Cox’s Bazar, 12 July, Wednesday – An outbreak of scabies, the skin disease, is affecting hundreds of thousands of Rohingya living in refugee camps in Bangladesh’s Cox’s Bazar district, demanding an urgent response, says international medical organisation Médecins Sans Frontières/Doctors Without Borders (MSF). To bring the outbreak under control, the response needs to be fast and comprehensive and include improvements to water, sanitation and hygiene within the camps, says MSF.
An estimated 40 per cent of people in the overcrowded camps currently have scabies, with a recent report by the World Health Organization (WHO) suggesting that prevalence in some camps is as high as 70 per cent.
Scabies is easy to treat but can cause severe physical and mental effects if left untreated. The usual treatment involves drugs applied to patients’ skin, clothes and home environments to eliminate the parasite that causes the infestation, but MSF warns that in this case drugs will not be enough and that the source of the outbreak needs to be tackled.
MSF teams in the camps have treated increasing numbers of patients with skin diseases in recent years. In March 2022, they started to see unusually high numbers of patients with scabies, since when the numbers have rocketed. Between January and May this year, MSF teams in the camps treated almost 70,000 patients for scabies – nearly double that of the same period in 2022.
“Some days we have reached peaks of 700 patients” says Pankaj Paul, Deputy Medical Coordinator of MSF Bangladesh. The situation remained the same until January 2023 and we have been alerting about this while having a huge workload to respond to this increase. Our team was seeing an increased number of patients and from February 2023 they decided to redirect patients to the health facilities close to their respective camps “At the moment, we cannot treat everyone who comes in with scabies – we just don’t have the capacity” says Paul.
“Our four-year-old son has had scabies since last December,” says Ajmot Ullah, a member of the Rohingya community living in the camps. “He started having rashes on his hands and then on his whole body. We spent money on doctors and pharmacies and eventually he got better, but he was reinfected with scabies very quickly. He doesn’t sleep much, his whole–body itches, especially at night, and he cries a lot from the pain. My other two sons also have scabies, and my wife and I have symptoms too. It has become a nightmare for my family.”
Medecins Sans Frontieres in Bangladesh conducted a study on water and sanitation conditions in the Rohingya refugee camps last year and it shows the situation is concerning. We see there is lack of proper sanitation and insufficient availability of water. While we see a considerable amount of water and sanitation infrastructure improvements over the last two years (installation of water networks, chlorination), there is degradation in the maintenance – There are fewer functioning latrines than previously. In some areas, people have access to water for just two hours per day. This is due to poorly functioning water systems but also linked to water rationing under the misconception that groundwater resources are being depleted by the refugee population, which has been refuted by specialised monitoring and modelling of these water sources. Last month, refugees’ soap rations were cut from two bars per month to just one bar.
This out-of-control scabies outbreak is happening in a context of reduced funding for Rohingya refugees in Bangladesh, including cuts to their food rations. Even before the reduction in funding, the level of services provided by aid agencies within the camps did not meet the refugees’ needs. Of particular concern to MSF is people’s lack of access to health facilities in the camps that are fully staffed and supplied with sufficient medicine.
The Rohingya refugee crisis began in August 2017, when violence erupted in Myanmar’s Rakhine state, forcing hundreds of thousands of Rohingya people to flee to Bangladesh. The camps in Cox’s Bazar are now home to over 900,000 refugees, making it one of the largest refugee settlements in the world. MSF has been providing medical care to Rohingya refugees in Cox’s Bazar since 2009 and is currently running several projects in the area, including primary healthcare, mental health support, and treatment for malnutrition.
