that two Myanmar soldiers had been taken to The Hague after confessing to slaughtering Rohingya during the 2017 crackdown. According to the non-profit Fortify Rights, the pair said on video they had killed dozens of villagers in northern Rakhine state and buried them in mass graves. On Wednesday, Myanmar military spokesman major general Zaw Min Tun dismissed the accusations, saying they were “not true”. Fleeing persecution in Myanmar and refugee camps in Bangladesh – where the coronavirus pandemic has worsened already difficult conditions – the Rohingya have for years boarded boats to seek refuge in other Southeast Asian countries. This week, 297 Rohingya refugees, including 181 women and 14 children, landed in Indonesia’s Aceh province. Dozens reportedly died during the boat journey. Thousands flee homes in Myanmar fearing military ‘clearance’ Chris Lewa, director of the Arakan Project, a non-profit group focusing on the Rohingya crisis, told Reuters the group had set sail from southern Bangladesh at the end of March or early April bound for Malaysia. But she said both Malaysian and Thai authorities pushed them back, as borders tightened due to the pandemic. Amnesty International Indonesia executive director Usman Hamid said that regional cooperation for search and rescue missions was crucial. “We call on the Indonesian authorities to immediately initiate a regional dialogue. Through their inaction, regional leaders have turned our waters into a graveyard,” he said. Meanwhile, a delegation of Rohingya community leaders were taken this week on a visit to Bhashan Char, an island on the coast of Bangladesh to where the government wants to relocate about 100,000 refugees. LONG-TERM IMPACT Palash Kamruzzaman, senior lecturer in social policy at the University of South Wales, said with the pandemic continuing to spread, donations for Rohingya and other refugee populations were likely to dry up and there would also be less international attention from both from humanitarian and political leaders. “The long-term impact will be that the Rohingya crisis will be protracted. This will add further stress to the host country and, therefore, the Rohingya will face more stigma and hostility from the host community,” Kamruzzaman said. “The longer it takes to resolve this crisis, the levels of frustration and distress will also grow among Rohingya refugees.” The professor said the situation could push more people to make risky journeys to other countries. “I also fear they will become easy prey for drug-peddling and human trafficking,” Kamruzzaman said. “More alarmingly, a sense of persistent neglect and injustice might make a section of these people easy targets for extremist groups. In that case, the long-term impact of this crisis can transform into a major local, regional, and global security risk.” Saleh Ahmed, assistant professor at the School of Public Service in Idaho’s Boise State University, said fewer resources for refugees and other marginalised groups would lead to “further marginalisation, hatred, fear, food insecurity, child and maternal deaths”. Rohingya drank urine to survive perilous high-seas horror He said it would be essential to have “a very strong voice of the United Nations” along with an adequate response to the Rohingya crisis from world leaders. “We should understand … that hunger, poverty, and marginalisation do not always stay in the place it occurs. It can cross [borders],” Saleh said. UN secretary general António Guterres last month called for greater attention to the Rohingya crisis, noting the need to address the causes of the conflict, and creating conditions for the safe, voluntary, and sustainable return of all refugees. “The ultimate responsibility rests with Myanmar authorities,” he said, adding that “beyond solutions for the immediate humanitarian suffering, accountability is an imperative for long-term reconciliation”. In Indonesia, Bangladesh and Thailand, refugees live in fear of virus Meanwhile, Mohammad’s family has been able to remain at their home in the camps. “My daughters said they would rather take their own lives than be taken away from their home … They don’t have any experience of being outside. It made me feel crazy with fear,” said the refugee, who was hospitalised for three weeks. He said he called community leaders from the isolation centre and managed to talk them into allowing his family to quarantine at home. Mohammad, who encourages more people to seek treatment, said he hoped his community was able to overcome the stigma and misconceptions. “People are traumatised from Myanmar, where family members were taken away and tortured,” he said. “So if people fear they will be separated from their families, then they won’t be willing to say they have Covid-19 symptoms. Even though they are dying, people prefer to die at home than be separated from their families.” *These interviews were conducted by MSF and shared with This Week in Asia. Mohammad’s name has been changed and some details about him and his family were withheld to protect their identity.