Global Humanitarian Response Plan for COVID-19: July Update for ROHINGYA CRISIS
Impact of COVID-19
Immediate health impacts on people and systems
Some 860,000 Rohingya refugees currently reside in 34 congested camps in Cox’s Bazar District. The District is one of the poorest in the country, home to 2.65 million Bangladeshis. Cox’s Bazar District is at extreme risk of severe impact from COVID-19, given the congested conditions in the refugee camps, high levels of vulnerabilities among the refugee and Bangladeshi populations, and the extremely limited public health capacity. People with chronic illnesses and older persons (approximately 4 per cent of the Rohingya population, or 31,500 individuals, are over age 59) are at particularly at high risk. The prevalence of respiratory illnesses combined with underlying factors such as malnutrition and other undiagnosed diseases could increase the impact of the COVID-19 outbreak in the camps. Planning is based on capacity, rather than on anticipated need; current modelling of the likely trajectory of the epidemic indicates that the requirement for beds will far exceed availability.
In close coordination with the Government of Bangladesh, humanitarian partners have been preparing for the outbreak since early in the year. Community transmission is now confirmed in the camps and wider District, with the number of cases increasing daily. To slow transmission of the virus, the Government has halted all but critical services in the camps; services such as health, nutrition, food and fuel distribution, hygiene, water and sanitation, construction of health facilities and additional WASH infrastructure, reception of new arrivals, quarantine and family tracing continue. Services that are temporarily closed include educational facilities, women and child friendly spaces, and markets.
Indirect impacts on people and systems
949,000 Bangladeshis in Cox’s Bazar are considered vulnerable to loss of livelihoods and income as a result of COVID-19. Loss of livelihoods coupled with rising prices on some basic food items is stretching the coping capacities of vulnerable Bangladeshis. In addition, the social impact of the outbreak is deepening inequalities. Emergency provisions enacted to curtail the spread of COVID-19 must conform to human rights standards, to avoid discrimination and the potential for conflict. Women and girls are being disproportionately impacted due to restrictive gender norms, with reports of increased domestic violence in camps and host communities.
Response priorities and challenges
Priorities and early achievements
Priorities include sustaining critical, life-saving services and assistance, with contextualized public health measures to minimize transmission, such as physical distancing and hygiene; scaling up Risk Communication and Community Engagement on health, and increasing availability of water, sanitation and hygiene services for Rohingya refugees and Bangladeshis; establishing the health response to COVID-19 for Rohingya refugees and Bangladeshis – a multi-sector effort; protecting older and vulnerable Rohingya refugees; augmenting Government social safety nets for vulnerable Bangladeshis whose livelihoods have been impacted by the pandemic; and scaling up critical common services to enable the humanitarian operation.
Among the achievements to date, twelve new Severe Acute Respiratory Infection Isolation and Treatment Centres (SARI ITCs) for COVID-19 are being established, three of which are already operational and receiving patients. Support to Government facilities is being provided across the District, with 10 new intensive care beds recently operational in the District Hospital. In the camps, the distribution of re-usable masks to everyone and installation of hand-washing stations outside all refugee shelters is underway. For Bangladeshis, food, cash or agricultural inputs are being provided to the most vulnerable. To support front-line humanitarians, a 50- bed facility is being established, which will be essential to the continuity of the operation.
Challenges and impact to operations
The refugee population remains entirely reliant on humanitarian assistance. The reduced footprint in the camps to deliver critical services only has made the role of refugee and Bangladeshi volunteers even more critically important and requires remote management. An increase in criminal and protection incidents has been observed since April. Shifting policies on movement restrictions call for constant negotiation to sustain access. Restrictions to supply chain, travel and entry of surge staff is presenting major challenges. Communication and trust between communities is fragile and maintaining privacy and data-sharing protocols is presenting challenges. The continued restriction on mobile data networks in the camp areas is a major impediment to the operation. The monsoon season has begun, with heavy rains and high winds in June causing flooding and damaging shelters and infrastructure, and the second cyclone season is approaching in October.
The 2020 Joint Response Plan (JRP) remains the core strategy, planning and resource mobilization platform for the operation. Guided by the JRP 2020, and through the Inter-Sector Coordination Group (ISCG), the humanitarian community works closely with the Government of Bangladesh and district health authorities. A total of 117 partners contribute to the JRP. The ISCG partners have developed a COVID-19 Response Plan as an addendum to the JRP 2020. The plan defines additional needs arising from the COVID-19 pandemic totaling US$182 million. The addendum also identifies priority activities and funding gaps within the JRP 2020: US$389 million is required to sustain critical, life-saving activities within the JRP 2020 to the end of the year.