Systematic human rights violations, traumatic events, daily stressors and mental health of Rohingya refugees in Bangladesh

Andrew Riley, Yasmin Akther, Mohammed Noor, Rahmat Ali, and Courtney Welton-Mitchell

Conflict and Health, Volume 14 (2020), Article number 60

https://doi.org/10.1186/s13031-020-00306-9

Review

This article examines the relationship between systematic human rights violations, traumatic events, daily stressors, and mental health symptoms among Rohingya refugees in Bangladesh. Almost 900,000 Rohingya refugees were living in refugee camps in Southeastern Bangladesh at the time of the study.

The analysis is based on cross-sectional data collected from a representative sample of 495 Rohingya refugee adults in camps in Bangladesh in July and August of 2018. The survey included questions on demographics, systematic human rights violations, traumatic events, daily stressors, mental health symptoms (including PTSD, depression, and anxiety), and functional impairment. The researchers used several measures, including scales adapted from existing instruments such as the Harvard Trauma Questionnaire and the Hopkins Symptoms Checklist.

Main findings:

  • Respondents reported high levels of systematic human rights violations in Myanmar. These violations included restrictions on obtaining citizenship, working in government positions, obtaining official documentation, using the name Rohingya, expressing thoughts and feelings publicly, meeting in groups in public, travelling, religious practices, voting, legal services, building or repairing homes, pursuing education, marriage, medical services, employment, and having children. Additionally, respondents reported pressure to accept unwanted documentation.
  • Respondents reported experiencing a high number of potentially traumatic events in Myanmar. The average number of traumatic events was 19, including exposure to frequent gunfire (99 percent), witnessing the destruction, or burning of villages (98 percent), witnessing dead bodies (92 percent), and witnessing physical violence against others (90 percent). Respondents also reported direct experience of torture (56 percent), being beaten (46 percent), being stabbed (29 percent), being shot (5), sexual assault (33 percent of women and 34 percent of men), and rape (3 percent of women and 1 percent of men).
  • Respondents reported experiencing numerous stressors in their current life in Bangladesh. These stressors included insufficient income (95 percent), insufficient food (79 percent), limited access to education (72 percent), travel restrictions (66 percent), inadequate living space (62 percent), poor sanitation facilities (62 percent), ill health (62 percent), and poor access to water (60 percent).
  • Symptoms indicative of PTSD and emotional distress were common. More than half (61 percent) of respondents had mental health symptoms indicative of PTSD, and 84 percent had systems indicative of anxiety and depression.
  • Experiences of systematic human rights violations, traumatic events, and daily stressors were found to be associated with symptoms of PTSD, depression, and anxiety. Higher PTSD scores were associated with older age, being a woman, a higher number of lifetime trauma events, higher levels of systematic human rights violations in Myanmar, a higher number of daily stressors in Myanmar, higher levels of feeling humiliated, and higher levels of feeling helpless. Higher levels of emotional distress were associated with older age, higher levels of daily stressors in Bangladesh, higher levels of daily stressors previously in Myanmar, a higher number of lifetime trauma events, and higher levels of systematic human rights violations in Myanmar.

The study concludes that systematic human rights violations, traumatic events, and daily stressors have a significant impact on the mental health of Rohingya refugees in Bangladesh, leading to high levels of PTSD symptoms and emotional distress. The paper emphasizes the need for interventions targeting these factors to improve the mental health of Rohingya refugees, and in particular, the importance of addressing systematic human rights violations and daily stressors in refugee camps.