Rohingya Refugee Crisis Analysis

This assignment delves into the Rohingya refugee crisis, examining its origins, consequences, and global reactions. It explores the situation of Rohingya Muslims in Bangladesh, their displacement from Myanmar, and the ongoing humanitarian challenges they face. The analysis also considers international efforts to address the crisis and potential solutions for long-term stability.

Diphtheria infection
among Rohingya
refugees

Table of Contents
EXECUTIVE SUMMARY ............................................................................................................1
INTRODUCTION...........................................................................................................................1
Background.............................................................................................................................1
History of Diphtheria infection..............................................................................................2
The current situation of diphtheria infection among Rohingya refugees...............................3
The different public approaches that can be used to describe diphtheria infection ...............5
The different intervention strategies to control the infection from spreading .......................7
CONCUSSION AND RECOMMENDATION ..............................................................................7
REFERENCES................................................................................................................................9

EXECUTIVE SUMMARY
In this research, the information about Rohingya refugees from Myanmar to Bangladesh
will be given. The history about Diphtheria infection will also be presented in this research.
Among Rohingya refugees, the current situation about diphtheria infection will also be outlined.
Furthermore, various public health approaches that are best to describe diphtheria infection will
also be evaluated in this research. The recommendations will also be given based on the research
findings.
INTRODUCTION
Background
Since the late 1970s, the discriminatory policies of government of Myanmar have
compelled many Muslim Rohingya to flew to their home in the predominately Buddhist country.
Some refugees have fled to Bangladesh, while others have taken to the sea to reach Indonesia,
Malaysia etc. The ethical Muslim minority are being considered as Rohingya. A Sufi-inflected
variation of Sunni Islam is being practiced by them (Sagonowsky & Pharma, 2018).
Many Rohingya people fled to Bangladesh in the year 2017 in order to avoid the persecution
from Myanmar's military. In Myanmar, Rohingya are a Muslim minority who are being regarded
as illegal migrant from Bangladesh by many Myanmar Buddhist. For generations, rohingya have
lived in Myanmar and in order to take back the refugees the Bangladesh government has called
Myanmar. In Myanmar, they are denied the citizenship and they have been described as the
world's most persecuted minority. Rohingya are being by the persecuted security forces and
Buddhist extremists . As the stateless entities, the Rohingya people are being considered as they
are not being recognised by the government of Myanmar as ethnic groups. Due to the
government of Myanmar the Rohingya people are not given legal protection. In the country, they
face a strong hostility as they are considered as refugees from Bangladesh. When the army
launched a national drive to register citizens in 1977, the rohingya were considered as illegal.
Due to further atrocities, more than 200,000 rohingya fled to Bangladesh. The group citizenship
was also denied to the rohingya refugees when the citizenship act of Myanmar was enacted in
1982 (Bangladesh: How 668,000 Rohingya are doing, 2017). As the illegal migrants the
rohingya was classified. In the world today the rohingya are defined as the single largest stateless
community. Their vulnerability is increased due to their statelessness or lack of citizenship. This
is because they are not given any legal security from the government (Schulze & Höper, 2018).
1

The basic rights are also not given without citizenship. They are not given access to health
services, education and employment. Among the rohingya the illiteracy rate is about 80 percent.
The right to worship freely is also being denied to them. They also face restrictions on the right
to marry and move freely. Due to their religious and ethnic identity, they face restriction on their
own property. On earth the Rohingya people have been described as the one of the most
persecuted people. These are the reason behind why the rohingya refugees fled to the other
countries where they can be given basic human rights. Many of them fled to Indonesia, USA and
Bangladesh. But major population of the refugees fled to Bangladesh. To the Bangladesh is the
home for the 32,000 registered Rohingya refugees. In order to relocate the registered rohingya
refugees the Bangladesh government announced the plans. The persecuting of rohingya is being
seined by the Myanmar. Since 1970 the Rohingya refugees are being coming to Bangladesh from
Myanmar. More than 250,000 Rohingya refugees resided in the refugees camp in the 1990s.
There were about 300,000 to 500,00 refugees were in Bangladesh in the year 2017.Along the
Teknaf-Cox's Bazar main road that is parallel to the Naf River, most of the refugees are staying.
The Rohingya refugee are the mass migration of thousands of Rohingya people from Myanmar
and Bangladesh. They are Muslim minority group residing in the Myanmar. They are moving
from the Myanmar as the government of Myanmar consider them as stateless entities and doe not
recognize them as ethnic groups. In the country they face strong hostility problem.
The government is offering help to the refugees. The new package of 1 million is for displaced
people inside Myanmar. The help from the government is being given to this group in order to
improve their standard of living.
2

History of Diphtheria infection
The upper respiratory tract is being affected by the diphtheria .It is a contagious
infectious disease. By the sore throat, fever and an adherent membrane on the tonsils and
nasopharynx Diphtheria it is being characterized. The skin can also be affected by the diphtherias
and the localized skin infections can be caused. To the systemic involvement the severe infection
with diphtheria can lead and the other organs such as heart and the nervous system can also be
faced by this disease. By Hippocrates in the fifth century BC diphtheria was first described.
Among children Diphtheria once was one of the major cause of illness and death. Before the 20 th
century the death rates of diphtheria were likely higher. By the bacterium Corynebacterium
diphtheria the infection of diphtheria is caused. From mild to severe the signs and symptoms of
3
Illustration 1: The grim scale of the Rohingya crisis
(Source: The Grim Scale Of The Rohingya Crisis, 2017)

this disease can vary (Hossain & Purohit, 2018). After exposure they usually start two to five
days. The sore throat and fever are some of the symptoms of Diphtheria. A grey or white patches
develops in the throat in severe cases. The airway can be blocked from this and it can develop a
barking cough as in croup. In the 1880s by F.Loeffler the diphtheria bacterium was first
identified and in the 1890s the antitoxin against diphtheria was later developed. In the 1920 the
development of the first diphtheria toxoid vaccine occurred and its subsequent widespread lead
to the dramatic decrease of diphtheria across the globe (Plummer & Jensen, 2017).A fever, chills.
A sore throat , bluish skin ,drooling etc are some signs and symptoms of diphtheria.
The current situation of diphtheria infection among Rohingya refugees
It is being found that hundreds to thousands of rohingya refugees who fled from
Myanmar to Bangladesh are at a risk from possible outbreak of diphtherial. Since the end of
august more than 600,000 people from Myanmar Rohingya minority have fled to Bangladesh
and in squalor they are being camped after escaping a military crackdown. In Cox's Baxr
Bangladesh diphtheria is rapidly spreading among Rohingya refugees .More than 110 suspected
cases of severe diphtheria disease have been found. In refugee camps in Bangladesh the WHO
has diagnosed more than 3,000 cases of the life threatening disease. It is being reported by the
NGO that in Bangladesh there have being a dramatic outbreak of diphtheria in Rohingya camps.
4
Illustration 2: Recent status of rohingya Muslims
(Source:REFUGEE AND MIGRATION ISSUES, 2017)

The epidemic is being aggravated by the bad hygiene and health care circumstances. The
main reason behind it that people particularly children are immunized. With little shelter and no
safe water supply the refugees live in primitive shelters. Before December there were total of
about 804 suspected case of diphtheria. Since then the rate of infection has increased rapidly.
Against diphtheria since about 24,000 children have being vaccinated. Five-ten percent is the
mortality rate of diphtheria and for young children and those who are at the age of 40 it can be as
much as 40.Among vulnerable population diphtheria usually appears who have not received
routine vaccination such as Rohingya. The rise in cases have been shown by the outbreak. It is
being indicated by world health organization(WHO) that there are about 722 probable diphtheria
cases which included 8 cases of deaths. By the bacteria that produced a toxin this disease is being
caused and it can be dangerous for the tissues and organs. Under the wrong conditions such as
vaccination coverage below, about 70 percent, malnutrition and plenty of people living in close
contact the infection can pop up. In the outbreak area in Bangladesh all of these situations are
there. It is critically analysed that against the disease there is a little immunity as many of the
refugees are not immunized. It is being found that a lady who belong the Rohingya refugees had
a swollen glands in neck and she was also not able to eat (Ajmera and Fields, 2016). It was the
symptoms of diphtheria disease. When the doctor was called it was confirmed that it was
diphtheria case. With low vaccination coverage this is an extremely vulnerable population.
The living condition is also not so good in which these refugees are living this may be a
leading ground for infectious disease such as diphtheria, measles etc. With the oral choler
vaccine more than 700,000 people were but now the there have been spread of diphtheria among
these people. There were about 31 death and about 3,954 suspect cases of diphtheria was there
in between 8 November 2017 and 11 January 2018.To the diphtheria disease the children are at
particular vulnerable. There were about 72% of younger people below the age of 14 years and
5

there were about 50% of females (Diphtheria Outbreak Among Rohingya Refugees Enters Third
Month, 2017).
Figure 1Refugge settled in PA
6

Among the suspected diphtheria cases fourteen of 15 deaths were children who were
young than 15 years of age. From its contingency fund for emergences WHO has released some
funds. This is being done in order to help the refuges. There were about 1,842 suspected cases of
diphtheria till 19 December with Cox's 22 deaths. A total of 2,245 cases suspected with
diphtheria have been repeated with 26 deaths till 26 the December 2017.Under the age of 15 over
220,000 children have being vaccinated. From Cox's bazr there were about 28 death and 3,201
suspected cases of diphtheria have being reported till 31st December. On the diphtheria
preventive medication nearly about 10,348 contacts of these suspected cases have been put on. A
total about 3,234 clinically suspected cases and about 54 laboratory confined cases have been
reported till the 6th January (Chan, Chiu & Chan, 2018). At diphtheria treatment facility about
100 of clinically suspected cases were admitted. In order to vaccine the children in the
Rohinygya camps the WHO are working with health and family welfare. In the Cox's baxar there
are so far 4,800 suspected cases of diphtheria and about 34 death are being reported. At the
camps a total of 250,467 rohingya have been administered with the diphtheria vaccination.
Under the diphtheria vaccination the locals living around the camps areas have also being
brought. The swollen glands in the neck, sore throats are the main characteristics of this disease.
The different public approaches that can be used to describe diphtheria infection
Health education -According to the view of Sagonowsky, & Pharma, (2018) that in order to
help the individual and communities to enhance their health the health eduction is any
combination of learning experiences that is being designed. Through the health education the
people can be made aware about the causes, effects of the certain disease. In case of diphtheria
the health education will be useful in order to make the people understand the signs, customers,
effects and the ways in which these diseases can be stopped from spread. Gelb & Metz, (2017).
found that the rohingya refugees do not have proper knowledge on this disease as they are not
well -educated and they do not know about the preventive measure that need to be taken in order
to reduce the spread of diphtheria disease in their community Through this health education the
awareness among this minority community can be made about the cause signs, symptoms and
preventive measures that can be taken for this disease
Immunization- By making use of vaccination the rohingya refugees can protect their life from a
spread of diphtheria diseases. From any disease such as small pox, tuberculosis, diphtheria etc
7

vaccines can protect the child from a fatal illness. In order to limit distribution of fatal illness
immunization is still the best methods. To the family or community there will be no spread of
bacteria due to vaccines that is being given to the people as that person will be an immunized
person and the bacteria will not spread. However, some time some vaccines may have a side
effect to the children. On diphtheria toxoid the diphtheria vaccines are based on. The most
effective way to step out of and this serious disease is vaccination. The different public
approaches that can be used to describe diphtheria infection (Immunization, Vaccines and
Biologicals, 2017)
5 doses of DtaP vaccine need to be given to all children at the two months of the age. One doze
of Tdap vaccine need to be given to older children, teens and adults. Through immunization the
number of people that are suffering from this disease can be reduced . 5 doses of DtaP vaccine
need to be given to all children at the two months of the age. One doze of Tdap vaccine need to
be given to older children, teens and adults. Through immunization the number of people that are
suffering from this disease can be reduced .
Screening – In an apparently healthy, asymptomatic population screening will be used to
identify the unrecognised disease. The disease such as diphtheria will be represented by means of
tests, examination or other procedures that can be applied rapidly. In the process of screening the
diphtheria screening program must have all the core components. One begins with the invitation
to participant in the process of screwing and ends with the treatment for appropriately recognized
individuals. Chan, Chiu & Chan, (2018) state that in order to treat this disease easily the
screening test can be useful as they find the disease at an early age. But on other side the
detection of disease early do not have automatically have a benefit. If there is no improved heath
outcome due to early diagnosis and treatment then early detection of ideas is not so useful. With
the serious consequence the screening should be done and the clear benefit for the health of the
people need to be given through screening tests. The test that will be used need to be reliable
enough and must not cause any harm to people. When detected at an early stage the effective
measures for the diseases must be there. To the c neural information need to be given.
Surveillance – In order to plan, implement and evaluate the public health practice the
surveillance is the continuous , systemic collection and interpretation of health related data. For
impeding public health emergencies it serves as an early warning systems .A routine report of
probable or confirmed diphtheria cases consist in the surveillance of diphtheria. With the
8

collection of case-based data an immediate investigative need to be there of all the diphtheria
outbreaks. It is also essential to monitor the number of infants two have received the third dose
of diphtheria toxoid containing vaccine
Environmental control – The change in the environment is being brought about by the
environmental control as they reduce the vector propagation and human interaction with the
vector pathogen. Through this the water-supply and water storage system can be improved and
also solid waste management can also be done. The non -essential containers can be destroyed,
altered, removed or recycled in order to provide the people with better living condition. With the
better living condition the spread of infectious disease such as diphtheria can be reduced to some
extent. By keeping the surroundings clean, by recycling the waste and also by improving the
water supply for the minority people.
In order to describe the spread of diphtheria disease the beast approach will be
immunization as by this to some extent the spear of this disease can be minimized and it is also
effective as well.
The different intervention strategies to control the infection from spreading
From the above given information it is clear that in this area there have being increase in
the number of diseases among this minority group. The disease such as malaria, measles etc are
being suffered by them . It is Farzana, (2017 state.that The mortality and mobility of diphtheria
can be reduced by the vaccination. In order to neutralise the effects of the toxin the treatment
such as administrating diphtheria antitoxin can be given and also to kill the bacterial the
antibiotics can be given. In combination with other vaccines such as DTP vaccines the vaccines
is given normally. With tetanus toxoid the diphtheria toxoid is combined in lower concentration
for the adolescent and the adults. A 3-dose primary vaccination series with diphtheria toxoid is
being recommended by the WHO.In order to save the million of the life each year immunization
is a successful and the cost effective ways that can be used. In order to find out where the human
is infected or not to some infectious disease screening individuals can be useful (American
Association for the Advancement of Science, 2018 ). It is critically analyse that the only
effective control is the widespread immunization against diphtheria. On the proper hygiene and
universal precaution the health teaching can be given. The surrounding and clean drinking water
etc need to maintained in order to reduce the spread of this disease and the vaccination to the
children and adults need to be given against this disease.
9

CONCUSSION AND RECOMMENDATION
Thus summing up the above report it can be concluded that the sore throat, swollen
glands around the neck, fever etc are some signs of dipterous disease. The rohingya refugees are
not being considered as the citizens of the Myanmar and they are not given their basic rights and
they are also being not give proper treatment. Due to this they are relocating to Bangladesh. But
in the recent time the number of people who are being suffering from diphtheria have been
increased. The mortality rates have been reached to 10 %.The inappropriate living conditions,
lack of vaccinations etc are some causes that lead to this diphtheria among these minority
refugees.
It is being recommended that living conditions need to be improved and also they need to
give vaccination in order to reduce the spread of this disease as if proper steps will not be taken
then the number of people who are suffering from diphtheria will continue to increase. The
vaccination, screening, environment management etc. need to be done in order to minimise the
spread of this disease
10

REFERENCES
Journals and Books:
American Association for the Advancement of Science. (2018). What's coming up in 2018.
Chan, E. Y., Chiu, C. P., & Chan, G. K. (2018). Medical and health risks associated with
communicable diseases of Rohingya refugees in Bangladesh 2017. International Journal
of Infectious Diseases.
Farzana, K. F. (2017). Everyday Life in Refugee Camps. In Memories of Burmese Rohingya
Refugees (pp. 145-190). Palgrave Macmillan, New York.
Gelb, A., & Metz, A. D. (2017). Identification Revolution: Can Digital ID be Harnessed for
Development?. Brookings Institution Press.
Hossain, M. M., & Purohit, N. (2018). Protecting Rohingya: lives, minds, and the future. The
Lancet, 391(10120), 533.
Plummer, N. W. & Jensen, P. (2017). A new mouse line for cell ablation by diphtheria toxin
subunit A controlled by a Cre‐dependent FLEx switch. Genesis, 55(10).
Sagonowsky, E., & Pharma, F. (2018). Category Archives: Uncategorized. The Lancet Infectious
Diseases.
Schulze, C. & Höper, D. (2018). A Novel Alphaherpesvirus Associated with Cases of Fatal
Penguin Diphtheria-like Diseases in Banded Penguin Chicks (Spheniscus humboldti and
S. demersus) From Two German Zoological Gardens. Journal of Comparative Pathology,
158, 141.
Ajmera, M. and Fields, G.A., 2016. Invisible Children: Reimagining International Development
at the Grassroots. Springer.
Online:
Immunization, Vaccines and Biologicals. 2017. [Online]. Available through:
<http://www.who.int/immunization/monitoring_surveillance/burden/diphtheria/en/>.
Bangladesh: How 668,000 Rohingya are doing. 2017. [Online]. Available through:
<http://crofsblogs.typepad.com/h5n1/2018/02/bangladesh-how-the-rohingya-are-doing.html/>.
The Grim Scale Of The Rohingya Crisis. 2017. [Online]. Available through:
<https://www.statista.com/chart/11185/the-grim-scale-of-the-rohingya-crisis/>.
11

Diphtheria Outbreak Among Rohingya Refugees Enters Third Month. 2017. [Online]. Available
through: <http://www.healthmap.org/site/diseasedaily/article/diphtheria-outbreak-among-
rohingya-refugees-enters-third-month-12518/>
Bangladesh PM urges Myanmar to take back Rohingya refugees. 2017. [Online]. Available
through:<http://www.aljazeera.com/video/news/2017/09/bangladesh-pm-urges-myanmar-
rohingya-refugees-170912154912867.html/>
REFUGEE AND MIGRATION ISSUES. 2017. [Online]. Available
through:<https://forumasile.org/2017/09/20/the-plight-of-40000-rohingya-refugees-in-india-
border-criminologies-blog/>
get the facts, 2010[Online]. Available through:<
http://www.refugeesinpa.org/GettheFacts/index.htm>
12