Who will champion the Rohingya?

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 was taken aback by the sheer scale of this makeshift setting. A jumble of humanity packed together in precarious bamboo and plastic shelters, all contained within kilometers of razor wire fencing.

The plight of the Rohingya—persecuted in Myanmar, living in containment in Bangladesh, trafficked, and living as illegals in Malaysia and elsewhere—is fast becoming 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 one million Rohingya, is increasingly unsustainable, with funding harder to secure. Five years on, the humanitarian response must transition from a minimum provision of emergency services to one better suited to long-term resettlement.

For Bangladesh, this policy shift remains unacceptable. With good reason, it 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 with itself since the military seized power in February 2021, and in Rakhine, tensions between the Myanmar military and Arakan army are increasing. Our teams on the ground know firsthand that the conditions for those who remain in Rakhine are unacceptable, and safe repatriation to this region is simply not a responsible option yet.

Additionally, across the region, Rohingya are treated as illegals and exploited by those who seek to benefit from their precarious status. In Malaysia, those who arrive by boats are turned away at sea, 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 center in Malaysia, allegedly due to poor living conditions and lack of access to medical services.

The latest scabies outbreak in the camps and the increasing number of dengue cases are symptomatic of the emergency health needs of the refugees, while year-on-year increases in mental health and noncommunicable 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 that 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 compensating for the failures of Myanmar to redress its wrongs. We are also trying to cope with the cost of political inaction, the collective failure of regional states and the international community to find durable or even temporary solutions, but better ones.

Looking out from MSF’s Hospital on the Hill, I realize we must all push back against the overwhelming sense that this cannot be fixed. There are things that can be done. A good start would be ending draconian refugee policies practiced across the region.

Australia’s new government could set the tone for humanity and solidarity, starting with the Rohingya from Malaysia and Bangladesh, and open resettlement pathways for them. It could recalibrate its anti-human traffic support across the region to be more accommodating of people who qualify as refugees.

Malaysia and Thailand must also be more accommodating of refugees who should not be treated as irregular economic migrants.

Diplomatic channels with Myanmar must remain open, and a stronger, coherent regional and international approach with it must be hammered out, with China at the forefront. China can lead in negotiating the safe return of Rohingya from Bangladesh, and include in the discussion how Rohingya can be compensated for lost property and livelihood. Their return must be more than a political façade and must solve the issues of the Rohingya themselves.

Failing their meaningful and safe return to Myanmar, I worry what the future holds. How long can people live with so little basic protection and hope? Trauma is cumulative. After 40 years of statelessness and injustice, I worry that the care we provide only manages to keep people alive to live in hopelessness. The Jakarta Post/Asia News Network

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Paul McPhun is currently the director for Doctors Without Borders/Médecins Sans Frontières regional Southeast and East Asia Pacific Partnership covering Indonesia, Malaysia, Philippines, and Thailand.

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The Philippine Daily Inquirer is a member of the Asia News Network, an alliance of 22 media titles in the region.