Issue 73 - Article 11

In the eye of the storm: responding to an emergency within an emergency

October 24, 2018
Julia Brothwell
Kutupalong-Balukhali is now the largest refugee camp in the world, home to 600,000 people. People live in cramped conditions on precarious slopes. The camp stretches as far as the eye can see.

Since August 2017, more than 700,000 people have fled their homes in Myanmar to find safety across the border in Bangladesh. The scale and speed of the influx were unprecedented in the region. The majority of people settled in congested camps, the biggest of which, Kutupalong-Balukhali extension, has become the largest refugee camp in the world, hosting more than 600,000 people. Humanitarian agencies on the ground have been racing against the clock to help provide people with basic essentials, including shelter, food, water, sanitation, psychosocial support and healthcare. Despite great generosity shown by local host communities – who were some of the first responders at the onset of the crisis – there is now a sense that some of this goodwill may be giving way to tensions, with local communities facing a number of challenges, including environmental degradation, competition for firewood and other natural resources, risks to water supplies, inflated food prices and job competition.

The challenge posed by the monsoon season

In the midst of this emergency, refugees living in the camps and humanitarian organisations soon found ourselves facing another layer of difficulty: the challenge of adjusting our operations to the demands of a harsh and volatile climate.

Bangladesh experiences heavy monsoon rains from June to August, as well as severe cyclones, with risks peaking in the months either side of the monsoon season. It was quickly apparent that, in a situation where hundreds of thousands of people are crowded together under flimsy shelters in hilly, dusty terrain, the consequences of monsoon rains could be catastrophic. The biggest fear was uncertainty around the impacts to be expected. Severe deforestation meant that the area housing refugees could be dangerously prone to landslides and flooding. The International Federation of the Red Cross (IFRC) estimated that around 200,000 people in the camps were at risk, including 25,000 in extremely high-risk areas. Given the size of the camps, it would not be possible to provide everyone with adequate support in preparation for the monsoon. Instead, efforts needed to focus on securing those at most risk.

Shelter was a primary concern. The Bangladesh Red Crescent Society (BDRCS) distributed thousands of shelter kits, along with tarpaulins and ropes to 50,000 families (about 200,000 people), and more than 7,000 households received cash for further shelter items. When the rains began, the BDRCS, with help from community volunteers, was reaching 15,000 people daily, assessing damage and providing emergency aid and shelter kits so that people could repair their homes. For our volunteers from the refugee camp community, we faced a constant dilemma around whether we should ask them to be part of the response, or whether we should instead advise them to focus on securing their own homes and families.

Health risks associated with monsoon have been another priority area, and since December 2017 the British Red Cross has deployed teams of specialists to set up a sanitation system in Camp 18 of the ‘megacamp’. This is the team I came to manage. Our objectives were to build safe toilets, run a treatment site disposing of human waste and help train people in the camps in safe hygiene practices to prevent the spread of disease.

Our first challenge was to maintain ongoing water, sanitation and hygiene (WASH) work in the difficult environment created by the monsoon rains. For several weeks before the monsoons were expected to begin, latrines in flood-prone areas or perched on hillsides were decommissioned, the superstructure of others was strengthened and groundworks were reinforced to give the facilities a better chance of withstanding the adverse weather and reduce the threat of faecal contamination. The first monsoon rains breached the banks of a nearby river, bringing water perilously close to beds where treated waste was being dried, and the river bank required constant reinforcement after each rainfall. Regular distributions of soap ensured that families had enough for one month to wash themselves and their clothes and bedding, and handwashing stations were assembled next to latrines. We also constructed a small warehouse to hold emergency stocks of chlorine tablets and water purification sachets for 10% of the population in Camp 18, sufficient for a three-day response before more supplies could be brought in from the Red Cross warehouses in Cox’s Bazar and Chittagong. In October 2017, the government and local agencies carried out tens of thousands of vaccinations against cholera, but as our health teams began to see an increase of acute watery diarrhoea and respiratory conditions, further contingency plans were put in place to deal with a major outbreak. Since the outset of the response, the Red Cross field hospital – the only 24-hour, seven-day-a-week surgical facility in the camps – has had a fully functional isolation ward of 40 beds to deal with a sudden outbreak of disease. The hospital has also dealt with injuries from road traffic accidents and falls.

Kutupalong-Balukhali camp. After a night of torrential rain, the author arrived to see a landslide had partly destroyed a health centre.
Kutupalong-Balukhali camp. After a night of torrential rain, the author arrived to see a landslide had partly destroyed a health centre.

Mixed impacts

Looking back at the overall impact of the monsoon, the picture is mixed. Conditions did become tangibly worse. Analysis of community feedback in June showed that one of the most common complaints from people living in the camps was that the rains were preventing them from collecting firewood or that wood was too wet to burn, making it difficult to cook. Between May and mid-August, almost 50,000 people were affected by weather-related incidents. Latrines were flooded and demolished by landslides, spreading waste; homes were flooded, and more than 6,000 people were displaced. Heavy rains forced roads to close and paths disappeared altogether. Facilities and infrastructure were damaged or destroyed. I saw the impact first-hand, arriving in the camps after a night of heavy rain to find a health centre half destroyed by a landslide. An hour and a half drive to our site became a three-hour trip, and that was on the days when we could get in. On days when we were stuck in Cox’s Bazar, we relied on contact with our teams of volunteers in the camps to find out what was happening.

While concerns about cyclone risk remain, the large-scale catastrophe that many feared did not materialise. Notwith-standing the many difficulties experienced, we did have respite from the downpours, meaning our teams had time to assess the damage and reach people who needed support before the rains resumed. Enormous efforts went into preparing for the monsoon season: in the months leading up to the rains, it was hard to walk anywhere in the camps without seeing mountains of bamboo and sandbags, and roads being reinforced or rebuilt. This work intensified during the monsoon itself, not only to repair and replace damaged infrastructure, but also to improve it. Were we sufficiently prepared? In our contingency planning, we didn’t expect our treatment site to operate beyond March 2018 due to its low-lying location next to a river. The fact that it was still operating in September with only the odd day where activities have been suspended has been a bonus to the thousands of camp inhabitants who rely on functioning sanitation facilities for their safety, dignity and health.


As we reach the end of this year’s monsoon season, it is crucial that, as a humanitarian sector, we reflect honestly and critically on what we have learned. With clear consensus that conditions are not yet right for refugees’ safe and voluntary return, it is likely that, when next year’s monsoon season comes around, we will be facing similar risks. In many ways, the humanitarian community is already in a better position. Preparedness and contingency strategies are in place and infrastructure has been improved, including reinforced roads and paths. However, it is also crucial to recognise that many of the main challenges, in particular the factors creating and exacerbating underlying vulnerabilities, have not changed. The terrain remains difficult, camps are still congested and shelter is still inadequate and must be improved. Humanitarian responders must continue to ask how these risks can be minimised. For example, the allocation of further land for camp extensions could ease congestion.

For the British Red Cross, one of the key lessons has been the incredible resilience of people affected by the crisis. The monsoon season made starkly clear that no one was simply waiting for help to come. From community volunteers in our sanitation programmes to individuals helping to reinforce roads and paths and carry bamboo to reinforce shelters, in many different ways refugees themselves were at the forefront of preparedness and response. Looking ahead, perhaps our best strategy is to find ways to support what people are already doing for themselves.

Julia Brothwell is a British Red Cross Surge Delegate. She was Programme Manager in Cox’s Bazar between May and August 2018.


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