Photo: SK Hasan Ali/ Kalerkantho
The Inter-Sector Coordination Group (ISCG) in collaboration with other humanitarian partners has released a detailed report on the Rohingya influx and the humanitarian crises in the refugee camps in Cox's Bazar. The report covers the camps' situations from September 16 - 21. The next report will be issued on October 1.
A glance at the report
Situation Overview & Humanitarian Needs
The Influx of Rohingya has restarted following the attacks in the Myanmar Border Guard Police posts in the Rakhine state on 25 August 2017.
An estimated 429,000 people have entered Bangladesh as of September 20.
Of the arrivals, 145,000 are currently residing in makeshift settlements and official refugee camps that are extremely overcrowded, while 88,000 are in host communities.
In addition, 196,000 arrivals are in six new spontaneous settlements in the host community area, which are quickly expanding.
According to the Joint Needs Assessment, out of the 128,000 Rohingya surveyed in the five makeshift settlements and new spontaneous sites, 57 percent are children, 67 percent are female, while 9 percent are infants below one year, 23 percent are children under five and 28 percent are children between 6-18 years.
People are making huts but the majority of people are staying in the open air, suffering from trauma, exhaustion, sickness, and hunger.
Most of them walked up to 60 kilometers for up to six days and are in dire need of food, water, shelter, and protection.
As of September 19, most of the shelters located in the low-lying land surrounding Balukhali were flooded, due to heavy rain, and more rain is forecasted in the coming days.
The rains, coupled with poor hygiene and sanitation infrastructure, is exacerbating the risk of disease outbreak in densely populated areas; underscoring the need to act fast and to deliver aid wherever people are across the district.
The new influx of 429,000 adds to the previous influx of 74,000 from last October 2016.
This is coupled with another 300,000-500,000 of the pre-existing Undocumented Myanmar Nationals (UMNs) and 32,000 registered Rohingya.
To deliver immediate life-saving humanitarian assistance, the ISCG is preparing a revised response plan targeting 1.2 million people, of which over 50 percent are children.
UNICEF’s revised response plan will be aligned to the ISCG plan and will require approximately US$70 million to provide life-saving services to over half a million children, which includes the existing Rohingya, new influx, and the vulnerable host community children.
As soon as the response plan is updated, revised targets and indicators will be reflected in the forthcoming Situation Report.
Prior to the new influx in August, UNICEF required US$20.7 million to provide Child-Centred Care (Child Protection), education, nutrition, and health support to 358,602 children in the period 2017-2018.
Out of this amount, US$9.45 million was a funding requirement for 2017 response.
UNICEF has already deployed an additional 60 staff, namely from its country office in Dhaka, its regional office (Regional Office for South Asia – ROSA) in Nepal, and from its headquarters in Copenhagen, Geneva, and New York, to Cox’s Bazar to support the programme scale-up.
Additional surge staff are being identified.
Shelter/NFI and Site Management Sector Coordinator
An estimated 470,000 people are in need of shelter assistance. This includes people who arrived prior to and after 25 August.
There are massive unmet shelter and site management needs across all sites. Newly created spontaneous sites are not yet suitable for mass habitation, with a lack basic access and infrastructure, particularly water and sanitation facilities.
The land that has been allocated for the new site is not suitable for habitation; there is no road access, and the
population density inaccessible areas is extremely high which poses multiple risks.
Conditions across all sites have been severely affected by heavy rains.
There is a significant need for camp management staff and agencies to be identified and allocated to all areas
of all sites to ensure basic site coordination is in place.
Since 25 August, 30,000 households, 150,000 people, have been provided with emergency shelter kits. Kits include tarpaulin, NFIs and unconditional cash (2,000 taka per HH). Distributions have been conducted in Kutupalong makeshift settlement, Balukhali makeshift settlement, Shamlapur, Leda makeshift settlement, and Roikhong/Unchiprang,
Site planning is being conducted in close coordination with the authorities. Site planning is primarily focused on establishing basic road access to Kutupalong Expansion Site, as well as the upgrade of footpaths within the site. Footpaths are being upgraded through community mobilization activities. In the first day of work, 363 metres of footpath were upgraded.
136,000 tarpaulins have been procured and are in transit to Cox’s Bazar.
A site development task force has been established.
Gaps & Constraints:
An estimated 320,000 people are still in need of emergency shelter assistance.
Expansion sites are not ready to receive people, and immediately require basic site access without which the
technical supervision of works and construction, including of drainage and sanitation facilities, is not possible.
There is a gap in the current pipeline for household items. Large procurements are pending.
A significant gap in operational agencies of staffing and technical capacity in shelter operations and camp
106,000 newly arrived Rohingya children are in need of education services.
27 schools and learning centres are currently used as temporary shelters for more than 7,000 new arrivals, hampering children’s access to education.
14,627 Rohingya children, including newly arrived children and children in Cox’s Bazar prior to 25 August, aged 4 to 14 years old are attending early learning and non-formal basic education in learning centers inside the registered camps and four makeshift settlements, Kutupalong, Balukhali, Leda and Shamlapur.
7,200 children have been provided with fortified biscuits in learning centres and schools in Kutupalong and Balukhali. As a result of the influx, education sector is working with food sector partners to increase coverage to all children attending the learning centres.
During the reporting period, 482 Education in Emergency kits were distributed, benefitting more than 14,000 children in makeshift settlements and host communities.
In the reporting period, 522 children attended children’s language and play clubs.
During the reporting period, 400 parents attended early childhood development sessions.
Gaps & Constraints:
91,373 children are not currently accessing education
The construction of learning centres has been suspended in many areas as construction sites have been occupied by new arrivals.
The attendance rate in the learning centres fell from 99 percent prior to influx to 80 percent during the reporting period. There was a slight increase in the attendance rate compared to the previous reporting period, however, the current rate is far below from the attendance rate prior to 25 August. Partners report that the main reasons for the decrease in attendance are concerns of parents for their children’s safety as well as the
mobility of families who have been relocating to new sites, seeking better shelter and improved housing conditions.
Education sector partners have funding constraints as education is not prioritized in the immediate response.
Meeting with Additional Secretary of the Ministry of Primary and Mass Education was undertaken to facilitate discussion with the Government on education response.
All new arrivals, 429,000 people are in need of emergency food assistance.
Amongst the new arrivals, an estimated 55,770 pregnant and lactating women, and children under 5 require targeted food assistance.
5.8 million food rations are required to meet people’s emergency food assistance needs.
Since 25 August, food security partners have provided 4.6 million individual food rations.
Since 25 August, food security partners have reached 358,979 people, or 84 percent of the population, with some form of food assistance.
An estimated 230,024 people, 54 percent of the population, have received sufficient food rations to cover their food needs.
Of the new arrivals, 6,219 pregnant and lactating women, and children under five – 11 percent of the target population - have received a targeted food assistance.
Market assessments and market monitoring will start next week led by the Food Security sector.
Gaps & Constraints:
An estimated 199,000 people still require support to meet their food assistance needs.
The vast majority of food assistance provided is rice and fortified biscuits; only 83,639 new arrivals have received a full food ration.
Organizations are not currently distributing a standard food security package for short-term food distributions. Given the scale of the response, the sheer number of new arrivals and the mobility of the target population, the response is currently still ad hoc.
Sufficient Primary Health Care coverage needs to be urgently established in all new settlements and in the rapidly expanding in existing settlements.
Existing health systems, which are currently severely overstretched, require support to cater to secondary health care needs and the needs of the host population.
Immunization for vaccine-preventable diseases is an urgent priority as well as establishing full EPI programming for Rohingya children.
Amongst the new arrivals, there are an estimated 24,000 pregnant and lactating women who require maternal health care support.
Reproductive Health services and SGBV support are priority areas particularly given high proportion of women in newly arrived influx.
Referral systems to and from health facilities need to be strengthened including support for transport, treatment and discharge.
Three suspected measles cases have been reported. Early Warning and Surveillance Systems must be established and adhered to given high likelihood of a communicable disease outbreak.
Outbreak preparedness, including the establishment of response capacity, is critical given current conditions within new and existing settlements
Mental Health and Psychosocial Support activities must be significantly scaled up.
Since 25 August, an estimated 102,000 people have been provided with healthcare assistance.
As of 21 September, 63,978 children have been vaccinated for measles and rubella, and 33,754 have been
vaccinated for polio.
An Early Warning and Surveillance system has been developed by WHO and DGHS and is currently being trialed. It is expected this will be fully functional as of week beginning 24 September.
Ministry of Health is mobilizing staff for 12 additional medical teams to provide support to existing clinics.
12 mobile medical teams are reporting to Health Sector coordination, with several more being operated by
local NGOs or local volunteer groups.
Some degree of Primary Health Care coverage is being provided to all major sites, however, capacity needs to be significantly strengthened and geographical distribution needs to improve.
Since 25 August, 27,055 people have been reached with Mental Health and Psychosocial Support Services. An additional 70 psychosocial workers are currently being mobilized.
Total number of women and girls reached with SRH services by midwives and support static facilities/mobile SRH Camps: 23,242.
In-patient capacity has been expanded in existing facilities but more is required.
Gaps & Constraints:
Access to new settlements is a significant challenge, particularly for establishing fixed medical posts in
Funding is urgently required to support health sector response as well as existing overburdened health
Lack of reporting from partners is hampering planning and coordination efforts.
Daily reporting to the newly establishes Early Warning and Surveillance System is required to maintain high vigilance of disease outbreak.
Human Resource constraints are becoming a challenge, with a need to recruit medical staff from outside the area.
Cramped and crowded living conditions with lack of adequate water and sanitation are presenting significant risks of disease outbreak.
Amongst the individuals who have arrived in Cox’s Bazar since 25 August, an estimated 300,000 people are in need of nutrition assistance.
154,066 children under 5 and 54,633 pregnant and lactating women need malnutrition prevention and treatment support through nutritious supplementary food.
14,420 severely acutely malnourished children require inpatient and outpatient treatment.
91,056 adolescent girls are in need of nutritional support
During the reporting period, 61,269 newly arrived children under 5 were screened for malnutrition; 759 were identified as suffering from SAM and were admitted to in- and outpatient settings for treatment.
During the last week, 4,260 children under 5 were admitted into a malnutrition treatment and prevention programme and received nutritious supplementary food
During the last week, 2,544 pregnant and lactating women were admitted into malnutrition treatment and prevention programme and received nutritious supplementary food.
During the reporting period, 184 pregnant and lactating women received counseling on Infant and Young Child Feeding.
Over the last week, 29,690 children aged 6-59 months received Vitamin A supplementation.
The Nutrition Sector is coordinating amongst nutrition stakeholders to ensure early identification and treatment of malnourished children and pregnant and lactating women, through the better use of human resources in a coordinated manner.
Gaps & Constraints:
Caregivers are afraid to access the existing nutrition centers that are often very far from the settlements.
There is a lack of safe breastfeeding spaces in the settlements that are necessary to ensure the promotion and protection of breastfeeding.
There is a need to establish mobile Community Nutrition Centers to rapidly scale up treatment of malnutrition amongst children under 5 and pregnant and lactating women.
Safety, Dignity, and Respect for Individual Rights
Emergency shelter and safe spaces are critical, particularly in the Kutupalong Expansion Site. Special arrangements need to be sought for especially vulnerable individuals, who are at serious risk of—and in some cases have already experienced exploitation and abuse.
Basic security in the Kutupalong Expansion Site and access to justice, so that assault, sexual or otherwise, cannot be committed with impunity.
Children and mothers with young children, especially those in the Kutupalong Expansion Site, lack basic assistance including food, shelter, sanitation facilities, safe places, and clothing.
Stable power supply required at all sites, but particularly lighting in the Kutupalong Expansion Site, is required to ensure safety at night.
Safe and immediate access, including without fear of arrest, for seriously injured/sick persons to medical facilities.
Regular programming for children, including access to schooling, should be resumed as soon as possible.
Given high numbers of separated families including unaccompanied children, strengthened family tracing mechanisms as needed.
Women and girls require dignity and safety items including washable menstrual hygiene products, basic clothing items, plastic sandals, and a torch/flashlight.
Establishment of life-saving health and psychosocial support services is an urgent, critical need.
It is estimated that 348,000 children and adolescents aged 6-18 years old, including new arrivals, pre-existing Rohingya population and host community, are in need of support to ensure they have access to a protective environment.
Since 25 August, an estimated 11,000 people have been reached with GBV sub-sector assistance
Community-based protection networks have been initiated in the Kutupalong Expansion Site.
During the reporting period, 61 reported cases of GBV in make-shift settlements were referred to support services.
In the last week, 909 dignity kits were distributed across Balukhali, Leda, Kutupalong, and Shamlapur make-shift settlement areas.
During the reporting period, 2,558 individuals received GBV service information through outreach and awareness raising in make-shift settlements.
During the reporting period, information desks in registered camps received unaccompanied children, found 37 missing children. In other locations,124 unaccompanied and separated children (59 boys, 58 girls) were identified and registered. Since August 25, a total of 1,543 unaccompanied and separated children (762 boys, 817 girls) have been identified and registered.
During the reporting period, an average of 1,676 children accessed psychosocial support and Child-Centered Care services including Child Friendly Spaces, recreational sessions and another form of psychosocial on a daily basis.
During the reporting period, 262 most at risk adolescents have received life skill-based education and/or GBV referral services.
17 children are currently living in Child Safe Space in the formal refugee camp (8 boys, 9 girls).
42 Child-Friendly Spaces are currently operational, and 90 adolescent clubs are active.
A set of key child protection messages to disseminate to communities have been agreed among partners of Child-Centered Care and GBV sub-sectors.
Gaps & Constraints:
Limited ability to contact refugees’ relatives who are still in Myanmar.
Access to life-saving care is severely limited in spontaneous settlements. First line treatment and referral for clinical management of rape services is not uniformly available across mobile emergency primary health care units.
Women and girls have no safe havens. Overcrowding in make-shift settlements and rapid population movement to spontaneous settlements is making it difficult for service providers to identify private, safe service points for GBV case management and psychosocial support services.
Distributions points are not safe, and women receiving aid have been targeted for theft, harassment, and assault.
Congestions in settlements and camps continue to pose safety and security risks for children.
Children and their families are in the need of basic services. Increased effort is needed to mainstream child protection into other sectors including food, site management, NFI required.
It is essential to engage with and support parents and care givers to provide psychosocial services and awareness-raising on child protection issues.
A limited number of agencies and service providers with Child Protection service and expertise are on the ground.
Water, Sanitation, and Hygiene
An estimated 391,000 newly arrived refugees need immediate WASH assistance.
Approximately 59 million litres of safe water are needed every day to meet the needs of the target population.
Due to the massive population increase in all sites, WASH facilities are under immense strain. To provide access to basic emergency sanitation to all targeted beneficiaries, 18,000 emergency latrines are required.
Areas that are close to the border and the Naf river, are the most in need of urgent WASH facilities with sites having no or very limited access to safe water and latrines.
In sites, people are in need of jerrycans for safe water transportation and storage.
Considering the poor sanitation conditions across the sites there is a serious risk for a public health hazard.
Unchiprang settlement has no access to ground water and requires trucking of 745,550 litres of water per day. Existing water sources are losing the capacity to supply the minimum water requirement, and by January may no longer be viable.
Since 25 August, 141,070 people have been reached with WASH assistance.
On a daily basis, 1.5 million litres of clean water are provided to makeshift settlements, spontaneous sites and camps.
During the reporting period, 213 tube wells were installed.
In the last week, 15,477 jerrycans were distributed to facilitate the safe collection and storage of water.
1,532 emergency latrines have been constructed and are being maintained by implementing agencies.
During the reporting period, 1,094 hygiene kits were distributions, and emergency hygiene promotion was conducted in all makeshift settlements and official camps.
Gaps & Constraints:
249,930 individuals still require WASH assistance.
Access to new sites is a major concern and hampering ability of partners to scale up the WASH activities.
Provision of safe water needs to scaled up by 51.96 million litres per day.
Due to lack of road access, water trucking to Unchiprang settlement has reduced.
Due to high numbers of new shelters being constructed, there is limited space available for WASH facilities.
The humanitarian response in Cox’s Bazar is coordinated by an Inter-Sector Coordination Group (ISCG), which meets at the national level in Dhaka and at the district level in Cox’s Bazar.
The ISCG was established after the previous significant influx of people in October 2016 to try and ensure better operational coordination amongst agencies.
Seven sectors are currently operational in Cox’s Bazar whose partners are responding to the needs of Rohingya refugees and Undocumented Myanmar Nationals, including the new arrivals; these are Shelter/NFI and site management, Food Security, WASH, Health, Education, Nutrition, and Safety, Dignity and Respect for Individual Rights. In addition, the refugee response (Multi-Sector) is represented at the ISCG.
The Sectors liaise with relevant Government counterparts: Ministries, Departments or other authorities, and ensure
clear linkages with the national level clusters. Sectors are underpinned by the principles of the cluster approach, allowing for a more effective coordination, the establishment of sector standards needs assessments and analysis, technical issues, and monitoring needs and gaps in the provision of humanitarian assistance.
Better coordination with large Bangladeshi civil society that is providing multiple, small scale but often uncoordinated distributions including clothing and food is required. Individuals and private companies in Cox’s Bazar who would like to provide support to the Rohingya population should contact the local authorities to ensure that this process is appropriately coordinated.
The District Administration has established a control room to support this – those individuals wishing to provide assistance should call them on +88 0161 5700 900.
The Department of Public Health Engineering DPHE and the District Civil Surgeon have established mechanisms in Cox’s Bazar to improve coordination with implementing agencies on WASH and health respectively.
The Ministry of Disaster Management and Relief (MoDMR) district level RRRC will also be engaging in coordination with
humanitarian actors on the Kutupalong site establishment.
The government has not requested support from Foreign Medical Teams at this stage.