According to WHO, diphtheria is “rapidly spreading among Rohingya refugees in Cox’s Bazar.” On 6 December, WHO warned that more than 110 suspected cases, including 6 deaths, have been clinically diagnosed by health partners, including Médecins Sans Frontières (MSF) and the International Federation of the Red Cross (IFRC). Diphtheria is a highly infectious respiratory disease that spreads through droplet and can be deadly, particularly in overcrowded areas with no proper sanitation system. WHO is working with the Bangladesh Ministry of Health and Family Welfare (MoHFW), UNICEF, and partners to contain the spread of the highly infectious respiratory disease through effective treatment and adequate prevention. For its part, UNHCR immediately made part of the Rubber Plantation Transit Centre available to serve as a treatment and isolation facility for patients under MSF management. Sixty-eight patients were transferred on 9 December 2017. The outbreak has impacted the upcoming relocation of some 10,000 refugees currently in border areas in Bandarban district; their relocation will be delayed to allow for the vaccination of children.

Registration, including birth registration, for all refugees is critical. UNHCR’s family counting exercise which began on 3 October has now been completed. UNHCR teams continue to count new arrivals and update the data for families who may move within settlements. In parallel, the Ministry of Home Affairs (MoHA) is conducting biometrics registration for some 830,000 individuals, including new arrivals. UNHCR will work jointly with authorities to update data records and share with the authorities complementary data which UNHCR gathered on the location of individuals and on family composition. This is expected to result in good data set that will enable UNHCR and the authorities to better plan together, with other partners.

As part of their winterization activities, UNHCR and its partners are continuing to distribute shawls and sweaters as the temperatures decrease. A total of 20,458 shawls were distributed as of 20 December. UNHCR is also distributing, through its partners, sweaters for children under five. In Nayapara, the military agreed for UNHCR to use its distribution point, which will increase the outreach from 526 families to 1,200 families during each distribution that takes place four times a week.

Arrivals from Myanmar have significantly decreased, with over 2,200 refugees crossing into Bangladesh from 1 to 26 December, compared to over 12,700 in November.

The second phase of UNHCR’s shelter strategy is underway in preparation for the monsoon season. Since November, UNHCR and its partners has distributed some 27,600 upgraded shelter kits, composed of bamboo poles, ropes, tools, and tarpaulins, to help refugees build sturdier homes. Since November 2017, over 27,500 kits were distributed. In four days only, UNHCR’s partner ADRA completed the distribution for more than 2,600 families in Charmakul / Karantoli. In addition, UNHCR continues to collaborate with the Asian Disaster Preparedness Centre (ADPC) to identify areas, which have the highest risk of landslides and to mobilize partners to prepare the sites for the upcoming rains.

UNHCR teams conducted a mapping of latrine and tube wells in two zones of Kutupalong to analyze the distribution of facilities in the zones and better assess whether coverage is sufficient in the area. So far, over 200 WASH facilities have been mapped. This exercise has shown an urgent need for desludging and for additional latrines. UNHCR and partners are already planning the constructions of 10 latrines and four tube wells in one zone of Kutupalong. These will cater for 500 and 2,000 people respectively.

The 190 active community outreach members (COMs), which cover four areas of Kutupalong, including the makeshift, Nayapara extension area and Chakmarkul, have conducted over 150 home visits and more than 210 information sessions, reaching out to some 3,500 refugees. Forty cases under monitoring have been resolved after actions by COMs and partners this week.

In the past two weeks, 623 families living in flood-prone areas of Kutupalong were relocated to safer parts of the settlement. UNHCR is working closely with the government and other partners to prepare for the upcoming monsoon season.

Nobel Peace laureates Mairead Maguire of Northern Ireland, Tawakkol Karman of Yemen, and Iran’s Shireen Ebadi visited refugee settlements in Bangladesh to raise awareness about the plight of Rohingya refugees. The laureates’ visit took place as part of the Nobel Women’s Initiative.

UNHCR and the International Union for Conservation of Nature (IUCN) launched a project to prevent dangerous encounters with elephants, which have resulted in at least 10 deaths in Kutupalong settlement. The highly congested site lies on one of the migratory routes for Asian elephants.