Bangladesh: Children arrive sicker, later and harder to save at MSF’s Kutupalong hospital for Rohingya refugees
As humanitarian funding shrinks, overlapping health crises are pushing families and health facilities beyond their ability to cope.
In the overcrowded refugee camps of Cox’s Bazar children — who make up half of the 1.3 million refugees — are arriving at medical facilities later, sicker and with complex, overlapping physical and psychological health needs.
Nine years after fleeing extreme violence in Myanmar, and with international humanitarian assistance funding fast disappearing families struggle to secure basic food, healthcare and education, placing children’s daily survival at constant risk.
At Kutupalong hospital — MSF’s largest hospital and main referral hub — what was once a hospital treating routine illnesses, has turned into an emergency facility managing children arriving in life-threatening conditions.
These observations are documented in a new MSF report, “Children arrive sicker, later, and harder to save” in Rohingya camps. The report finds children are increasingly arriving with complex, overlapping health needs, including malnutrition and mental health distress, as healthcare capacity in the camps shrinks.
Facilities like Kutupalong hospital are left to absorb critical needs far beyond their original design.
“Children arrive sicker, later, and harder to save” in Rohingya camps
Children admitted multiple times to pediatric ward
Inside the pediatric ward of Kutupalong hospital, Yasmida holds her one-and-a-half-year-old daughter, Halima. Halima has severe malnutrition, fever and persistent infections. Yasmida fled Myanmar in 2017, surviving a treacherous 15-day journey across mountains and rivers to reach Bangladesh. Living in the camp with a family of seven, her days are consumed by Halima’s constant illness — sometimes resulting in multiple hospital admissions in a single month.
“When parents are forced to prioritize food or safety, they delay seeking hospital care for a sick child until it becomes a life-threatening emergency.”
Nadim Shahariyar, physician and deputy hospital director at Kutupalong hospital
“Since her birth, we have frequented various hospitals and health facilities inside the camps around 10 to 12 times, and she was admitted to the MSF hospital four times,” Yasmida says.
There are other barriers when navigating health emergencies in the camps. “Once at 2 am, my daughter became extremely ill. After walking a short distance, we came across a group of men. They beat up my husband and looted everything he had. We returned home with our daughter and only took her to the doctor the next morning. If the child falls ill at night, we cannot go out, and her health worsens further due to not receiving timely treatment.”
Nadim Shahariyar, physician and deputy hospital director at Kutupalong hospital, says this is part of a broader trend. “Over the last few years, we have seen significant changes in pediatric admissions,” Shahariyar says. “People are arriving in more critical condition and with multiple illnesses at the same time. Previously, people usually came in with a single illness and recovered well. Recently, however, children are arriving at our hospital later in the progression of their conditions, often with multiple illnesses and complications. This makes their clinical management much more challenging.”
Shahariyar has noted the drastic cuts to humanitarian aid. “Families are struggling to meet their basic daily needs. When parents are forced to prioritize food or safety, they delay seeking hospital care for a sick child until it becomes a life-threatening emergency.”
A tipping point for adolescent wellbeing
Chronic stress, severe poverty, lack of educational opportunities and exposure to family disputes are driving a sharp rise in adolescent distress. Teenagers, Beauty and Jasmine, both received psychiatric care and counselling at MSF’s Shantikhana mental health counselling room and safe space.
“With the rations we receive, we somehow get by eating just rice and lentils,” says Beauty, who attempted suicide following severe food scarcity and family conflict. “Driven by so much suffering and deprivation, I made that decision. I now understand that dying is not a solution.”
Jasmine says that life in the camp is difficult for younger people. “The living conditions here are not good,” she says. “Many people are crammed into small shelters and families have barely any income, which causes a lot of distress. Life here is barely manageable. If only the environment in the camp were better, perhaps we would feel better.”
Between 2023 and 2025, more than one quarter of suicide attempts (27%) were by children under 18. Over the same period, 81% of these were directly attributed to family violence, exacerbated by severe crowding and relentless daily stress. This crisis is growing rapidly, with the proportion of children under 15 seeking MSF mental health support jumping from 9.7% (131 cases) in 2021 to 29.4% (232 cases) in 2025.
Shariful Islam, MSF’s mental health activity manager, says these acts are a clear cry for help in an unviable environment. “Our team observes that suicide attempts are driven by a complex interplay of factors rather than a single isolated cause. The root drivers stem from inadequate humanitarian assistance, lack of freedom of movement and a pervasive loss of hope after nearly nine years of displacement.”
A critical call for solutions
Pediatric illness and rising child mental health distress are not isolated medical issues, but indicators of a broader protection and public health emergency. Reduced funding across the camps has crippled primary healthcare, compromised nutrition programs and eroded basic living conditions — forcing secondary facilities like Kutupalong hospital to absorb critical needs far beyond their original design.
