Chapter 4: Rohingya Refugee Camp: The Confusion/Midwives


The Rohingya refugee camp is both enormous and small, which is confusing, and that’s normal. Refugee camps are very confusing.

Only 3,000 acres, 1.2 million people live on his steep rabbit warren of terraced dirt.  Highly provisional shelters made of baked mud, or bamboo and tarps (materials that are often hauled by children far too small to realistically handle their weight), blanket, dot, and snake all over the available surface of every inch of land.  I see sandbags plotted out to make steps for an improbably unused hill that will within days become another Rohingya settlement.

Refugees from Myanmar cross the border and are directed to the UNHCR Transit Center, where they are counted, given health check-ups, a bit of clean water and nutrition, and an emergency blanket.  They stay at the transit center up to a few days, until they are given postage stamp area of ground on which to assemble their construction paper flimsy new home.

We spend some time just driving through the camp, getting a sense of the scale and scope of it.  I feel the possibility emotional unrest, a distant foretaste of claustrophobia. I self-regulate by checking in with my breathing, by observing my thoughts, and I am intrigued later to learn how my friend Kate copes.  She imagines a Rohingya woman doing just one normal thing: going to sit on a toilet.  Turning on a tap for some water to come out.  Lying down on a bed. She never allocates more than a normal thing, she fixates on imagining these individual interactions.

The roads are narrow and swarming with refugees. The dust is swirling and thick, at times obscuring the view, as if looking at the world through a muddy lens.  The camp has no end in sight.  Most importantly.  Crucially.  The life of a Rohingya refugee has no end in sight.

There is a consuming, inescapable tension here.  Life is suspended.  Life is urgent.  There is absolutely nothing to do but to try to make sense, in a state of flaming trauma, of chaos, to navigate to an Elderly Friendly Space or a Child-Friendly Space or to be in the right line at the right time for a ration of some life-giving supply.  Plotting when to pee, how to poop, maybe when and if to try to wash up a bit, all require exaggerated effort, timing, and risk. Waiting in line to check in for labor and delivery is boring even when life, the most exciting thing in the world, is emerging.  It’s unnatural.  That’s the word.  Unnatural.  And as such, it is utterly exhausting. 


Primary Health Clinic in D5 camp has  UNFPA maternity care and midwives, and it is swollen with bodies and bellies.  Women line the outdoors.  They stand in an almost agitated and unruly U shape, pressing toward the entrance.  Inside, like the cool length of a barn, they sit on benches and their bodies make dark shapes as far as the eye can see.  A few, having pain, squat rather than sit.  Little rooms off the central axis are full of women, and I wend my way to one in the back, the anteroom of the delivery room. I hear newborns crying.  Lying on tables waiting to deliver, lying on tables with just delivered babies, sitting and lying on the floor ready for water to break and with a shoulder raised up to shield a nursing baby, women are in quiet heaps and piles.


Bangladesh has just graduated its first and second batches of midwives.  Ten young women sit at a dinner table at our hotel, dressed in their finest. Several look like portraits of queens, their scarves nobly encircling their heads, secured with pins and shiny baubles, as they describe how there are restrictions by custom against women receiving health care from a male.  Some women, they share, are even prohibited from leaving home to seek health care at all.  They have been drawn to midwifery by the skill – technical and emotional – that is demands. They have been enticed by the promise of cultivating the trust and confidence of a woman.  They are so young themselves, and far from home (24-30 hours by bus), and choosing the work in an emergency humanitarian setting.  Their parents, they say, are “scared and proud.” They love being the first cohort of educated midwives in their country, and they are the first educated girls’ in their families. When I ask one how many babies she has delivered, and she says “More than 400,”, I am astonished.  In total, the ten women with whom I am having supper have safely delivered more than 1,700 babies.

Our dinner consists of such sweetness.  They talk about their youthful exuberance, how they experience “natural” tiredness but they never tire of the work.  They are on duty 24/7, living at the clinics where they deliver, working in pairs to physically coach and emotionally soothe humans in the primal space of giving birth.  We talk about stress, and invariably the topic of trauma comes up.  Trauma inheres, is the baseline, of Rohingyan life.  We talk about what we choose to do, touch people who have such emotional pain and profound wounds, and how we can do so consciously, intentionally, and with a boundary.  My eyes rest on the dinner table, and I hope a pithy example of boundaries is right at my finger tips.  There are two tables pushed together, their edges making a barely detectable seam.  Both are covered with identical red table clothes. There is the smallest sliver of space between them, and I say that’s what I have to be careful of, that even as I am a woman amongst women, there needs to be that little piece of psychic space between me and another person’s pain.  Otherwise I am actually less useful and helpful to her.  We talk about the difference between empathy and enmeshment.

It’s my favorite conversation.  We even practice breathing together, the UNFPA midwives and me, one hand on our hearts, one hand, fingers spread widely, on our bellies, breathing so deeply our bellies move out and nearly touch the table’s edge. 

They need these skills.  Their work includes clinical management of rape, in addition to L&D and voluntary  family planning counseling.  They struggle to gain the trust of raped women in order to provide post exposure STI and hepatitis B medicines, and emergency contraception.

I ask if I may take a picture with these darlings, and they leap up faster than they did to serve themselves from the three course buffet. We go downstairs to where a traditional band is playing music in a local ethnic style, and take a zillion group pictures of different arrangements, standing, seated, in small and large groups.  Then we get started with selfies, and I feel the bookend to the day that began with hundreds and hundreds of pregnant women at the sexual and reproductive health clinic. It’s been a lot and I think I’ll cry. But I don’t, I sleep ten and half hours.