Probably not a massive camp made of bamboo and tarps with muddy paths, exposed to torrential rains and disease. But for more than 650,000 Rohingya refugees who fled the Burmese military’s campaign of ethnic cleansing campaign that began last August, these squalid camps in Bangladesh are as close to sanctuary as they can get.

When I traveled to these camps in October I interviewed women and girls who had fled massacres, mass burning of villages, and widespread sexual violence by uniformed soldiers. Brutal gang rapes left survivors with bleeding vaginal tears, infections, and trauma. Rape is a powerful tool of ethnic cleansing: it not only drives terrified victims from their homes but also makes them afraid to return. “How can I go back?” one survivor asked.

While the international community has provided considerable aid to the Rohingya refugees, there is still a woeful lack of adequate reproductive health care, including an undersized response to widespread sexual violence. The Inter-agency Working Group on Reproductive Health in Crises (IAWG), of which Human Rights Watch is a member, released a statement today noting that five months after Rohingya fled, only a “small proportion” of refugees have access to post rape care.

Why? One reason, according to agencies working there, is that the Bangladesh government, whose local health services are stretched to breaking, has been slow to register new nongovernmental agencies that want to begin working. And NGOs that are registered struggle to get new programming approved.

Second, the contraceptives that women want, especially long-acting reversible contraceptives such as injectables or intra-uterine devices, have often been in short supply, according to agencies. Further, the Bangladeshi government restricts long-acting reversible contraceptives, only allowing doctors and other senior medical personnel to administer them to registered women with addresses (which refugees don’t have). And many Rohingya do not know that abortion is legal in Bangladesh, and abortion providers are simply hard to find.

A third reason for insufficient reproductive health care for Rohingya refugees is funding.

Donor countries should continue to fund aid efforts and pay specific attention to basic reproductive rights if they want to provide real sanctuary for Rohingya rape survivors. Bangladesh needs to recognize that treating the Rohingya humanely means shifting from a short-term approach to a long-term one. Women and girls suffering from severe trauma should not be treated as a temporary problem.

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