Immad Ahmed is the executive director of OBAT Helpers, a nonprofit organization that has been working in Bangladesh’s refugee camps. The camps have existed for decades and are home to both refugees and internally displaced people, but have seen a massive influx of Rohingya refugees over the past six months, since violence erupted in Myanmar’s Rakhine state. He shared the story of what he saw those first few months with us. 

No one was able to keep up.

The people we saw were showing up hungry and malnourished because they hadn’t eaten in days.

Many of the refugees had walked all the way to Bangladesh’s border from their villages — and it took anywhere from a few days to a week to get there. Some of them literally ran and didn’t take anything, no supplies, nothing with them. 

They were so thankful and felt blessed that Bangladesh allowed them to come and gave them a safe haven, but it still wasn’t easy.

There was no real coordination in the initial response effort and, to be completely honest, because such a massive number of people came in such a short time-frame. It was incredibly complicated to try to coordinate and it was unexpected. No one — none of the humanitarian agencies and NGOs — could move fast enough to accommodate that influx in any kind of really, truly strategic way.

In a humanitarian emergency everything is constantly moving. Camp sites and people as an entire population can move several kilometers overnight.

When the refugees arrived they were provided materials to build temporary shelters — some bamboo, some tarp, and some string — to build makeshift, temporary shelters to stay in until the UN and humanitarian agencies were able to assess the needs on the ground and plan out the camp.

Image: Amaluna Studios/Courtesy of OBAT Helpers

And so, with the support of the local community as well, people just started setting up camps and shelters near roads. Within a couple of weeks from the initial influx of refugees on Aug. 25, everything on both sides of the main highway going toward the area of Teknaf had been turned into makeshift camps. There were something like 200,000 to 300,000 people camped out on the side of the roads with issues accessing clean water and sanitation.

Read more: Timeline: How the Rohingya Crisis Unfolded in Myanmar

And at that point everyone had to start throwing their site planning — for things like hospitals and schools — out the window.

The problem is: when you have 700,000 people in about 3,000 acres, the population density makes it really hard to go in and say, “I need 100 square meters to build a hospital.”

Where do you move the thousands of people already living there, even temporarily, to gain access to that space?

Image: Amaluna Studios/Courtesy of OBAT Helpers

People were moving in so quickly that governments, humanitarian agencies, and NGOs didn’t have time to build according to their plans before people started setting up shelters.

And that led to problems down the line.

Toilets — these 5-feet-deep holes that just became deposits of feces in the ground when full — were built a few feet away from shallow-dug hand pumps for water. So when it rained the deposits spread easily down the hilly terrain, making it ideal for cholera and diptheria — both of which became problems in the camps.

Communication was another major challenge.

In some cases, medical facilities and other resources were already on the ground as refugees were coming in, but nobody knew where to go. 

At one point, we were in Jamuthali, a camp that’s south of Kutupalong, and had been running a medical camp there all day, but as our team was leaving I saw a woman who was frantic and distraught.

She told us a family member was pregnant and having problems. So I grabbed our doctor and we ran to help. In a shelter about half a kilometer away from the medical camp, up a hill, we found the girl.

She was in pain but we had nothing on us, no clean water or clothes or anything.

The doctor couldn’t deliver a baby right there, so we needed to take her to the hospital. We found a sheet to wrap around bamboo polls and created a makeshift stretcher and then carried her on it about a kilometer outside of the camp, past the site where we had had a medical camp all day, and to another clinic — as soon as we got there she gave birth to a baby boy. 

That’s just one example of this huge challenge — even though the services she needed were available, she hadn’t been able to find them.

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On top of all that, there are small rolling hills that actually pose big challenges for humanitarian aid access. Aid workers have to climb these hills to reach people with supplies, even in the rain when the hills become slippery. It’s extremely hard. And then there are flood zones, elephant pathways that go through the camp, and just a massive amount of people moving continuously through that area all the time.

The huge number of people in the camps, means that health continues to be a massive concern. In these really crowded camps, kids are the most susceptible to illness and all the environmental factors that impact health too.

I saw so many young kids running around completely naked, even though it rains a lot in this part of Bangladesh and gets cold. And everyone is living in really basic shelters — we’re talking about a bamboo frame with tarp on top as a roof, nothing to hold heat, and limited access to fuel.

For weeks, tons of kids between the ages of 4 and 9 were just going through fields cutting trees and burning bushes all day to get to the roots and collect wood for fuel. That not only created tension with the local host community, but was also an issue for our work. If families didn’t have fuel and needed their kids to collect wood, then they weren’t going to school until that problem was addressed.

Image: Amaluna Studios/Courtesy of OBAT Helpers

This crisis that’s happening affects everything and everybody there.

Our goal has been to build more classrooms to get kids in school and create a momentum of positive engagement in the camps. And by doing that I think we can preempt some longer-term issues that these refugees face.

While the Bangladesh army and government with other governments and organizations have done as good a job as possible, there’s a lot more than can be done — and that goes for everyone — there’s still more we can do.

But we have to be strategic and follow guidelines. Because when people — with the very best of intentions — jumped in without any kind of strategy in the beginning I saw things like donations being passed out from a moving truck. Eventually a mob of hundreds gathered behind to collect donations and then when the people on the truck couldn’t handle the mob, they panicked and started beating the refugees back with bamboo.

In high-stress situations like that when people want to help but aren’t prepared and don’t have the right training, their responses can end up being very negative and harmful. So proper training and coordination — for all the donors, volunteers, and organizations on the ground — is really key.

Image: Amaluna Studios/Courtesy of OBAT Helpers

We’ve really tried to take that approach and deal with the crisis holistically by hiring and training refugees, as well as community health workers and volunteers, to become full-time employees on the ground with us. And that helps us with access, with transparency, and community engagement. 

Our strategy now, since we’re already there and there’s now a network in place, is to really work to empower this community.

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