Hunger is a constant for the 800 Rohingya living in Salehdi, a refugee camp in northern India, but the situation is especially dire for pregnant women and for mothers and their newborn children.
The women are falling sick with diarrhea from the dirty water they have to drink, robbing their fetuses and breastfeeding children of critical nutrients. Others have no way to get iron in their diets, which can lead to anemia and heighten the risk of giving birth prematurely.
"Check out the graveyard nearby," said Rafiya Haroon, a resident at the camp. "It's full of newborns and mothers." She estimates one in every five deliveries at the camp is a stillbirth.
This situation is repeating itself across India, which is home to more than 40,000 Rohingya refugees, according to officials. The country is one of the few major global actors not to have signed on to international refugee conventions. That has allowed the Rohingya to be excluded from public relief and assistance initiatives, including basic health care and nutrition programs. International agencies, which are short on funding and access, are unable to fill the gaps.
Activists and lawyers are now trying to upend that situation, pushing the Indian government not just to open up access to public health and nutrition programs for Rohingya refugees, but to adopt or develop a refugee protocol that would protect those rights. If their effort is successful, it could have significant ramifications for a country with one of the largest refugee populations in the world.
India hosts over 207,000 people identified by the United Nations High Commissioner for Refugees as populations of concern. The Rohingya, one of the largest of those groups, began arriving in significant numbers from Myanmar in 2012 after an increase in ethnic violence there. They have settled largely in camps in the north of the country.
Despite its population of refugees and asylum seekers, India has never signed on to the 1951 U.N. Refugee Convention or the subsequent 1967 Protocol. The government has argued that doing so could open up the country to security risks—but it has also provided India with cover for not meeting the guarantees laid out in the two documents.
The nutritional status of the Rohingya refugees has suffered without guaranteed access to housing and public relief and assistance programs, especially among pregnant women and new mothers and their children.
The Rohingya live in squalid conditions. In Nangali camp outside New Delhi, where 300 refugees live, "infants and lactating mothers do not have a safe environment away from dust, snakes, and smoke," Salma Khatoon, who lives in the settlement, told News Deeply. "There isn't even an area to dispose of solid and liquid waste."
There is little drainage, so, during monsoon season, water can rise to residents' knees. That is when waterborne diseases really set in—malaria, diarrhea, dysentery. Illness exacerbates the undernutrition that comes from not getting enough to eat. Many of the refugees live largely on fruits and vegetables discarded by nearby vendors.
The situation becomes worse when they step outside the camps. They are essentially denied access to any services that could help prevent malnutrition or even diagnose those who are suffering from it.
Most expectant Rohingya mothers are blocked from access to a basic maternity benefit program that provides pre- and post-delivery care and vaccinations for newborns. They are also locked out of the Pradhan Mantri Maternity Scheme, which provides lactating mothers with roughly $100, which they could use to buy food and improve their diet. Rohingya children who have been allowed to attend local government schools are not included in the midday meal programs, which are run by the Indian government to improve the nutritional status of students.
"This is not just illogical, but also discriminatory and inhuman," said Ravi Hemadri, secretary of the Development and Justice Initiative, a trust that works closely with Rohingya refugees. The results, activists say, are premature births and deaths from diseases that undernourished residents are too weak to fight off—and that nobody is even attempting to count.
One initiative, the Right to Food Campaign, is pushing for the government to extend a program that provides poor citizens with subsidized food to include the Rohingyas.
"Until the time India decides to be a part of the United Nations Convention on Refugees, we have a Right to Food Campaign which argues that basic rights for food and housing should be not just for Indian citizens, but for all residents," said Dipa Sinha, an activist with the campaign. "This also includes the Rohingya refugees."
Reversing the Course
UNHCR and other international organizations try to fill the gaps, but their presence is limited. Civil society groups such as the Right to Food have tried to monitor and intervene. But increasingly they are dealing with a backlash from a government that does not even consider the Rohingya to be refugees, seeing them instead as illegal immigrants, and now making moves to try to kick them out of the country.
In that backlash, though, activists hope they have discovered an opening to improve the situation for the Rohingya and, ultimately, all refugees in the India.
In response to the Indian government's efforts last year to begin kicking out the Rohingya, two refugees filed a plea with India's Supreme Court to direct the government not to deport them and other members of their community. They argued that they met the conditions for refugee status and that the Indian government should provide them with "basic amenities to ensure that they can live in humane conditions as required by international law."
A favorable judgment could open up access to Indian food programs and the health and nutrition services they are currently denied. The petition is scheduled to be heard in March, and activists are hopeful it could also push the government to officially adopt the international protocols, which would extend protection to all refugees.
This article originally appeared on Malnutrition Deeply, and you can find the original here. For more news coverage and community engagement focused on malnutrition, you can sign up to the Malnutrition Deeply email list.