Rohingya walk near closed shops in an alley of a refugee camp during a government-imposed lockdown of Cox's Bazar district as a preventive measure against Covid-19, in Ukhia, Bangladesh, on April 9, 2020. Photo: AFP / Mohammad Kalam

There are broadly two things that govern how nations and communities are coping with Covid-19: leadership and resources. More than three months after the World Health Organization declared a global pandemic, it’s clear that some countries are doing well while others aren’t. 

But top of everyone’s minds – not least those with the finances to help – should be the world’s most marginalized and at-risk children. If we don’t protect them, we have failed in our battle against Covid-19, as they will be impacted hard by a full-blown outbreak – they’ll lose loved ones, they will miss out on education, and they might need to work to help with the family income as caregivers fall ill or succumb to the virus.

In the Rohingya refugee camps in Cox’s Bazar, leadership is not an issue. The Bangladeshi government moved quickly to implement a lockdown across the whole district. It is working closely with partners – including Save the Children – to respond to this new health crisis. 

However, resources can be a problem. In the subdistricts of Teknaf and Ukhia there are an estimated 850,000 Rohingya refugees from Myanmar and 400,000 Bangladeshis. The Bangladeshis who live here are not rich – they eke out a living by farming and fishing. The refugees are even poorer. 

Having already fled for their lives in the face of brutal violence in Myanmar, Rohingya refugees now live in overcrowded camps. They share communal washing facilities and latrines. They live off the food distributed by aid agencies.

After decades of discrimination in Myanmar and poor facilities for learning in the camps, literacy and numeracy skills are low, their trust is limited, and the amount of misinformation swirling through the camps is high.

Covid-19 has now reached the world’s largest refugee settlement. Refugees and the humanitarian community have been preparing for this for some months. But despite that, it’s likely Covid-19 will quickly spread through the camps – which have a population density four times that of New York City. 

The atmosphere is one of fear. Findings from a recent consultation with Rohingya refugee children found that 64% of respondents reported they were scared of getting sick while 40% said they were worried they or someone they loved was going to die.

We will continue to do all we can to slow down the outbreak, but just as we have seen in Europe, Asia and the United States, we will not be able to stop it. Our job will be to treat those who become sick and save as many lives as possible.

This weekend, Save the Children is opening an Isolation and Treatment Center with the capacity to treat up to 60 patients with confirmed or suspected cases of Covid-19, in the heart of one of the camps. This will help to serve patients from both the Rohingya and host community with severe cases of Covid-19, so they can be isolated from the wider community and closely monitored.

We will stabilize those in critical condition – treating them with dignity and respect – and hope they may secure a referral to one of the few intensive-care units in the main town of Cox’s Bazar. 

The hard reality, though, is that this will be inadequate. At best, it’s estimated there will be an additional 1,000 to 1,500 isolation beds in the camps to support Covid-19 patients, serving a population of more than a million Rohingya refugees and the host community. That’s less than one bed for every 1,000 people in and around the camps. Life for the sick and critically ill will be unimaginably tough. 

To meet this challenge, Save the Children has put in place mobile health teams to provide support to refugees who will need medical attention but are unable to access a bed or get to a treatment center. 

Once the outbreak is over, we must collectively demand compassion, justice and commitment to the plight of the Rohingya community. The world owes them much. Those who forced them to flee and inflicted egregious violations must be held to account.

Refugees must be allowed to return safely and with dignity to their towns and villages in Myanmar. They must be given a stronger voice in the decisions affecting them in both Cox’s Bazar and Myanmar. Their rights – in full – should be the focus of governments, donors, and aid agencies.

At the same time, support from the international community to the government of Bangladesh as it continues to host the Rohingya must continue. 

It is impossible to be anything but nervous at this stage. Many people are working hard to avert a catastrophe, but there is real concern that it won’t be enough. The Rohingya will once again suffer – the extent of this is dependent on the steps taken now.

As they face yet another horrific experience, the Rohingya community in Cox’s Bazar – especially the half a million children – must be given hope that their future will be better than their past. 

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David Skinner

David Skinner OBE is the team leader for Save the Children's Rohingya response. Based in Cox's Bazar, Bangladesh, he oversees nearly 2,000 staff. Skinner joined Save the Children in 2005. Before that, Skinner worked for 25 years in the British government, including coordination of the Sino-British negotiations for the handover of Hong Kong.