The refugee camp visit that made me realise mental health is equal to physical health

Urgent action is needed to recognise mental health as equal to physical health in the support being provided to Rohingya refugees

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Along with hundreds of thousands of others, Khurshida escaped Myanmar following an eruption of violence on the 25th of August 2017 that saw Rohingya shot, beaten and burned to death in their own homes. Women were raped and mutilated, children murdered and villages were looted and torched. An estimated 10,000 Rohingya were killed. Secretary-General of the United Nations António Guterres called the violence “one of the most tragic stories in relation to the systematic violation of human rights”.

After witnessing unimaginable atrocities, Khurshida and her family fled for their lives, crossing the border to Bangladesh and reaching Kutupalong, which quickly came to be the largest refugee settlement in the world.

Today, 912,000 Rohingya refugees live in refugee camps in Bangladesh – over half of them children. Conditions are tough, with limited access to shelter and food and where such an overwhelming number of inhabitants is stretching the resources of humanitarian aid organisations.

However, the challenges I witnessed on my most recent visit – hunger, poor physical health and poverty – are equalled by those that are unseen: the mental health of those who have been witness to unspeakable atrocities.

These are compounded by the challenges the refugees continue to face on a day-to-day basis – the difficult environment of the camps they live in, the ongoing uncertainty over their future and, for some, modern slavery – forced labour, forced marriage and forced prostitution.

While women and girls are most likely to be the victims in Rohingya trafficking, according to the UN Migration Agency, in Khurshida’s family it was her 12-year-old son, Mohamed Faisal, who fell victim to traffickers. Imagine escaping violence like that experienced in Rakhine State and the relief of reaching a place of safety only to then find your family’s safety is compromised by a new threat.

Sadly, Khurshida is just one of hundreds of thousands of Rohingya refugees who have experienced highly traumatic events since August 25th 2017. For some, these traumas have contributed to poor mental health and there are currently limited services available in the refugee camps to provide support.

The need for mental health services in Rohingya refugee camps is clear. Recognising, understanding and talking openly about the complexities of mental health is challenging in all cultures and when tackling Rohingya mental health, we face a number of specific additional difficulties. The Rohingya language does not have words for many of the terms used to describe mental and emotional health. Many Rohingya are unfamiliar with concepts around mental health and mental health care and for some there is a shame attached to mental health conditions. This means the refugees frequently do not seek formal help for mental health problems.

There are some mental health services offered in Rohingya refugee camps but the number of people they can currently support is limited. More resource is needed to reach the great number of Rohingya who may be struggling with mental health challenges but may not proactively seek support.

Urgent action is therefore needed by the international community to recognise mental health as equal to physical health in the medical support being provided to the Rohingya – otherwise mental health risks being a long-term public health challenge for generations of Rohingya refugees.

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