One in five Rohingya refugees in Cox's Bazar has Hepatitis C

In Cox's Bazar, where nearly a million Rohingya refugees live in sprawling camps, a medical crisis is unfolding largely out of sight. Nearly one in five adults among them carries Hepatitis C—a rate almost seventeen times higher than the surrounding Bangladeshi population. The virus arrived with them from Myanmar, embedded in their bodies like a silent inheritance, the consequence of medical systems that had never prioritized safety.

A study published this May by icddr,b, a leading research institute, laid bare the numbers. Among Rohingya refugees, viral hepatitis prevalence stood at just under nineteen percent. Among local Bangladeshis in the same region, it was barely above two percent. The gap was driven almost entirely by Hepatitis C: seventeen percent of refugees carried it, compared to just one percent of host community members. When researchers looked at the newest arrivals—the roughly 150,000 Rohingyas who had entered Bangladesh in recent months—the infection rate climbed even higher. Between twenty and twenty-two percent of them tested positive.

The evidence pointed clearly backward, not forward. These infections did not originate in the camps. They came from Myanmar, where unsafe medical practices had been routine. Sarwar Jahan, an assistant medical coordinator with the Refugee Relief and Repatriation Commissioner, explained that the pattern of infection among recent arrivals made this clear. Doctors in Myanmar had reused syringes without sterilization. Traditional procedures were performed without hygiene protocols. Blood transfusions went unscreened. Childbirth care lacked basic safety measures. For people who had lived through these systems, the virus was simply part of what they carried when they fled.

Kamal Hossain was thirty years old when his diagnosis came in 2025, eight years after he had escaped Myanmar. For years before that, he had felt inexplicably tired. His appetite would vanish. His vision would darken without warning. He had no framework for understanding what was happening to his body. When the test came back positive, the pieces fell into place. His parents and his sister were infected too. Looking back, Kamal understood: the doctors in his hometown had used the same needle on multiple patients without changing it. "At the time, we thought that was normal because nobody explained the risks," he said. He has since been cured through antiviral treatment administered in the camp.

But Kamal's recovery is the exception. Nearly 59,000 Rohingya patients have been enrolled in antiviral therapy, but approximately 50,000 others remain untreated. The reason is simple and brutal: there is not enough money. Without treatment, Hepatitis C progresses silently. It becomes cirrhosis. It becomes liver cancer. It becomes death.

The alarm was first raised by Mohammad Ali, a professor and founder of the National Liver Foundation of Bangladesh, whose 2021 study identified the crisis and traced its roots to Myanmar's medical infrastructure. He has since become the voice calling for action. The problem, he argues, is not confined to the refugee camps. Hepatitis C prevalence among Bangladeshis living in the border towns of Ukhiya and Teknaf has reached 2.3 percent—more than double the national average. The virus does not respect the boundary between refugee and host community. Both populations need protection.

Sumaiya Yousuf, a doctor with Médecins Sans Frontières, notes that Hepatitis C often announces itself quietly or not at all. Patients complain of fatigue, poor appetite, abdominal pain—symptoms that could mean almost anything. Many arrive in the camps without knowing they are infected. The disease can remain dormant for years, a passenger in the body, until suddenly it is not.

Experts are calling for a coordinated response: expanded screening, universal access to treatment, stronger infection prevention, and sustained awareness programs. They want Rohingya refugees fully integrated into Bangladesh's national viral hepatitis elimination strategy. They want culturally appropriate health education, rapid testing, free treatment for all active cases, routine screening during pregnancy, and timely vaccination for newborns. What they are asking for is not extraordinary. It is the baseline of public health. Whether the resources and political will exist to deliver it remains an open question.