Hopes of controlling the COVID-19 pandemic are increasing, with nearly five billion doses of vaccines administered globally. Yet for vulnerable populations such as Rohingya refugees in Bangladesh, there is a long road ahead. As a result of the violent August 2017 crackdown on Rohingya previously living in Myanmar, Bangladesh hosts a population of nearly one million Rohingya refugees who have fled violence and ethnic persecution. Living in crowded refugee camps, the Rohingya population faces the grave risk of contracting COVID-19 amid a major surge of the highly contagious Delta variant. The Bangladeshi government acquired a large stock of vaccines in August, allowing for the start of vaccinations for Rohingya refugees. However, with more than 7,000 daily new confirmed COVID-19 infections in Bangladesh as of August 19, access to vaccinations for Rohingya refugees is critical to the health of a population already ravaged by the trauma of persecution and facing deficient health care.
The provision of reliable access to such information and the building of trust with health care providers is essential for a successful vaccine campaign.
The Status and Access to Health Care of Rohingya Refugees in Bangladesh
The displaced and stateless Rohingya came to Bangladesh’s borders seeking safety and security. However, they are not recognized as refugees by the Bangladeshi government – which considers Rohingya to be “forcibly displaced Myanmar nationals” – and, as a result, do not have the same protections as other refugees living in the country.
The COVID-19 pandemic opens old wounds for the Rohingya, who have faced numerous challenges in accessing basic health care since arriving in Bangladesh. Rohingya refugees often express hesitancy in trusting health care systems in the refugee camps and in reporting symptoms of COVID-19. COVID-19-related restrictions previously put in place by the government of Bangladesh have limited aid workers’ access to the camps and included internet blackouts and phone restrictions there, further complicating the delivery of aid. Given these challenges, it is unsurprising that Rohingya refugees have not received adequate information on health care and the COVID-19 pandemic. The provision of reliable access to such information and the building of trust with health care providers is essential for a successful vaccine campaign.
COVID-19 Response in Rohingya Camps
The majority of the nearly one million Rohingya refugees in Bangladesh live near Cox’s Bazar, in an area which became host to the world’s largest refugee camp following the 2017 influx. Prior to the COVID-19 pandemic, the dense living conditions in Cox’s Bazar had already resulted in severe health hazards and disease outbreaks.
However, while the establishment of 14 COVID-19 treatment facilities was expedited in Cox’s Bazar, no vaccines have been provided to some 20,000 Rohingya who were relocated to the remote island of Bhasan Char to ease overcrowding in the refugee camps.
Exacerbating this, the vaccination of Rohingya refugees against COVID-19 was delayed until August 10 due to dramatically inequitable global vaccine distribution that limited supplies to Bangladesh and the deprioritization of refugee populations in Bangladesh and elsewhere, which runs counter to the World Health Organization’s framework for vaccine allocation urging all countries to prioritize high-risk groups, including people over age 65 and those with underlying health conditions, regardless of residency and legal status. The second wave of COVID infections in India resulted in the suspension of vaccines provided to Bangladesh through the COVAX program, halting Bangladesh’s vaccine rollout.
Following efforts by the government to secure vaccines from other sources, the vaccine supply in Bangladesh recently increased, as did vaccination rates. True to its promise to include Rohingya refugees in the national vaccination roll out, the Bangladeshi government has started vaccinating the Rohingya, with the U.N. High Commissioner for Refugees predicting that 65,000 of nearly 900,000 refugees will be vaccinated in the first cohort. However, while the establishment of 14 COVID-19 treatment facilities was expedited in Cox’s Bazar, no vaccines have been provided to some 20,000 Rohingya who were relocated to the remote island of Bhasan Char to ease overcrowding in the refugee camps. No vaccination plans have yet been announced for the Rohingya on Bhasan Char.
Recommendations
For at-risk populations in low-income countries to gain sufficient access to vaccines, the international community must move more quickly to meet the demands of the People’s Vaccine Alliance, of which PHR is a proud member
The Rohingya’s vulnerability during the pandemic has only further demonstrated the urgency of protecting the universal right to health for all people, regardless of legal status. While the renewed vaccine supply to Bangladesh has brought a wave of relief, the near 15-month delay in vaccine access for the Rohingya and the limited reach of the first cohort speaks to the urgent need to address global vaccine supply and inequity, which threaten to prolong the unrelenting spread of COVID-19 worldwide.
For at-risk populations in low-income countries to gain sufficient access to vaccines, the international community must move more quickly to meet the demands of the People’s Vaccine Alliance, of which PHR is a proud member. High-income countries like the United States must make a significantly greater investment in global vaccine manufacturing to have any hope of controlling and ultimately ending the COVID-19 pandemic. Bangladesh should uphold the human rights of refugees by adhering to global public health recommendations to prioritize refugee and displaced populations in their vaccination efforts. The Bangladeshi government must provide legal status to the Rohingya as refugees and ensure their reliable access to health care as well as timely and accurate health information to allow the smooth vaccination of the Rohingya population once the vaccine supply is made available to Bangladesh.