Bangladesh/Myanmar: Rohingya Mental Health Crisis Demands Attention
New report reveals extreme rates of traumatic stress among Rohingya genocide survivors
(BANGKOK, December 10, 2020)—Rohingya refugees in Bangladesh who survived genocide in Myanmar are experiencing a severe mental health crisis, according to data in a new report published today by Fortify Rights. The report includes quantitative data on Rohingya experiences with human rights violations in Myanmar, traumatic events in Myanmar and Bangladesh, symptoms of mental harm—including post-traumatic stress, depression, and anxiety—functioning difficulties, as well as Rohingya opinions on returning to Myanmar.
“The Rohingya mental health crisis is life threatening and has been largely overlooked,” said Matthew Smith, Chief Executive Officer of Fortify Rights. “The scale of the problem is massive but not insurmountable. Governments should prioritize the mental health of the Rohingya community and ensure survivors of the genocide in Myanmar can rebuild their lives with dignity.”
United Nations agencies estimate that 12 months after an emergency, approximately 15 to 20 percent of adults will experience some type of moderate or mild mental health disorder. However, data published today reveals that 88.7 percent of Rohingya refugees experienced symptoms of depression, 84 percent experienced symptoms of emotional distress, and 61.2 percent experienced symptoms of Post-Traumatic Stress Disorder. The data further shows how these symptoms adversely impact the daily lives and functioning of Rohingya genocide survivors.
The 99-page report, “The Torture in My Mind”: The Right to Mental Health for Rohingya Survivors of Genocide in Myanmar and Bangladesh, is based on participatory action research conducted between March 2018 to November 2020 by a team of ten ethnic-Rohingya researchers trained and supported by Fortify Rights. The report provides new evidence of the severe mental health toll that genocide, human rights violations, and violence has on survivors.
The quantitative methods used in the report ensure the results are representative of the entire Rohingya refugee population in Bangladesh.
The most highly reported symptoms experienced by Rohingya refugees in Bangladesh related to reliving traumatic events. For example, 97.6 percent of Rohingya experienced some level of “recurrent thoughts or memories of the most hurtful or terrifying event,” “feeling as though the event is happening again” (96.6 percent), and “recurrent nightmares” (82.2 percent). The trauma symptoms experienced by a majority of Rohingya are indicative of Post-Traumatic Stress Disorder, a serious mental-health condition that can interfere with leading a constructive life.
“When I try to sleep, I imagine what the military and Buddhists have done to me,” a 40-year-old Rohingya woman told the research team. “I feel like they are coming, chasing, and shooting me. I think of how they hacked and killed people and threw children on the fires. When I am in bed, the imagination of the torture appears in my mind.”
Nearly all Rohingya survey participants reported personally experiencing or witnessing traumatic experiences in Myanmar: 98.6 percent of Rohingya refugees experienced exposure to frequent gunfire in Myanmar, 97.8 percent witnessed the destruction or burning of villages, 91.8 percent witnessed dead bodies, and 90.4 percent witnessed physical violence against others. Some 86.2 percent experienced the murder of an extended family member or friend by security forces, 70.6 percent experienced the “death of family or friends while fleeing or hiding,” and 29.5 percent experienced the murder of an “immediate family member.”
“[The Myanmar military] hacked two of my cousins,” a Rohingya man from Maungdaw Township, Rakhine State told the research team. “The other five are missing, and we’ve received no information yet.”
Of those indicating the murder of an immediate family member, 99.3 percent reported that security forces in Myanmar perpetrated the killing.
Many Rohingya participants also reported experiencing bodily harm in Myanmar, including torture (55.5 percent), beatings by a non-family member (46.1 percent), stabbings (29.4 percent), or physical injury from being shot (5.1 percent).
Eight Rohingya women (3.1 percent) reported being raped, and 87.5 percent of these women reported being raped by Myanmar security forces. The research also found 34.3 percent of Rohingya refugee men experienced sexual abuse, sexual humiliation, or sexual exploitation in Myanmar, compared with 31.1 percent of women—figures that may be affected by underreporting. In addition, 67.3 percent of Rohingya survey participants indicated that they had witnessed sexual violence or abuse in Myanmar.
The report findings demonstrate that restrictions on education, freedom of movement, healthcare, religious expression, and other violations are pervasive in Myanmar and contribute to protracted symptoms of trauma, depression, and anxiety.
The vast majority of Rohingya also experienced symptoms of anxiety and depression, including “worry[ing] too much about things” (92.5 percent), “feeling sad” (91.3 percent), “loss of interest in things [they] previously enjoyed doing” (89.5 percent), and “feeling tense or [agitated]” (88.7 percent).
Most of Rohingya refugees in Bangladesh (68.7 percent) reported feeling “humiliated or subhuman,” which also significantly contributes to mental-health distress.
“They treated us worse than animals,” said a 44-year-old Rohingya research participant referring to actions by Myanmar authorities. “They considered and counted us like animals. They put people inside houses, locked the door, and burned the houses and the people as well. Would anyone do that to an animal?”
According to the report, 91.3 percent of Rohingya refugees in Bangladesh face some level of difficulty carrying out common daily activities, such as maintaining basic hygiene, engaging in social or religious activities, or performing other daily tasks. Of those who experience functioning difficulties, 62.3 percent attributed these difficulties to ailing mental health.
“I feel like it is very difficult to do anything,” said a 27-year-old research participant. “Although it has been seven months since I came here [to Bangladesh], I cannot forget the pain and torture.”
Participatory action research is intended to advance community-supported, action-oriented solutions. The ten-member Rohingya research team who worked on this project conducted 495 household surveys, 13 pre-research focus-group discussions, 33 participant feedback sessions, and 16 community workshops with Rohingya refugees in Bangladesh. The report includes a chapter profiling the research team, providing further insight into their contributions and the impact of the research process itself.
“We shaped the whole project, and we shaped the goals,” said one Rohingya member of the research team. “Regarding this project, one of the best things that makes me happy, that makes me confident, is that this project helps us serve our own community by ourselves, not by any others.”
Members of the research team also contributed to a participatory photo essay published in the report by award-winning Bangladeshi photographer Saiful Huq Omi, whereby each team member decided how they would be photographed.
“Rohingya are not merely victims,” said Matthew Smith. “The idea that persecuted groups can’t objectively represent themselves is false and pernicious. The Rohingya team did excellent work documenting information that will affect humanitarian priorities and efforts to ensure justice.”
The Rohingya are a predominantly Muslim ethnic minority indigenous to Myanmar’s Rakhine State. There are an estimated 2.5 million Rohingya worldwide, including approximately 600,000 in Rakhine State and approximately one million living as refugees in Bangladesh. More than 700,000 Rohingya fled to Bangladesh following attacks led by the Myanmar armed forces in 2016 and 2017. Fortify Rights, a U.N. Fact-Finding Mission, Rohingya-led organizations, and others determined those attacks amounted to genocide and crimes against humanity.
Humanitarian agencies operational in the refugee camps in Bangladesh face needless government obstacles in doing their work, and mental health interventions have been limited in scope since the 2017 genocide, said Fortify Rights.
“No one is helping us in proper ways,” said “Saiful,” a 27-year-old Rohingya refugee in Bangladesh. “I cannot sleep when I remember my relatives who had been killed. It is very difficult for me to do any work . . . I cannot think well. I’ve become thin and gangly because of the stress. I feel tired. I cannot eat well. I feel angry when I imagine the persecution.”
Certain foreign governments have considered whether or not to designate the situation in Myanmar a genocide. All Rohingya surveyed for this report (100 percent) believe that the ultimate intent of the Myanmar military and government was to destroy the Rohingya people.
As Bangladesh plans to transfer upwards of 100,000 Rohingya refugees to Bhasan Char island—a move that raises serious human rights concerns—the vast majority of Rohingya refugees in Bangladesh (94.7 percent) reported a desire to return to Myanmar in the future. The majority of Rohingya respondents (65.6 percent) said they already forgave ethnic-Rakhine people who may have been involved in violence against Rohingya.
Rohingya refugees in Bangladesh identified certain rights and protections that the Myanmar government would need to restore or guarantee before they would return to the country, including citizenship (92.5 percent), compensation for losses (85.9 percent), protection (e.g., a U.N. security force) (75.4 percent), and freedom (e.g., of movement, to attend school, etc.) (71.7 percent).
The report makes 32 detailed recommendations to the governments of Myanmar and Bangladesh, the U.N. Security Council, and the international community and U.N. member states.
The governments of Myanmar and Bangladesh are obligated to ensure “the right of everyone to the enjoyment of the highest attainable standard of physical and mental health” under Article 12 of the International Covenant on Economic, Social, and Cultural Rights, to which both Myanmar and Bangladesh are state parties. As expressed by the U.N. Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, “there can be no health without mental health.”
The new research published today provides evidence that the Rohingya mental health crisis is largely rooted in genocidal attacks, pervasive human rights violations, and impunity. While culturally appropriate psychosocial care is in urgent demand, in order to fully tend to the crisis, the root causes must be addressed and solved, including through international efforts to hold perpetrators accountable for international crimes and through domestic efforts in Myanmar to restore Rohingya rights, said Fortify Rights.
“The human right to mental health for Rohingya is inextricably linked to ending the violations and ensuring justice and accountability,” said Matthew Smith. “Many direct-service providers do excellent work to address the mental health needs of refugees and migrants, and Bangladesh and donor governments should ensure those efforts are brought to scale for Rohingya. Bangladesh should do everything in its power to remove any conditions that cause psychological harm to the refugee population.”