Malnourished Rohingya children at heightened risk during pandemic

On a normal day the nutrition centre set on a dusty road in the Rohingya refugee camps in Cox’s Bazar, Bangladesh, is teeming with people. It is one of 27 facilities supported by UNICEF that offers life-saving treatment to children suffering from severe and moderate acute malnutrition

The countrywide lockdown measures, in place in Bangladesh since the end of March to reduce the spread of COVID-19, have impacted operations at UNICEF nutrition facilities. To reduce crowds and facilitate physical distancing, many services have been scaled down, reducing humanitarian access for UNICEF and partners.

The impact of COVID-19 has specialists such as Dr. Karanveer Singh, UNICEF Nutrition Manager, Cox’s Bazar, worried. 

The level of food insecurity is high. The camps are overcrowded and there is poor sanitation. These factors place malnourished children at high risk when there is a disease outbreak in the camps, further spiraling the vicious cycle of malnutrition and infection,” says Dr. Singh.

The sprawling camps are home to more than 860,000 Rohingya refugees who fled from persecution in Myanmar. Over 11 per cent of children suffer from acute malnutrition and more than 30 per cent suffer from chronic malnutrition in the refugee camps.

COVID-19 threatens to disrupt global food supplies and limit food choices. Many Rohingya families do not eat well enough or frequently enough, and what they do eat is of poor diversity threatening children’s development, growth and even survival.

We are afraid because we fled from Myanmar to save our lives. If our children die, what will happen to our people?

Coping with fear and uncertainty

Globally, malnutrition accounts for 45 per cent of deaths in children under five. Children suffering from severe acute malnutrition are also nine times more likely to die than a healthy child.

With the first cases of COVID-19 confirmed in the refugee camps in mid-May 2020, and rising cases in the nearby Bangladeshi communities, there is an increased sense of fear and alarm among the Rohingya population.

“We are afraid because we fled from Myanmar to save our lives. If our children die, what will happen to our people?”, said Fatima, a mother of five living in the congested camps in Cox’s Bazar.

“When I visit women in their homes, they ask a lot of questions about coronavirus,” says Taslimata, a community nutrition volunteer. “I tell them about handwashing and to keep a distance from other people,” she adds.

Pushing through amid lockdown measures

Last year community nutrition volunteers screened an average of 135,000 children for malnutrition every month in the refugee camps, but these services are now suspended due to COVID-19 mitigation measures.

To offset risks, community nutrition volunteers are now training Rohingya mothers to identify new cases of malnutrition in households using a colour coded tape, which is wrapped around children’s’ arms to measure the severity of malnutrition.

Presently, the process is at a smaller scale than the usual screening mechanisms and nutrition workers are working against the clock to ensure that children who are severely malnourished are referred for treatment and support.

This approach has yielded positive results, new admissions saw a fourfold increase in mid-May  compared to the early stages of the lockdown in March. UNICEF is now scaling up this programme to train more mothers and caregivers while the movement of aid workers to the camps remains restricted due to COVID-19 mitigation measures.”

Frontline workers, everyday heroes

Despite bearing so much on their tiny shoulders, the children’s laughter used to fill the play area of the nutrition centre with the resolute essence of childhood. Now those sounds of laughter have considerably faded but the children’s spirit is what keeps frontline workers going.

“Our work is needed to prevent more children from becoming malnourished. It’s a great pleasure to see the smile of a child we helped get better” says Alimul, manager of the nutrition centre run by UNICEF partner Concern Worldwide.

Alimul’s family lives more than 800 kilometers from Cox’s Bazar and as all public transportation have been suspended nationwide, there is no way for him to go home if someone from his household falls ill.

The sacrifice and dedication of frontline workers allows UNICEF to continue providing critical nutrition services to children and pregnant women in need.

Since their arrival in the refugee camps, Rohingya children have been exposed to many dangers such as measles, cholera outbreaks, poor access to sanitation, food insecurity and weather hazards to name a few. These factors can contribute to new cases of children suffering from malnutrition, in addition to a deterioration in health for those already battling with malnutrition.

It is critical for UNICEF to continue providing treatment services for children suffering from malnutrition. Good nutrition has a long-lasting impact for every child, helping them to grow up healthy, learn and be active members of their community.

“We must ensure children are healthy, as the entire Rohingya community braces to face the COVID-19 pandemic. We must act now to prevent the COVID-19 crisis spiraling into a nutrition crisis,” says Dr Karanveer Singh, UNICEF Nutrition Manager, Cox’s Bazar.

UNICEF wishes to express its sincere gratitude to the European Union, the European Commission Humanitarian Aid (ECHO), the United Kingdom’s Department for International Development (DFID), the United States Agency for International Development (USAID) Office of Food for Peace,  the Government of Japan and Australian Committee for UNICEF for their generous contributions towards supporting Integrated Nutrition Centers.

We also thank our implementing partners CARE International, Concern Worldwide, World Concern, World Vision, Society for Health Extension and Development (SHED) and Social Assistance and Rehabilitation for the Physically Vulnerable (SARPV) for their tireless efforts.