Executive Summary: "In recent months Bangladeshi authorities have waged an unprecedented campaign of arbitrary arrest, illegal expulsion, and forced internment against Burmese refugees. In this emergency report Physicians for Human Rights (PHR) presents new data and documents dire conditions for these persecuted Rohingya refugees in Bangladesh. PHR?s medical investigators warn that critical levels of acute malnutrition and a surging camp population without access to food aid will cause more deaths from starvation and disease if the humanitarian crisis is not addressed... Methods: The plight of the Burmese refugees in Bangladesh came to PHR?s attention while its researchers were conducting a quantitative study in the region on health and human rights in Burma. This emergency report is based on a sample of 100 unregistered refugee households at the Kutupalong makeshift camp in southeastern Bangladesh as well as in-depth interviews with 25 refugees and 30 other key informants throughout the region. Richard Sollom MA MPH, PHR?s Director of Research and Investigations, and Parveen Parmar MD, emergency physician at Harvard University?s Brigham and Women?s Hospital, conducted the eight-day assessment from 8-16 February 2010. Both team members have considerable experience working in refugee populations throughout the world and describe the conditions for unregistered Burmese in Bangladesh as alarming... Arbitrary arrest and forced expulsion of refugees by Bangladesh: The Burmese refugee population in Bangladesh is estimated at 200,000 to 400,000. The Government of Bangladesh and the UN refugee agency (UNHCR) jointly administer two ?official” camps with a combined population of just 28,000 registered refugees. The remaining unregistered refugees are currently not protected by UNHCR because they arrived after 1993 when the Bangladesh government ceased conferring refugee status to any Rohingya fleeing Burma. In an apparent attempt to dissuade the influx of any further refugees fleeing anticipated repression prior to elections in Burma later this year, Bangladesh police and border security forces are now systematically rounding up, jailing or summarily expelling these unregistered refugees across the Burmese border in flagrant violation of the country?s human rights obligations. Although Bangladesh has not acceded to the UN refugee convention, it is minimally obligated to protect this vulnerable population against refoulement (forced deportation across the border)... Makeshift camp is ?open-air prison”: Arbitrary arrest and expulsion by Bangladeshi authorities have acutely restricted all movement out of the unofficial camp, effectively quarantining tens of thousands of refugees in what one experienced humanitarian called ?an open-air prison.” Because refugees fear leaving the camp, they are no longer able to find work to buy food. This confinement, coupled with the Bangladeshi government?s refusal to allow unregistered refugees access to food aid, presents an untenable situation: refugees are being left to die from starvation... Refugee children facing starvation and disease: Tens of thousands of unregistered Burmese refugees in the burgeoning camp in Bangladesh have no access to food aid. Physicians for Human Rights researchers observed children in the unofficial camp who were markedly thin with protruding ribs, loose skin on their buttocks, and wizened faces ? all signs of severe protein malnutrition. The PHR team also came across many children who appeared to have kwashiorkor, as evidenced by swollen limbs and often distended abdomens. One out of five children with acute malnutrition, if not treated, will die. Results from the PHR household survey reveal that 18.2% of children examined suffer from acute malnutrition. In emergency settings, acute malnutrition is traditionally measured among children age 6?59 months. High rates of malnutrition in this age group correspond with high rates in the population as a whole. Child malnutrition levels that exceed 15% are considered ?critical” by the World Health Organization (WHO), which recommends in such crises that adequate food aid be delivered to the entire population to avoid high numbers of preventable deaths. In addition, PHR received numerous testimonies from families who had not eaten in two or more days. As a coping mechanism, many refugees are now forced to borrow food or money to feed their families. Results from the PHR survey show that 82% of households had borrowed food within the past 30 days, and 91% of households had borrowed money ? often with exorbitant interest rates ? within the previous 30 days. Walking through the Kutupalong camp, PHR investigators saw stagnant raw sewage next to refugees? makeshift dwellings. Human excrement and open sewers were visible throughout the camp. Results of the PHR survey show that 55% of children between 6?59 months suffered from diarrhea in the previous 30 days. Such inhuman conditions presage a public health disaster... Obstruction of humanitarian relief: PHR received reports of Bangladeshi authorities? actively obstructing the little amount of international humanitarian relief that reaches this population. Corroborating eyewitnesses report that a Bangladeshi Member of Parliament recently Persecuted Rohingya Flee Burma and Starve in Bangladesh rounded up four national staff of an international humanitarian organization, tied them to a tree, and beat them for providing aid to the Rohingya refugees. This environment of regular harassment by Bangladeshi authorities severely impairs the ability of NGOs to provide assistance to unregistered refugees. The UK-based organization Islamic Relief ceased its humanitarian operations in one camp on 28 February 2010 because the Bangladeshi government refused to approve the group?s humanitarian activities that benefit these refugees... Bangladeshi hate propaganda and incitement against Rohingya refugees: The Bangladeshi government?s ongoing crackdown against Rohingya refugees appears to be coordinated among local authorities, police, border security forces, and the ruling political elite. Bangladeshis near the southern coastal town of Cox?s Bazar have formed Rohingya ?resistance committees” that demand the expulsion from Bangladesh of the Rohingya. Bangladeshi authorities threaten villagers with arrest if they do not turn in their Rohingya neighbors. Local media disseminate ominous anti-Rohingya propaganda in editorials and opinion pieces, all of which incite xenophobic antagonism among local inhabitants... Background to the refugee crisis: Burma?s de facto president, Senior General Than Shwe, seized power 20 years ago while promising free and fair elections in 1990. That year, the opposition National League for Democracy (NLD) defeated the military-backed State Law and Order Restoration Council (SLORC), garnering 59% of the vote and 80% of the seats in the People?s Assembly. SLORC dismissed the results, and subsequently detained NLD?s Prime Minister-elect Aung San Suu Kyi, who is currently under house arrest. To fend off risk of a second defeat at the polls in late 2010, the Burmese military regime has stepped-up militarization and abuses against all ethnic minorities, who represent nearly 40% of Burma?s total population of 50 million. Than Shwe?s Tatmadaw military has locked up 2,200 political prisoners, destroyed more than 3,200 villages, and forced millions to flee, ensuring that opposition parties cannot organize prior to upcoming elections. Burmese ethnic minorities, including the Rohingya, continue to flee, seeking refuge in neighboring countries. An additional 8,000 Rohingya have fled to Bangladesh in 2009. The Rohingya have a well-founded fear of persecution if forcibly returned to Burma. During the past five decades