Rohingya refugees cry while praying during a gathering to mark the fifth anniversary of their exodus from Myanmar to Bangladesh. Photo / Shafiqur Rahman, AP
OPINION
I have spent nearly 30 years exposed to emergencies and humanitarian crises. Yet, standing at our "hospital on the hill" in Cox's Bazar, Bangladesh, now the world's largest refugee camp, I'm taken by the sheer scale of this makeshift setting.
A Rohingya mother-of-six says: "The military was brutally killingRohingya and burning our houses… now, we live here in the refugee camps. It is five years of living in distress."
The plight of the Rohingya – persecuted in Myanmar, living in containment in Bangladesh, trafficked and living as illegals in Malaysia and elsewhere – is a pressure cooker that no one seems inclined to take off the stove.
The approach to assistance in Bangladesh, the only country to open its borders and offer sanctuary to now over a million Rohingya, is increasingly unsustainable. Five years on, the humanitarian response must transition from a minimum provision of emergency services to a long-term resettlement reality.
Bangladesh wants the Rohingya to return to Myanmar, which stripped them of their citizenship 40 years ago. This is also what nearly every Rohingya I have spoken with wants. But the country has been at war since the military seized power in February 2021. In Rakhine, tensions between the Myanmar military and the Arakan army are increasing and safe repatriation to this region is simply not a responsible option yet.
Across the region, Rohingya are treated as illegals and exploited. In Malaysia and Indonesia, boats are turned away, with some left adrift for months and others dying due to heat and starvation. In April this year, more than 500 Rohingya escaped from a detention centre in Malaysia allegedly due to poor living conditions and lack of medical services.
Bangladesh feels the weight of responsibility is unfairly on them alone. I agree with Bangladesh, Regional States are becoming part of the problem, favouring securitisation of their own borders over persevering to find solutions together. It feels like ASEAN has run out of steam, with nothing new to try and no one willing to champion what has become a fraught political problem.
The latest scabies outbreak in the camps and the increasing number of dengue fever cases are symptomatic of the emergency health needs of the population, while year-on-year increases in mental health and non-communicable disease consultations at Doctors Without Borders / Médecins Sans Frontières (MSF) facilities are indicative of the protracted nature of the crisis. In Cox's Bazar, our mental health professionals told me how emotionally draining it is to know that they cannot change the root cause of people's mental health conditions. At the end of a psychosocial session, our patients return to an existence devoid of prospects, in overcrowded camps that are becoming increasingly unsafe.
It is easy to argue this response has been a success. It has reduced the loss of life, alleviated the worst suffering, and created order out of chaos. But we must ask ourselves: are we becoming complicit in a system of containment (repression? apartheid even?) for a population with nowhere else to go?
The reality is we are substituting for the failures of Myanmar to redress its wrongs. We are also trying to cope with the cost of political inaction, an impotent failure of collective progress from regional States and the International Community to find durable or even temporary solutions but better ones.
In all of this, the Rohingya remain extremely grateful to Bangladesh for giving haven, as hopeless as their situation appears to be. They don't consider themselves to be Stateless, rather, denied the right to citizenship in a State and region they historically identify as their own. The majority say they want to return, but they will not risk a repeat of history where their children may be taken at any moment, never to be seen again.
Looking out from Médecins Sans Frontières' Hospital on the Hill, I realise we must all push back against the overwhelming sense this cannot be fixed. There are things that can be done. A good start would be ending draconian refugee policies practised across the region.
Australia's new Government could set the tone for humanity and solidarity, starting with the Rohingya. They can seek to open resettlement pathways for Rohingya from Malaysia and Bangladesh. Australia could recalibrate its anti-human traffic support across the region to be more accommodating of people who qualify as refugees and deserve extra protections.
Malaysia, Thailand and Indonesia must be more accommodating of refugees. They cannot be treated as irregular economic migrants. While both are extraordinarily vulnerable, refugees seek refuge from persecution and require special protection.
Diplomatic channels with Myanmar must remain open, and a stronger, coherent regional and international approach with Myanmar must be hammered out, with China at the forefront. China can lead in negotiating the safe return of Rohingya from Bangladesh, but it must consider how Rohingya will be compensated for lost property and livelihoods within those negotiations. Returns must be more than a political façade and must solve the issues of the Rohingya themselves.
Failing meaningful and safe return to Myanmar, I worry about what the future holds.
How long can people live with so little basic protection and hope? Trauma is cumulative. After 40years of statelessness and injustice, I worry the care we provide only manages to keep people alive to live in hopelessness.
• Paul McPhun is the Director for Médecins Sans Frontières/ Doctors Without Borders regional South-East & East Asia Pacific Partnership covering Indonesia, Malaysia, Philippines and Thailand.