Background

The Rohingya are a Muslim ethnic minority from Rakhine state in Myanmar, and the largest stateless population globally (UNHCR). In 1982, they were excluded from a citizenship law recognising 135 ethnic groups in Myanmar, effectively rendering them stateless (UNGA 74/246, ICJ Legal briefing). For decades, Rohingya have faced persecution and discrimination, including restrictions on their healthcare, education, and freedom of movement. They have also experienced repeated cycles of violence, notably in 1978, 1991-2, 2012, and 2017, resulting in Rohingya populations fleeing Myanmar, predominantly to Bangladesh (MSF timeline).

In Aug 2017, Myanmar’s military attacked Rohingya villages in Rakhine state. Massive scale violence and human rights violations led to 740,000 Rohingya fleeing to the Cox’s Bazar district of Bangladesh, joining existing Rohingya populations in the region (see background). In Sep 2017, the UN Human Rights Commissioner Zeid Ra‘ad al-Hussein called the situation 'a textbook example of ethnic cleansing', and the Sep 2018 UN Human Rights Council Fact Finding Mission found evidence of genocide, crimes against humanity and war crimes. In Nov 2019, The Gambia lodged proceedings against Myanmar with the International Court of Justice (ICJ) concerning alleged violations of the Genocide Convention. In Jan 2020, the ICJ ruled that it had jurisdiction to deal with the case and ordered Myanmar to take measures to protect the Rohingya from genocide. Public hearings for this case have commenced in Jan 2026.

The situation for Rohingya populations in Myanmar has deteriorated further after the military coup in Myanmar in Feb 2021, which left 3.5 million people internally displaced and 20 million people in need of humanitarian support (DFAT), and by disasters and extreme weather, including Cyclone Mocha (May 2023), Typhoon Yagi (Sep 2024), and a 7.7-magnitude earthquake (Mar 2025) (UNHCR). A further 363,000 Rohingya refugees have fled Myanmar since 2022, including 23,400 by sea, with more than 2300 people reported dead/missing at sea/river over this period (UNHCR).

Cox's Bazar refugee camps

Refugee camps in Cox’s Bazar are some of the most densely populated in the world, with 1.14 million Rohingya refugees living across 33 camps in 24 square kilometres; 52% of this population are children. Since 2021, more than 34,400 refugees have been relocated to Bhasan Char, an island developed to reduce congestion in the camps (see UNHCR data portal, UK government country policy and information). Conditions within Cox’s Bazar’s refugee camps are extremely challenging, with overcrowding, poor sanitation, growing security issues and fragile shelters that are vulnerable to monsoon rains (Jun-Oct) and landslides (see Amnesty, Refugee Council of Australia and media). The camp populations account for more than one third of the total population of the Cox's Bazar region (UNHCR), creating tensions with host communities. 

Rohingya refugees in Bangladesh face not only trauma from past experiences but also deep uncertainty and limited prospects for their future. They have no right to work and movement is highly restricted.  Bangladesh continues to emphasise that it is hosting the Rohingya population on a temporary basis, designating them as 'forcibly displaced Myanmar nationals - FDMN', with no pathways for permanent resettlement in Bangladesh and a stated plan for repatriation to Myanmar. The Bangladesh government has repeatedly urged the international community to increase support for the Rohingya population, including through permanent resettlement in third countries.

Demography

• Population: the global Rohingyan population is uncertain, but estimated to be 2.8 million people, with 39% in Cox's Bazar (see UNHCR and MSF). There are currently 1.3 million Rohingya refugees and asylum seekers displaced from Myanmar, including 1.15 million in Bangladesh and smaller stateless populations in Malaysia, India, Pakistan, Indonesia, Saudi Arabia and Thailand. Around 550,000 stateless Rohingya remain in Myanmar, mostly in Rakhine State. More than 75% of the Rohingyan refugee population are women and children (UNHCR). 
• Language: Rohingya or Ruaingga, which is closely related to the Bengali Chittagonian dialect spoken by the Bangladeshi population around Cox’s Bazar. It is a primarily oral language without a standardized written script.
• Religion: Sunni Islam
• Identity documentation: Rohingyan people have been denied citizenship in multiple countries, and those remaining in Myanmar do not have access to identify cards or documentation. In Cox's Bazar camps, the UNHCR has registration programs including biometric identity cards, although not everyone in the camps has been formally registered.
• Education: in 2022, UNICEF reported around 75% of 400,000 children in the camps attended 3400 learning centres across the camps, although in 2025, Save the Children reported closure of 6400 learning centres due to funding cuts. Data on adolescents from the 2019 Cox's Bazar Panel Survey found only 14.8% were enrolled in any formal/informal schooling. Also see review article.
• Food security and humanitarian aid: 95% of Rohingya households in Bangladesh are dependent on humanitarian assistance (UNHCR). In 2025, global humanitarian funding cuts caused significant shortfalls in food aid for Rohingya, reducing to $6 per person per month, and increasing malnutrition risk.

Australian response

Between 2017-25, Australia committed $556 million to support Rohingya refugees and host communities in Bangladesh, with a new 3–year funding program for Myanmar and Bangladesh of up to $370 million starting in 2026. Australia does not have a dedicated quota for Rohingya refugees, although organisations such as Amnesty have called for a specific quota given the scale of the Rohingya refugee crisis. There have been increasing numbers of Rohingya humanitarian arrivals to Australia in the last 2-3 years. In 2023–2024, 358 stateless people in Bangladesh received humanitarian visas (2% of Australia's offshore program), more recent data are pending. Also see Refugee Council of Australia. 

Pre-arrival health screening

All permanent migrants to Australia, including humanitarian entrants, undergo an Immigration Medical Examination (IME) 3-12 months before travel. Humanitarian entrants are offered an additional Departure Health Check (DHC), which, for Rohingya refugees, should include treatment with albendazole, ivermectin and praziquantel (check HAPlite, get HAP number from AMES if needed). See summary on Initial assessment guideline, and also DHA Panel Members Instructions (Nov 2025) and DHC supporting material (Aug 2024). 

Health screening

All Rohingya arrivals should have an initial health assessment and catch-up immunisation. Immediate health triage (for all ages) should assess for acute physical health issues (including scabies, malnutrition and injuries), acute mental health issues, disability, frailty/mobility issues in elders, pregnancy and medication type and supply. Like any situation where people have been living in very crowded conditions, consider outbreak risk and vaccine preventable diseases (VPD), including hepatitis A and C, scabies, dengue, malaria, measles, varicella, typhoid, cholera and other enteric infections. 

Recommended health assessment Rohingya arrivals

Recommended investigations are based on the 2016 Refugee guidelines, and updated based on prevalence. Extended nutrition screening and HCV screening (all ages) and diabetes screening (adults) are included  for these reasons. Parasite screening is likely to have high yield, although changes to the DHC should mean individuals are treated before arrival in Australia.  

Screening tests children 

• All: FBE/film, ferritin, folate, vitamin B12, D, A, C, zinc, ALP, IGRA or TST, HBsAg, cAb, sAb, HCV, malaria, Strongyloides, Schistosoma, faecal COP 
• Age/risk based: consider MMR and varicella serology in adolescents, HIV (15y+/clinical/unaccompanied humanitarian minors - UHM), STI screening, syphilis (clinical/UHM), H pylori (symptoms), dengue (clinical), Pb (exposure, including use of thanakha, developmental delay, microcytosis).

Screening tests adults

• All: FBE/film, BSL/HbA1C, ferritin, folate, vitamin B12, D, A, C, zinc, ALP, IGRA, HBsAg, cAb, sAb, HCV, HIV, STI screening, syphilis, malaria, Strongyloides, Schistosoma, rubella (women), consider MMR and varicella serology, faecal COP.
• Age/risk based: H pylori (Sx), Pb (exposure, including use of thanakha, microcytosis).
  
• Catch-up primary care: see RACGP Red book HPV screen (women 25-74y), kidney disease (risk based, Alb:creat/eGFR), diabetes (40y+, BSL/HbA1C *suggested for all adult Rohingya arrivals given prevalence reported), lipids (45y+, frequency varies with risk), FOBT (45-74y), mammogram (women 50-74y, younger if increased risk).

Catch-up immunisation

Immunisations in the Cox’s Bazar camps were initially delivered through mass emergency vaccination campaigns beginning in September 2017, before a routine vaccination program commenced in February 2018. The routine program follows Bangladesh’s WHO Expanded Programme on Immunisation (EPI), with the following schedule:

Missing compared to Australian schedule: birth HBV, rotavirus, mumps, meningococcal ACWY, varicella, zoster, dTp boosters, and HPV males. Also note use of 10vPCV (vs 20vPCV in Australia), and measles-rubella at 9m (vs MMR). Also consider covid (age dependent) and influenza vaccines (seasonal).

• Where written records are not available, full catch-up vaccination is recommended - see Catch-up immunisation guidelines and calculator (<20y). 
• Entering information on to the Australian Immunisation Register (AIR) - use 'encounter overseas', schedule = 'other', add dates, and use generic vaccine type where needed (e.g. for pentavalent vaccines, may need to record as DTPa generic, Hib generic and HepB generic). Enter dose numbers accurately, and the record should submit.
  • AIR records can be created for people without Medicare. In order to do this, a vaccination must be entered (either from an overseas record or a vaccine given in Australia) - it is not possible to create a record for someone without Medicare and enter natural immunity alone (a quirk of AIR). 
    
  • AIR will not allow entry of the same antigen on the same day, which means overseas schedules with simultaneous OPV and IPV cannot be entered accurately.  
    
• Note - Abridged catch-up - RCH/MVEC protocols for catch-up vaccination after chemotherapy use infanrix-hexa^TM and MMR-V up to age 18 years, this reduces needles required, and we use this in practice. AIR will accept these vaccines for adolescents, **AIR data entry - use other, and enter by antigen, and then accept queries. 
• Translated catch-up information: not available for Rohingya.

Prevalence data for Rohingyan populations

The following summary provides background for the screening investigations recommendations above.

Immunisation

• Vaccine coverage in Myanmar has historically been very limited for Rohingya due to restrictions on their access to healthcare. A 2018 household survey of Rohingya families in Cox’s Bazar camps found 42% of children under 4 years had received no injectable vaccines in Myanmar, and only 2.8% had received 5+ doses.
• Despite immunisation programs in Cox’s Bazar, vaccine coverage remains low.  A 2018 cross-sectional study conducted after emergency vaccination campaigns found 10-40% of children lacked seroprotection against measles, rubella, diphtheria and tetanus, and a 2023 study found only 63.1% of parents had completed the full vaccination schedule for their children. 
• In 2017, there was a major measles outbreak in Cox’s Bazar, with 17,000 cases reported between Sep - Nov 2017, which led to mass vaccination campaigns. Sporadic cases have continued, including in July 2025.

Hepatitis and HIV

• Hepatitis C: A 2023 MSF cross-sectional study using random household sampling of adults in Cox’s Bazar’s camps found HCV seropositivity of 30.4%, with active infection in 19.8%, suggesting the population prevalence is the highest in the world. This contrasts sharply with an estimated prevalence of <1% in Bangladesh and 2.6% in Myanmar. Reasons for the extremely high prevalence remain unclear, HCV seropositivity was associated with reported medical injections, surgical interventions and female sex, and very few respondents reported injected drug use, and research is ongoing. On this basis, HCV screening is recommended for all ages.
  • In response, MSF and WHO expanded HCV screening and treatment, with MSF aiming to provide treatment to 30,000 people by 2026. In a scaled up WHO screening program Mar 2024 - Mar 2025, 40.5% of those screened were anti-HCV positive. Although paediatric data are lacking, the same program found 16.2% pregnant women were anti-HCV positive, raising concern about vertical transmission.
    
    
• Hepatitis B: A 2022 study of 2,000 Rohingya refugees found HBsAg positivity in 7% of adults and 2% of children. A 2023 survey of 465 pregnant women in one camp reported 11.4% HbSAg positivity, highlighting the risk for vertical transmission, especially as the vaccination schedule does not include a birth dose of HBV vaccine.
  
  

• HIV: Prevalence data for Cox's Bazar are limited; 319 cases had been confirmed by March 2019. A 2025 study found very low awareness among young Rohingya women about HIV and STIs, and minimal testing. 

Tuberculosis

• In 2023, TB incidence was 248/100,000 in Cox's Bazar, slightly higher than the general Bangladeshi population (221/100,000). In contrast, Australia’s TB incidence was 6.2/100,000 in 2024. TB screening is a priority. 

Parasites

• Malaria: Cox’s Bazar is malaria-endemic, although rates are decreasing. A 2023 study of 30,460 febrile patients (2017-20) found a test positive rate of 0.05%.
• Protozoal infections are common, a 2025 study of 419 Rohingyan children aged 6-16 years found Giardia in 47.0%, Cryptosporidium in 4.3% and Entamoeba histolytica in 1.2%.
• Soil transmitted helminths (STH) are common, a 2023 study of 416 Rohingya children aged 6-16 years in Cox's Bazar found an initial prevalence of 91.7%, including T. trichiura in 87%, A. lumbricoides in 49.2% and hookworm (N. americanus or A. duodenale) in 8.3%. In this study, children were given 2 doses of albendazole 7 days apart, and followed, repeat screening at 12 months found prevalence of STH was 95.3%, with T. trichiura in 89.1%, A. lumbricoides in 52.1% and hookworm in 4.1% confirming reinfection.
  • Strongyloides - no data available for Cox’s Bazar camps, but a 2020 study modelling global prevalence of Strongyloides, estimated prevalence in Myanmar 19.2% (95% CI: 9.8–28.6%), and Bangladesh >15%.
• Schistosomiasis: No data available for Cox’s Bazar, but schistosomiasis is reported in Myanmar, including Rakhine state. WHO lists Myanmar and Bangladesh as non endemic, although Schistosoma serology was positive in 947 out of 1734 suspected cases in 2016-2018. 
  

Other infections

• Dengue: Outbreaks of Dengue have occurred each year in Cox's Bazar, with 16,556 confirmed cases in 2024.

• H. Pylori: No data available for Cox's Bazar, a 2020 study in Myanmar found 67.4% of 193 children 2-13 years had Helicobacter pylori.

Nutrition

• Malnutrition: 2025 Integrated Food Security Phase Classification (IPC) data suggest 94% of Rohingya households in Cox’s Bazar are unable to meet minimum consumption without humanitarian aid, with 40% experiencing acute food insecurity, 70% expected to have inadequate food consumption by the end 2025, and 16% children experiencing acute malnutrition. 
  • The 2023 Standardized Expanded Nutrition Survey (SENS) found stunting in 41% and anaemia 38.2% of children <5 years; 91% children surveyed had received vitamin A supplementation in the preceding 6 months.
  • The 2023 STH study above found stunting in 37.8% 6-16 year old children at baseline and 51.3% of the same cohort 12 months later.

Non communicable diseases

• A 2023 retrospective study of electronic health records from >51,000 Rohingya attending two primary clinics in 2017–19, found the prevalence of adult hypertension was 14% and diabetes prevalence was 11%.

Mental health, trauma

• A 2020 cross sectional survey of 495 Rohingya refugee adults in Cox’s Bazar showed most had experienced systematic human rights violations, including restrictions on work, marriage, healthcare, travel and meeting with others. 99% reported exposure to gunfire, 93% loss of their home, 92% had witnessed dead bodies, 56% had been exposed to torture and 33% to sexual assault. 61% reported post traumatic stress disorder (PTSD) symptoms, and 84% demonstrated anxiety and depressive symptoms.
• Estimated rates of depression and PTSD vary, with another 2023 study drawing on a large Cox’s Bazar Panel Survey from 2019, showing 30% Rphingya reported symptoms consistent with depression and 4.9% with PTSD
• A 2021 study of 361 Rohingya adolescents within 32 camps reported 55% had depressive symptoms, 12.5% had major depression, and 3.7% had PTSD. 

Gender based violence (GBV), early marriage, sexual and reproductive health (SRH)

• Ongoing insecurity, lack of opportunity, and cumulative trauma have contributed to rising protection concerns within the camps, including the presence of armed groups, child abduction and forced labour, gender based violence and neglect. Child marriage remains widespread, driven by cultural norms, entrenched gender roles, poverty, and ongoing concerns about security within the camps - see Child protection situation analysis report 2024. 
• A report SRH for Rohingya young people in Bangladesh (2024) completed as part of the Gender and Adolescence: Global Evidence (GAGE) research program, found 29.2% females had been married before 18 years; widespread restriction of activities during menstruation due to cultural reasons; 81% females had some knowledge of contraception, although girls and women were infrequently able to make their own family planning decisions; abortions appeared to be common, especially after rape, and while antenatal care rates were high (90%) only 40% young mothers delivered their first child in a clinic or hospital. 
• A 2021 study of Rohingya girls (10-19 years) who experienced child marriage found their average age of marriage was 15.7 years, and 88.5% had given birth in the preceding 2 years or were pregnant at the time of the study.
• A 2022 systematic review of SRH in Rohingya (and Afghan) women in Asia found 72% of Rohingya refugee women had experienced GBV, and 56.5% had engaged in unwanted sexual intercourse with their husbands.

Disability

• The 2024 GAGE research including 834 young people from 24 Cox's Bazar camps, reported disability in 8%.
• A 2021 age and disability inclusion needs assessment survey of 2,530 households, including 11,187 people aged 2 years and older, found the prevalence of disability was 12% overall, and 35% households reported at least one person with disabilities. The majority of people with disability faced barriers to mobility in shelters (52%) and camps (76%), and barriers to accessing services (64%). The prevalence of disability  increased with age (2% in 2-4 year-olds, 51% in 60 years and older). 

Resources

• 2025-26 Joint Response Plan Rohingyan refugee crisis
• Inter-sector Needs Assessment 2025 - Rohingya refugee response 
• MSF: Behind the wire: Impact of state containment and exclusion strategies on the Rohingya (2024)
• MSF: Rohingya a timeline (2022)
• UNGA 74/246: Situation of human rights of Rohingya Muslims and other minorities in Myanmar (2019)
• UNHCR A route based snapshot: Data & Trends for Refugees from Myanmar, as of end-December 2025
  
• UNHCR Culture, context and mental health of Rohingya refugees (2018)
• UNHCR Rohingyan refugee crisis explained (2024)
• UNHCR Situation report Myanmar (2026)

^{Immigrant health resources. Author Sally Egan, Georgie Paxton 16 Jan 2026. Contact georgia.paxton@rch.org.au}