Four things to know about Covid in the world’s largest refugee camp

Nineteen-year-old Nur Jahan (pseudonym) shares two flimsy tents with her baby and 14 other family members. Life is really tough for Nur in the sprawling refugee camps of Cox’s Bazar, Bangladesh, where she fled four years ago from violence and persecution in Myanmar.
 
“Simple things like finding clean water or food are hard,” she says. “Crammed in these tiny tents, it would be hard to keep safe if a family member got coronavirus.”

A year on since the World Health Organization declared Covid-19 a global pandemic, the virus has had far ranging impact on marginalized Rohingya refugees like Nur. The over-riding lesson has been how Rohingya refugees braved the new challenges of the pandemic with incredible determination and resilience. 

Here are four things to know about how residents of the world’s largest refugee camp have braved Covid-19. 

Covid has fueled hunger and poverty

Despite the difficult conditions in the camps, the Rohingya people seem so far to have escaped from the worst. Infection rates have remained far below initial projections with only 406 people having tested positive, and ten deaths, since the first confirmed Covid-19 case was discovered on May 14. The WHO and Bangladesh Institute of Epidemiology plan further research to better understand the trajectory of the virus in Cox’s Bazar. There is some suggestion that many refugees were initially reluctant to seek tests. 

Humanitarians and the Government of Bangladesh quickly built-up health services, but the low number of cases is still extraordinary. The camps are severely crowded with almost one million people sharing 26 square kilometres—that’s 40,000 people per square kilometer. In many areas up to 250 people share a single water tap. Social distancing is virtually impossible. Health experts warned that conditions were set for a devastating outbreak and catastrophic loss of life. So far, they have thankfully been proved wrong.

However, the pandemic has fueled an economic crisis. There has been a sharp decline in refugees’ wellbeing. More than half the men and 84% of all women say they’ve not been able to make the same money as before. Nearly a quarter of all refugee households moved into a higher category of vulnerability—meaning they had less food and experienced more economic stress. Families were much more likely to accept high-risk jobs or send their children to work.

The pandemic also fuelled hunger. Only half of refugee households today have acceptable levels of food. Both refugee and host communities reported overwhelming difficulty to find sufficient or good quality food.

“Before Covid-19, we could get food from the distribution centres after checking it very carefully, but now much of the food gets rotten after two days because it now takes so long to arrive.” The most vulnerable people are hardest hit, particularly single mothers, pregnant and lactating women, the elderly, and people with disabilities.

Women and girls bore the brunt of the crisis

Oxfam and several partners conducted a Gender Analysis that found women and girls—both in the camps and in the host community—were facing greater risks and burdens, such as a  spike in violence even as they got less lifesaving services and support. “Intimate partner violence, domestic violence, sexual harassment and kidnapping increased as security dropped and several organizations stopped their protection work,” a female Rohingya Youth Leader told the research team. “Gender-based violence protection services are not available every day and it was difficult to access them remotely.”

The study also found many Covid-19 messages were not reaching women and girls because of lockdown. Rohingya women in the camps and the host communities were consequently made less aware of Covid-19 risks than men.  

Lockdowns also increased women’s and girls’ burden of unpaid care work which remains almost exclusively their responsibility. “Women are always expected to do more household chores than men. To ensure cleanliness during the pandemic, washing has increased for example and so women’s workload has doubled,” a host community woman, who also works as a police officer, told us.  

Rohingya led the Covid response

Rohingya refugees were at the heart of their own Covid-19 response. Nur and her family, for example, learned about the disease from refugee volunteers in her community. “They came to make us aware of this virus using megaphones to explain what to do…so we know how to wash hands, how to be safe,” she told Oxfam.

The Bangladeshi authorities had to significantly limit relief operations and reduced the humanitarian footprint in the camps by 80 percent. Thousands of community volunteers both from the Rohingya and Bangladeshi host community stepped in. They ramped up awareness on prevention, health and safety, began disinfecting communal areas and taught about the importance of handwashing and social distancing. Youth in the camps used social media to share songs with information about the virus. Women were leaders; more than 70% of volunteer community health workers in Cox’s Bazar are female.

Oxfam worked with nearly 400 camp-based volunteers to monitor conditions and promote women’s rights and public health. “Every day we help the community with soap and water and providing valuable information,” says twenty-year-old Zahid Hossain, an Oxfam volunteer working in the camps. Zahid travels door to door explaining the virus symptoms and precautions, and where people can seek care.

“I’m happy to provide support for my community. If we don’t spread messages about how to fight Coronavirus there will be more cases in the camps and more people will die,” Zahid said.

The virus inspired humanitarian innovation

The pandemic sparked innovation. Oxfam has provided clean water and sanitation facilities to 73,552 people in Cox’s Bazar camps. Together with partners, we also delivered gender and livelihoods programs to both refugees and members of the Bangladeshi host community.

To limit physical contact, Oxfam and partners developed a new foot pedal-powered hand-washing station which made it possible for people to wash their hands without contaminating a tap or soap container. Refugees first tested it and gave us advice on how to improve it.

To reach more women and girls with Covid-19 awareness Oxfam provided new ways to communicate essential information, through dedicated information kits, powered with a Bluetooth speaker with pre-recorded messages in the Rohingya language, a solar charger, and a waterproof pouch. They helped us maintain contact during the pandemic while reducing human contact. This initiative was led by Rohingya women’s groups, who shared messages across households.

“Men used to give us confusing information about Covid-19 and we were uncertain what to believe and what not to believe,” a Rohingya woman told us. “After getting the audio kit we got to know the right things regarding covid-19 and it cleared our confusion.”