Zaifur Hussein, 50, managed to escape the fire that swept through the Cox’s Bazar refugee camps in March, but he lost his home. While taking refuge with friends, Hussein witnessed dozens of people dying – and how the fences around the camps made it difficult to get out.

Hussein’s story was one of those shared by Reuters news agency in its coverage of the disaster. The March 2021 fire had a devastating effect on these camps, where more than a million refugees live in southern Bangladesh. Black smoke billowed over burning huts and tents as people scrambled to retrieve their possessions.

When they lived in Myanmar, Hussein and the other Rohingya in the camps endured a vicious military campaign to eradicate their people. But the fire was a new blow, because the refugees lost what little they had left of their old lives, and what they had been able to build since fleeing their homeland.

“When we were in Myanmar we faced lots of problems… they destroyed everything,” he told Reuters. “Now it has happened again.”

The Rohingya are the largest Muslim minority ethnic group in Myanmar and also the most persecuted. In recent decades, discrimination and oppression toward Hussein’s community has given many no choice but to leave.

The Rohingya live in an environment of systematic human rights violations, including the removal of citizenship. The Myanmar government refers to this minority as “Bengalis,” and they are classified as illegal immigrants from Bangladesh, where this community is not recognized as its own either. Many of the Rohingya, however, can trace several generations of their family tree in Myanmar (formerly known as Burma.)

A large number of Rohingya have fled to neighboring countries, such as the makeshift camps of Cox’s Bazar, which is on the other side of the border from Myanmar’s Rakhine State. Others have managed to reach Saudi Arabia, Pakistan, Malaysia, or Indonesia, leaving themselves at the mercy of human traffickers.

Since the end of August 2017, their situation has dramatically worsened. At the time, military operations in northern Rakhine State caused more than 700,000 Rohingya to seek refuge in Bangladesh. Nothing has improved since that moment.

Then, in 2020, the COVID-19 pandemic arrived, complicating the situation in the camps, where the refugees live in overcrowded and unhygienic conditions.

To this difficult reality, other extreme seasonal climatic events have been added, such as floods or the fire in March of this year. This, according to Sandra Zanotti, head of mental health activities at Doctors Without Borders (MSF), “is contributing to existing mental health problems,” as new griefs have been added due to the loss of family and friends.

The fire killed at least 15 people, while 400 disappeared and tens of thousands of refugees were forced to evacuate from the Cox’s Bazar camps.

The refugees who visit Zanotti’s team have stopped telling them about the traumas that they lived through in Myanmar, as used to be commonplace. Now, she said, “their concerns are centered on their current living conditions in the refugee camps, in their day-to-day lives.”

Of all the consultations that they receive, 35 percent are psychiatric, which includes epilepsy, since “it has a lot to do with living conditions, even though it is neurological,” she explained. Beside the existing disorders, Zanotti has been seeing “new” ones, such as severe anxiety or very severe conversion disorders.

This, according to the psychologist, is something that “has not been discussed previously.” Many of her patients already had mental health problems when they lived in Myanmar, and this has been maintained or worsened after so many years without access to a house that would give them some stability and comfort.

At the moment, MSF is serving 400 refugees on average each month, and according to Zanotti, almost all of them share the same sense of despair.

“They feel that their lives do not depend on them: whether they can return to Burma or not, where they will live, or how they can improve their shelter [if it] has a leak. Wanting to correct these things, but not having the possibility, affects their mental health,” she said.

She also works with a large number of young people, a group that is not a majority but has its own vulnerabilities. Their problems are similar to those of adults, but beyond that, they have lost the possibility of going to school. Bangladesh does not allow Rohingya children to attend school, fearing that would encourage the refugees to integrate into Bangladeshi society.

Now some of these young Rohingya are 18 years old, an age in which, according to their culture, they should be putting together their lives. Instead, they see that their future is conditioned, broken.

As the scale of the Rohingya refugee crisis has increased in recent years, so has the pressure to find solutions.

The Rohingya are not only asking for improved conditions in the refugee camps; they also want to be able to return to their home in Myanmar, a feeling that grows stronger with the arrival of the added pandemic restrictions, or whenever any event occurs that directly impacts them, such as the recent fires, according to Zanotti.

As Phil Robertson, deputy director for Asia at Human Rights Watch, said, “every single poll, focus group, and research report has found the Rohingya consider Myanmar to be their homeland and they are ready to return.”

However, “based on their experience as persons who have suffered ethnic cleansing, crimes against humanity, and acts of genocide, they are also correctly insisting that their human rights must be recognized and protected if they return,” Robertson added.

The Rohingya want to be officially recognized as full citizens of Myanmar. They insist on their rights to freedom of movement and access to livelihoods, and want some form of international supervision to help ensure their protection.

They also want to return to their homes and towns whenever possible, and have the same rights as others to access services such as education and health care. Since many of them are farmers, access to land is also of vital importance to them.

The problem is that all these demands are “increasingly far from reality,” in Robertson’s words, especially since Myanmar’s military junta took power in a coup on February 1. He points out that the same senior military commanders who led the atrocities against the Rohingya in 2017 “now enjoy dictatorial powers” in Myanmar.

With Myanmar’s army in charge of the country, Robertson said the Rohingya recognize that returning now would subject them to further rights abuses. This would simply force them to flee again.

Bangladesh has been trying to negotiate with Myanmar to take back the Rohingya, and is pressing the international community to demand that the junta take these issues seriously. “But they are really getting nowhere because there is no political will in the Burmese junta to address the plight of the Rohingya,” Robertson said.

“So far, Bangladesh has remained faithful to its word that it will only engage in voluntary repatriations, but Dhaka’s patience is wearing thin because they don’t see any light at the end of the tunnel of this Rohingya refugee crisis,” he added.

Meanwhile, the Rohingya increasingly see their situation aggravated in the refugee camps.  Squeezed between a traumatic past and a future holding out little hope, it’s no wonder that their mental health is deteriorating.