Nearly 340,000 Rohingya children are living in a "hell on earth" in overcrowded, muddy and squalid refugee camps in Bangladesh without enough food, clean water and health care, the United Nations Children's Fund (Unicef) said on Friday (20 October). Simon Ingram, author of the Unicef report titled "Outcast and Desperate", says about one in five children in the area are "acutely malnourished" and require medical attention.

Rohingya children
Noor Bejum, 32, holds Rojaika, her seven-month-old malnourished daughter at her shelter in the Kutupalong refugee camp Zohra Bensemra/Reuters

The refugees need clean water, food, sanitation, shelter and vaccines to help head off a possible outbreak of cholera — a potentially deadly water-borne disease. Safe drinking water and toilets are in "desperately short supply" in the chaotic, teeming camps and settlements, Ingram said after spending two weeks in Cox's Bazar, Bangladesh.

Children make up 58 percent of the refugees who have poured into Cox's Bazar, Bangladesh, over the last eight weeks. Up to 12,000 more children join them every week, fleeing violence or hunger in Myanmar, often traumatised by atrocities they witnessed.

"Many Rohingya refugee children in Bangladesh have witnessed atrocities in Myanmar no child should ever see, and all have suffered tremendous loss," Unicef Executive Director Anthony Lake said in a statement.

Ingram also warned of threats posed by human traffickers and others who might exploit children in the refugee areas. "These children just feel so abandoned, so completely remote, and without a means of finding support or help. In a sense, it's no surprise that they must truly see this place as a hell on earth," Ingram told a news conference in Geneva

"This isn't going to be a short-term, it isn't going to end anytime soon," Ingram told a news briefing. "So it is absolutely critical that the borders remain open and that protection for children is given and equally that children born in Bangladesh have their birth registered." Most Rohingya are stateless in Myanmar and many fled without papers, he said, adding of the newborns in Bangladesh: "Without an identity they have no chance of ever assimilating into any society effectively."

Unicef is providing clean water and toilets, and has helped vaccinate children against measles and cholera, which can be deadly, Ingram said. The agency is seeking $76 million (£57.7m) under a $434 million (£329m) UN appeal for Rohingya refugees for six months – but is only seven percent funded, he said, speaking ahead of a pledging conference in Geneva on Monday (23 October).

UN agencies are still demanding access to northern Rakhine, where an unknown number of Rohingya remain despite reports that many villages and food stocks have been burned. "We repeat the call for the need for protection of all children in Rakhine state, this is an absolute fundamental requirement. The atrocities against children and civilians must end," Ingram said. "We just must keep putting it on the record, we cannot keep silent."