UPDATED at 3:58 P.M. ET on 2020-08-25
Arat Ullah was 14 when Myanmar forces stormed into his village in northern Rakhine state and began a rampage three years ago as part of a wider military-led crackdown against members of the stateless Rohingya Muslim minority.
The brutal military offensive and atrocities that accompanied it, beginning on Aug. 25, 2017, unleashed an unprecedented exodus of Rohingya refugees into neighboring Bangladesh — on a scale and pace the world had never seen. Memories of the violence have left thousands of Rohingya boys and girls psychologically scarred, experts say.
“They shot at our house at around 3 a.m. We started running. We saw that everyone was running, and they were killing people — hacking people,” Arat told BenarNews, an RFA-affiliated online news service, earlier this month.
“Some of us witnessed our fathers lying there dead. Some of us saw our brothers lying dead. Some of us lost our mothers. I lost my brother-in-law and a brother,” Ullah said.
According to Ullah’s 40-year-old mother, Anwara Begum, vigilante Buddhists who joined Myanmar forces in the melee shot dead Ullah’s brother-in-law and cousin in front of the boy.
“After witnessing the murder and firing of shots, Arat became sick when we came to Bangladesh,” she said. “He used to scream while sleeping, but we took him to camp clinics for treatment, and he has improved.”
Arat is relatively lucky compared with many other Rohingya Muslim children who are sheltering at camps and settlements near the Myanmar border in southeastern Bangladesh.
Three years after the onset of the crackdown in Rakhine, many Rohingya children here are still experiencing trauma and psychological fallout from the atrocities they witnessed, according to experts with U.N. relief agencies and NGOs, as well as Bangladeshi government officials.
“I still cannot forget the scene that the Myanmar military shot dead my sister’s husband in front of me,” Mohammad Ayachh, another Rohingya teenager who had fled from Rakhine, told BenarNews. He was 11 years old when the crackdown began.
Fellow refugee Taslima Akhter was only six when relatives were slain in front of her eyes.
“They burnt our houses. I saw them killing my grandfather, my maternal uncle, and paternal uncle,” Taslima recalled.
The violence in Rakhine that left thousands of people dead drove more than 740,000 Rohingya across the border into Bangladesh, where they now live in sprawling and overcrowded displacement camps. Myanmar’s military launched the offensive in response to deadly raids carried out by a Rohingya insurgent group against army and police outposts in Rakhine.
Although Rohingya children have been extremely resilient in handling the trauma of the crackdown and with adapting to a challenging environment in the refugee camps in Bangladesh during the past three years, they still require mental health services, officials from U.N. agencies and NGOs said.
“Prolonged displacement coupled with the trauma many Rohingya children experienced in their flight from Myanmar has had a significant impact on their mental health and well-being,” said Athena Rayburn, senior advocacy manager for Save the Children.
Rohingyas, who are considered in Myanmar as illegal immigrants from Bangladesh, have endured decades of persecution, discrimination, and, at times, atrocities that have forced other waves of refugees to seek shelter across the border.
The 2017 crackdown was by far the most brutal and extensive campaign that has targeted the group. A U.N. Independent International Fact-Finding Mission on Myanmar concluded in a 2019 report that war crimes and serious human rights violations had been committed against the Rohingya during that time.
More recently, coronavirus-related restrictions in effect since April have meant a scale-back in services provided by U.N. agencies and NGOs in the camps, while minors now face other risks that can impact their physical and mental well-being, according to officials and health care professionals who work in Bangladesh’s Cox’s Bazar district, which is home to most of the Rohingya camps in the country.
Children under 18 account for more than half of the 855,000 Rohingya refugees who are huddling at camps and settlements in Cox’s Bazar and require humanitarian assistance, according to the most recent Joint Response Plan on the Rohingya humanitarian crisis issued by U.N. agencies and their NGO partners.
The number includes Rohingya who fled from Myanmar during crackdowns that preceded the one in August 2017. The refugees live in 34 camps formally designated by the Bangladesh government in the Ukhia and Teknaf sub-districts of Cox’s Bazar.
“While significant progress has been made, the need to scale up structured psychosocial support and access to effective mental health support for those most severely affected remains urgent,” the response plan said.
Psychosocial support is not a clinical intervention, but actions that address both the psychological and social needs of individuals, families, and communities to decrease the risk of developing mental health problems. Health care workers say that such support services are necessary to help children deal with their anguish.
“The current situation has called for greater reliance on community structures for service provision, presenting an opportunity to strengthen these structures and ensure strong community leadership on critical matters affecting refugees,” Ezatullah Majeed, chief of the field office for UNICEF in Cox’s Bazar, said in an email.
Other causes of mental distress
In a recent survey by Save the Children, a British-based NGO, participants cited several other causes of mental distress, including insufficient support with basic needs, scarcity of economic opportunities, safety and security, loss of or separation from family, a desire to return home, and restrictions on freedom of movement, Rayburn said.
Children who witnessed massacres of family members could develop aggressive behavior in the future unless they receive adequate psychosocial support, said Dr. Helal Uddin Ahmed, a child, adolescent, and family psychiatrist with the National Institute of Mental Health and Hospital in Bangladesh’s capital Dhaka.
“The memory of these traumatic experiences may stand in the way of their mental development,” he told BenarNews. “They are likely to develop mental problems which may turn into behavioral changes such as aggressive attitudes and criminal minds.”
Mohammad Al Amin Jalali, an official at the Bangladesh government’s social welfare department in Cox’s Bazar, said health professionals in 2017 prepared a list of 40,000 traumatized Rohingya children, including 8,000 who had lost both parents amid the violence in northern Rakhine state.
Officials now estimate that 13,000 members of the group have overcome the trauma, but the remaining 27,000 are still trying to cope with it, said Jalali, who credited U.N. agencies and NGOs, along with the availability of recreational and sports facilities inside the camps, for the progress.
U.N. agencies and NGOs not only provide a range of health services for the refugees, but also offer assistance with shelter, food, sanitation, hygiene, child protection programs, education initiatives, and mother and child nutrition programs.
Although the Rohingya refugees are completely reliant on international aid, some of the refugees have stepped in to provide support services for children.
“The Rohingya themselves are very engaged, and thousands of Rohingya volunteers are the backbone of service delivery in the camps,” said Fredrick Christopher, interim Rohingya refugee response director at World Vision Bangladesh, an international Christian humanitarian group that works with children and their families worldwide.
Still, Rohingya refugee children face a double whammy beyond the mental and physical blows they suffered from the 2017 crackdown.
First, COVID-19 restrictions have meant that some aid workers have left Cox’s Bazar, while services for children have been cut back. Efforts to reduce coronavirus transmissions have led to a reduction in some services provided by humanitarian groups since April, officials and experts said.
Second, refugee children face myriad dangers inside the camps that can cause further psychological torment.
Dr. Ferdyoli Porcel from the Goyalmara Mother and Child Hospital in Cox’s Bazar, which is operated by Paris-based Doctors Without Borders (MSF), said changing health care priorities had resulted in cuts in mental health services at the facility, which provides neonatal and pediatric care to Rohingya refugees.
“Right now with COVID, due to the prioritization of services and resources in the hospital, we had to reduce the mental health services provided, and of course that has been a challenge for the care being provided,” Porcel said in an email.
Other humanitarian organizations also have reported service cutbacks.
“Since the beginning of April, services in the camps have been restricted to ‘critical’ only in a bid to prevent COVID-19 transmission,” Save the Children’s Rayburn said. “This has essentially stripped-down service provision in the camps to health programming, food distribution, and some water and sanitation activities.”
It has resulted in the closure of child- and girl-friendly spaces run by the Save the Children as well as learning facilities, leaving children without access to key support services, she added.
“For children, one of the key gaps and challenges we face is ensuring enough expertise on the ground to specifically treat and support children with trauma and other mental health issues,” Rayburn said.
“Often these children need specialized support and we know that many children will not have access to this,” she said.
And, according to a new report released by Save the Children on Monday, the children’s population at refugee camps has swelled since the beginning of the 2017 exodus from Myanmar.
Using population data provided by U.N. refugee agency UNHCR, the British NGO estimates that nearly 76,000 children living in the refugee camps were born after the crackdown began in Rakhine, the report said.
Vulnerable to abuse, exploitation
Rohingya children in the camps also are vulnerable to abuse, exploitation, physical and sexual violence, neglect, and human trafficking as well as at risk of being forced into child labor and early marriage — other factors that can take a toll on their psychological welfare, experts said.
“Such violence against children happens at home, as well as in the broader Rohingya society,” said Christopher of World Vision Bangladesh.
That makes it critical for all Rohingya children to have access to education in the camps, he said, despite a temporary close down of learning facilities — a key support service in the camps — in keeping with COVID-19 restrictions.
“Without such protection, they are even more vulnerable to abuse and exploitation,” Christopher said.
“If children are to recover from the violence they survived in Myanmar and the daily hardship and stress in the camps, they need the protection that education provides,” he said.
Additional reporting by Kamran Reza Chowdhury for BenarNews, an RFA-affiliated online news service.
CLARIFICATION: This updated version adds a quote by Dr. Helal Uddin Ahmed.