Lack of trust between the Rohingyas and healthcare providers must be urgently addressed to ensure effective Covid-19 treatment in the refugee camps in southeastern Bangladesh.
There is a widespread fear amongst the Rohingyas living in the refugee camps in Cox’s Bazar that they risk getting killed by medical staff if they are sent to Covid-19 isolation facilities, recent research by the International Organization of Migration (IOM) has found.
“If there is to be serious headway and acceptance on the current plans being developed for isolation and shielding, the lack of trust between Rohingya and health providers must be urgently addressed”, reads the IOM research report, titled “Covid-19 explained: No isolation without consultation” and dated April 9th 2020.
The IOM research was carried out to inform United Nations and government plans for dealing with a Covid-19 outbreak in the camps. It was cited in the most recent Covid-19 update published on April 12th by the ICSG, the UN coordination body that manages activities at the Rohingya camps, “Negative perceptions around healthcare and distrust of responders are already impacting Covid-19 preparedness efforts.”
IOM carried out 16 focus group discussions between March 24th and April 8th, half of which had female-only participants, 7 comprised of male-only participants and 1 was mixed.
The groups found that participants in 13 out of the 16 discussions believed that “no one would go on their own to isolation facilities, that at least one family member must accompany them.”
The IOM report notes, “The primary reasons cited for needing a caretaker to ‘protect’ them is the risk of being killed by medical staff. […] To illustrate this point participants in 12 out of the 16 consultations explicitly addressed fear of being killed by authorities while in isolation and that the risk of this occurring would increase if there was no relative or Rohingya acquaintance there to protect those who were required to go into isolation.”
The authors of the IOM report quoted the following comments made by the participants:
“When someone [is] take[n] into isolation, we worry that [the doctor] will kill the patient. That’s why they should allow [us] to take one person with the patient for safety.”
“Some people are scared that we will be killed or will not be treated well… ”
“If [the isolation facility] is in a different place, then some may not want to go. Because we heard that the infected people will be killed by crossfire.”
Based on these quotes by the informants, the report notes, “This clearly indicates the widespread perception that such practices are commonplace at health facilities, at the very least with respect to Covid-19 outbreaks. While this distrust is partially due to historical experiences of discrimination in Myanmar, it has also been contributed to by responders in the camps who are reported to have not treated the Rohingya patients with respect and dignity.”
Earlier this week, Bangladeshi human rights activists released a report alleging that between March 1st and April 10th, law enforcement officials extrajudicially killed at least 44 people — 12 of them are reported to be Rohingyas.
The IOM report also noted that many people would be unwilling to go into isolation if they had no symptoms equating it “with a prison sentence.” As one woman was quoted, “Why would I go to the prison if I am not sick. I heard from people that doctors are taking the patients and killing them”.
The research report also states that many people rejected the idea of isolation on the basis that they do not want to be separate from their family “citing the traumatic journey to Bangladesh with their family as a key reason why.”
These findings followed a previous report published by ACAPS, an independent group of researchers working for IOM, which concluded that the Rohingyas seriously mistrust the health system, “Among the Rohingya refugees in Bangladesh, distrust and lack of confidence in the medical system of the [Covid-19] response is widespread. The implication of this on the effectiveness of any Covid-19 response cannot be overstated or ignored.”
Other research recently conducted by IOM also found that the cessation of all non-essential services and activities in the Rohingya camps has not been understood by most Rohingyas in the camps “who report to feeling abandoned by humanitarian responders.” That report, published on April 2nd, also found that there were “rapidly deteriorating security dynamics within the camps between Rohingya and host communities” including a destruction of a tube well by Bengalis who “did not want Rohingya coming close”.
850,000 Rohingya refugees currently reside in 34 makeshift camps in Cox’s Bazar. Netra News recently reported on the ICSG concerns about major gaps in the government’s response to the Covid-19 infection in these camps and the surrounding area pointing out that there is “extremely limited testing” of the population for Covid-19 infections; an “absence” of intensive care capacity; and, inadequate supply of oxygen required to treat seriously ill patients. It also set out its concern about the reduction in mobile phone and internet facilities in the camps.
The most recent ICSG reports notes that these all remain major gaps, adding that “adequate PPE, including masks, gowns, gloves and eye protection for frontline health workers is another major supply challenge.”●