© Antonio Faccilongo


“Hundreds of thousands of refugees are living in an extremely precarious situation"

Targeted violence against the Rohingya population in neighbouring Myanmar has resulted in more than 693,000 people fleeing to Bangladesh since 25 August. 

Those who have fled are living in extremely precarious conditions with limited access to health care, portable water, latrines and food.

The most recent influx of Rohingya refugees has added to the hundreds of thousands of Rohingya who had already fled across the border during episodes of violence in the previous year.

“The situation in the camps is so incredibly fragile, especially with regard to shelter, food and water and sanitation, that one small event could lead to an outbreak that may be the tipping point between a crisis and a catastrophe,” says Robert Onus, MSF Emergency Coordinator.

“Hundreds of thousands of refugees are living in an extremely precarious situation, and all the preconditions for a public health disaster are there,” adds Onus.

“We most likely still haven’t seen the full impact of this crisis in terms of health. There is an acute need for a massive humanitarian intervention focusing on food, clean water, shelter, and sanitation, and a solution is needed to reduce the size of these massive, congested camps.”


Summary of operations in Cox's Bazar (May 2018)

  • Number of patients: Between August 2017 and the End of April 2018, our teams carried out 506,324 outpatient and 10,655 inpatient consultations.
  • Number of staff: To respond to the fastest growing refugee crisis in the world, MSF’s team in Cox’s Bazar has increased to more than 2,000 staff – the majority of them Bangladeshi nationals.
  • Number of health facilities: 10 health posts; 3 primary health centres (open around the clock); and five inpatient health facilities (providing 24-hour secondary healthcare).
  • Main morbidities: Respiratory infections, diarrheal diseases, skin diseases – all related to poor living conditions, and non-communicable diseases.
  • Water and sanitation: This is key to prevent the spread of disease. Activities include drilling boreholes and tube wells, installing a gravity-fed water supply system, trucking in water, desludging old latrines, constructing new sustainable latrines, doing bucket chlorination and distributing domestic water filters. 
  • Mental health services: This has been scaled up, with more counsellors added to existing teams, services available at additional health posts, and training outreach workers to provide basic psychosocial support.
  • Outreach: Teams focus on health promotion, outbreak prevention, alert and response, while a surveillance team gathers demographic, nutritional, mortality and natality indicators, covering 80% of the refugee’s settlements. The teams also do active case-finding and referral to health facilities for diagnosis and treatment as well as defaulter tracing and mobilisation for vaccination. An all-female team spreads messages about sexual and reproductive health in the community.

Country profile

Bangladesh, formerly East Pakistan, was formed in 1971. It is one of the world's most densely populated countries.

Poverty is widespread, but it has been recognised as having the potential to become one of the world's largest economies in the 21st century.

A low-lying country on the Tropic of Cancer, with the Bay of Begal to the south, Bangladesh is often impacted by flooding and tropical cyclones.

Médecins Sans Frontières/Doctors Without Borders (MSF) first worked in Bangladesh in 1985. Our work in the country has involved responding to people excluded from healthcare and people affected by severe malnutrition.

Patient story

Ambia Khatun, 39-year-old post-kala azar dermal leishmaniasis (PKDL) patient

I work at home and my husband has a job at a Chinese restaurant in Dhaka. In this village there have been plenty of cases of kala azar. In our family two out of three members contracted the disease.

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Kala azar hit me five years ago. I got frequent fevers; I became very weak and even lost my appetite. I went to doctors in Mymensingh but they failed to identify kala azar.

Finally in Trishal subdistrict they treated me with tablets for one month. After that I felt good, but one and a half years later I developed PKDL. I consulted doctors in Trishal again, but the medicines didn't help.

MSF tested me and referred me to their clinic in Fulbaria. With the treatment my lesions have almost disappeared. I think it is crucial to get cured of PKDL. I know that the kala azar virus was in my lesions. Luckily I got rid of it.

MSF’s work in Bangladesh: 2016

In 2016, MSF continued to provide healthcare to vulnerable people in Bangladesh, including a large number of Rohingya refugees from Myanmar.

Many of the Rohingya who have fled violence and persecution in Myanmar have been living in makeshift camps close to the Bangladeshi border for decades, yet they continue to suffer from discrimination and healthcare exclusion.

Close to the Kutupalong makeshift camp in Cox’s Bazar, MSF runs a clinic providing comprehensive basic and emergency healthcare, as well as inpatient and laboratory services to Rohingya refugees and the local community.

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During 2016, teams carried out around 109,000 outpatient, 19,800 antenatal consultations and 6,900 individual mental health consultations.

Poor living conditions in slums

In Kamrangirchar and Hazaribagh, teams visited factories and tanneries and conducted more than 8,000 outpatient consultations. We are looking for ways to increase access to healthcare for workers based in the slum, many of whom are exposed to hazardous conditions for long hours.

We scaled up our sexual and intimate partner violence programme in Kamrangirchar, providing medical and psychological support to over 500 people who had been victims of sexual violence and intimate partner violence. 


Close to the Kutapalong makeshift camp in Cox's Bazar district, MSF runs a clinic offering comprehensive basic and emergency healthcare, as well as inpatient and laboratory services to Rohingya refugees and the local community. There was a sharp increase in patient figures in the last two months of the year, due to a large influx of Rohingya fleeing Myanmar's northern Rakhine state. The team treated 113 violence-related injuries in November and December, including 17 gunshot wounds. During the year, teams carried out 89,954 outpatient, 2,491 inpatient, and 4,559 mental health consultations. They also treated 103 victims of sexual violence in 2016, more than double the number in 2015. In addition, 15,194 antenatal consultations were conducted.

kamrangirchar slum

In Kamrangichar slum, in the capital Dhaka, MSF offers reproductive healthcare to adolescent girls, carrying out 4,578 antenatal consultations and assisting in 457 deliveries in 2016. The team also provided medical and psychological support to 535 victims of sexual violence and intimate partner violence. In addition, 2,324 family planning sessions and 2,379 individual mental health consultations were conducted with people of all ages. MSF continues to run its occupational health programme for factory workers in Kamrangirchar, and this year carried out a total of 8,923 consultations.

find out more in our international activity report

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