Critical health services must be scaled up for nearly 1.3 million people – Rohingyas and their surrounding host communities – in Bangladesh’s Cox’s Bazar, where vulnerable populations in crowded settlements and ‘mega camps’ are at risk of a host of waterborne diseases, the United Nations World Health Organization (WHO) warned Tuesday.

“Commendable efforts have been made by the Government of Bangladesh and partner agencies to provide health services; prevent diseases such as cholera; and rapidly control outbreaks of measles and diphtheria. However, the challenges are huge, multiple and evolving,” said Dr. Poonam Khetrapal Singh, Regional Director for (WHO) South-East Asia.

“The magnitude of the crisis requires continued efforts and generous contributions by all partners to scale up health services for the vulnerable population,” she added.

One of the largest population movements in the shortest time span began 25 August when an estimated 688,000 Rohingyas crossed from Myanmar to Cox’s Bazar – joining nearly 212,500 others who had arrived in earlier waves.

Health needs continue to be immense, particularly surrounding reproductive care. Some 60,000 children are expected to be born in the camps over the next year. Besides mothers, newborns and children, the elderly need basic health services, including for trauma and various non-communicable diseases, such as heart disease, diabetes and psychosocial support.

“Water and sanitation, and shelter continues to be far from optimum, increasing the risk of rapid spread of several communicable and water borne diseases,” the Regional Director said, stressing the need to accelerate efforts to address the key determinants of health on a priority.

The upcoming rainy season increases the vulnerability to waterborne diseases, such as diarrhea and hepatitis, and vector borne diseases, including malaria, dengue and chikungunya.

When the crisis first began, WHO established the Early Warning and Response System (EWARS) for rapid detection and response to disease outbreaks to minimize death and disease, which along with risk assessments, prompted Bangladesh to carry out large scale vaccination campaigns for cholera, measles and rubella, polio and diphtheria.

“The health sector is grossly under-funded and grappling to meet the needs of the affected population,” Dr. Khetrapal Singh said, appealing to international community to contribute generously and commit to support what clearly is set to be a protracted emergency.

UNHCR/Caroline Gluck

Rohingya refugees at Kutupalong Refugee Camp in Cox’z Bazar, Bangladesh, preparing for monsoon season., by UNHCR/Caroline Gluck

Living in ‘no man’s land’

At the same time, Andrej Mahecic, spokesperson of the Office of the UN High Commissioner for Refugees (UNHCR) warned on “the situation of several thousand Rohingya who have been living in a so-called ‘no man’s land’ near the border between Myanmar and Bangladesh” since end-August.

“We estimate there are some 1,300 families, approximately 5,300 men, women, boys and girls living in the area near Tombru canal,” he stated, noting that some feared returning home and wished to seek safety in Bangladesh.

He reiterated that everyone has the right to seek asylum, just as they also have the right to return home when they deem the time and circumstances right.

“People who have fled violence in their country must be guaranteed safety and protection, and must be consulted on their future,” he underscored.

Meanwhile, ahead of the monsoon season, UNHCR and partners continue to step up preparations to protect refugees, including encouraging those most at risk of floods and landslides to relocate to other areas. 

“UNHCR staff are facilitating community engagement in preparedness efforts, in particular on appropriate messaging to communities likely to be affected by landslides, floods or cyclones, and analyzing community coping mechanisms and preparedness plans,” he concluded.

Newborns are dying at “alarmingly high” rates in countries that are poor, conflict-ridden or have weak institutions, the United Nations Children’s Fund (UNICEF) said Tuesday in a new report, which reveals that babies born in these places are 50 times more likely to die in the first month of life than those born in some wealthier nations. 

“Every year, 2.6 million newborns around the world do not survive their first month of life. One million of them die the day they are born,” said UNICEF Executive Director Henrietta Fore.

“We know we can save the vast majority of these babies with affordable, quality health care solutions for every mother and every newborn. Just a few small steps from all of us can help ensure the first small steps of each of these young lives,” she added.

UNHCR

Newborn twin babies at Myanmar Refugee Camp in Bangladesh, born to their mother nine days ago after she fled her home in Myanmar.

According to the report, babies born in Japan, Iceland and Singapore have the best chance at survival, while newborns in Pakistan, the Central African Republic and Afghanistan face the worst odds.

In Japan, one in 1,111 newborn babies die in the first month of life while in Pakistan, the ratio is one in 22.

Globally, in low-income countries, the average newborn mortality rate is 27 deaths per 1,000 births, the report says. In high-income countries, that rate is 3 deaths per 1,000. 

The report also notes that 8 of the 10 most dangerous places to be born are in sub-Saharan Africa, where pregnant women are much less likely to receive assistance during delivery due to poverty, conflict and weak institutions. If every country brought its newborn mortality rate down to the high-income average by 2030, 16 million lives could be saved.

More than 80 per cent of newborn deaths are due to prematurity, complications during birth or infections such as pneumonia and sepsis, the report says.

“Given that the majority of these deaths are preventable, clearly, we are failing the world’s poorest babies,” Ms. Fore said.

These deaths can be prevented with access to well-trained midwives, along with proven solutions like clean water, disinfectants, breastfeeding within the first hour, skin-to-skin contact and good nutrition. 

However, a shortage of well-trained health workers and midwives means that thousands don’t receive the life-saving support they need to survive. For example, while in Norway there are 218 doctors, nurses and midwives to serve 10,000 people, that ratio is one per 10,000 in Somalia.

This month, UNICEF is launching Every Child ALIVE, a global campaign to demand and deliver solutions on behalf of the world’s newborns. 

The humanitarian situation of civilians in Syria’s east Ghouta is spiraling out of control, a senior United Nation aid official has warned in the wake of escalating conflict which resulted in more than 40 civilian deaths on Monday alone.   

“I am deeply alarmed by the extreme escalation in hostilities in east Ghouta,” Panos Moumtzis, UN Regional Humanitarian Coordinator for the Syria Crisis, said in a statement issued following clashes that killed over 40 civilians and injured more than 150 injuries in the besieged enclave.

Hundreds of civilians, many of them women and children, have lost their lives or been injured in airstrikes and shelling since November. There have been daily reports about civilians being killed and others being severely wounded, in addition to warehouses, hospitals and schools being damaged or destroyed.

The recent escalation of violence compounds an already precarious humanitarian situation for the 393,000 residents of east Ghouta, many of them internally displaced, and which account for 94 per cent of all Syrians living under besiegement today.

“The humanitarian situation of civilians in east Ghouta is spiraling out of control,” Mr. Moumtzis warned, noting that the lack of access to besieged areas has led to severe food shortages and a sharp rise in food prices, malnutrition rates have now reached unprecedented levels, and the number of people requiring medical evacuations continues to surge.

“We continue to call for unconditional, unimpeded and sustained access to close to 3 million people in besieged and hard-to-reach locations across Syria, including east Ghouta, and urge all parties to the conflict to strictly adhere to their obligations under international humanitarian law to take all feasible measures to protect civilians from harm,” he said.

Recognizing Latin American and Caribbean countries as “pioneers” in the protection of refugees and asylum seekers, the United Nations High Commissioner for Refugees urged the region to bolster its standards even further given the global increase in number of people being driven from their homes.

“I encourage those States who have not yet done so, to accede to the refugee and statelessness instruments, and to move forward with extending pragmatic protection responses to those in need,” said High Commissioner Filippo Grandi, speaking at a regional consultation on the Global Compact for Refugees, in Brasilia, the capital of Brazil.

In his remarks, Mr. Grandi drew attention to the gaps in the international refugee protection regime and how these could be overcome. He also highlighted the need to support the displaced both at the places of origin and reception.

Further, Mr. Grandi also noted the “innovative practices” in the region to address challenges facing people on the move, such as complementary mechanisms, humanitarian visas, and national and regional migration arrangements.

Arthur Max/FM. Ministério das Relações Exteriores

UN High Commissioner for Refugees Filippo Grandi addressing the regional consultation in Brasilia, Brazil.

“I ask you to continue doing so, especially now, when the numbers of refugees are increasing,” he added, noting that the region has more “success stories” on the inclusion of refugees and local communities than anywhere else in the world.

According to estimates, the Latin America and the Caribbean region represents about 16 per cent of the 65 million people who have been forced to leave their homes due to wars, conflicts and persecutions.

Being held on 19 and 20 February, the consultation (more information, in Portuguese) will see officials from 36 countries and territories in the region as well as civil society and other stakeholders discuss and consolidate the region’s contributions to the Global Compact on Refugees that will be adopted by the General Assembly later this year.

Many migrant workers end up trapped in low-pay, unsafe and unhealthy jobs, the head of the United Nations labour agency warned Monday, calling for the adoption of fair labour migration governance frameworks at the global, regional and national levels.

“Most migration today is linked, directly or indirectly, to the search for decent work opportunities,” said UN International Labour Organization (ILO) Director-General Guy Ryder in his message for World Day of Social Justice, which is annually observed on 20 February. 

“But many migrant workers end up trapped in jobs with low pay and unsafe and unhealthy working conditions, often in the informal economy, without respect for their labour and other human rights. They often have to pay high recruitment fees to get a job, on average over a year’s wages – this makes them highly vulnerable to forced labour and child labour,” he added.

Marked this year with the theme ‘Workers on the Move: the Quest for Social Justice,’ the Day focuses on the world’s 150 million migrant workers, many of whom face exploitation, discrimination and violence and lack even the most basic protections.

“This is particularly true for women, who make up 44 per cent of migrant workers,” he said.

Mr. Guy stressed that migrant workers like all workers are entitled to fair treatment and fair treatment for migrant workers is also key to preserving the social fabric of societies and to sustainable development.

If labour migration is well-governed, fair and effective, it can deliver benefits and opportunities for migrant workers, their families and their host communities.  

Governance should be guided by international labour standards, in particular the fundamental principles and rights at work and the relevant ILO and UN conventions. The ILO’s Multilateral Framework on Labour Migration and the General Principles and Operational Guidelines for Fair Recruitment offer further guidance.

The ILO is encouraging the adoption of fair labour migration governance frameworks at all levels – global, regional and national, including a comprehensive, integrated and “whole of government” approach that engages labour ministries together with business, and employers’ and workers’ organizations – those on the frontlines of labour markets. 

“We can choose to make labour migration a win-win situation for migrants and host communities,” he said, noting that how the international community develops and helps Member States implement a global compact on migration – to be adopted later this year – will be instrumental in determining the future course of labour migration. 

In 2007, the UN General Assembly proclaimed 20 February as World Day of Social Justice, inviting Member States to promote national activities in accordance with the objectives and goals of the World Summit for Social Development and the twenty-fourth special session of the General Assembly.