KUALA LUMPUR: Approximately 50 per cent of adolescent Rohingya girls seeking treatment at Médecins Sans Frontières (MSF) or Doctors Without Borders Malaysian clinics require antenatal care.
The average age of these pregnant Rohingya adolescents is 15.5 years old, with the youngest patient at the MSF clinic being 12.
Of these cases, three out of every four pregnant girls arrived in the last two years, many through arranged marriages to Rohingya men in Malaysia.
Due to the deteriorating economic situation, exacerbated by decreasing funds and security in Bangladeshi camps, many families have informed MSF that they perceive marrying their daughters to Rohingya men in Malaysia as their sole option.
For most, this decision entails entrusting their daughters' safety to human trafficking networks, often resulting in the likelihood of never seeing them again in person.
According to MSF, many pregnant adolescent girls suffer from anaemia and face a higher likelihood of malpresentation and ectopic pregnancies compared to their adult counterparts due to common complications associated with pregnancies at a very young age.
MSF Malaysia head of mission Froukje Pelsma told the media today that the girls are often forced into marriage as a means of seeking safety, particularly with the worsening conditions in Bangladeshi camps.
"It all comes back to their statelessness, they marry early not because they anticipate a better life here.
"In fact, many women express regret, saying, 'If I had known how arduous this journey would be, I wouldn't have come. I discourage others from coming because it's an extremely challenging road.
"Ultimately, they seek safety and security, especially with the deteriorating situation in Bangladesh and no improvement in Myanmar," she explained.
She hoped that the government would work together with their MSF.
"We hope they get full access to antenatal care and a pregnancy workbook or the pregnancy booklet, which is very expensive.
"But we also work with other NGOs to show them we have a model that works. We reach out to the community to ensure that the women are coming to us," she said.
Their stateless status exacerbates their plight as they have limited access to the healthcare system, as they have no money and no jobs.
Pelsma said the long wait for UNHCR registration and subsequent documentation leaves unregistered asylum seekers at risk of arrest, detention and limited healthcare help.
She said the whole process for UNHCR registration could take up to three years on a case-by-case basis.
"Only once they have their UNHCR cards do they have a 50 per cent foreign discount, and the foreigner fee is around 100 times more than the local fee.
"We also have regulations such as the Circular 10 in Malaysia which obligates doctors in the public health system to report to the Immigration Department when treating an unregistered person which adds to their fear of seeking treatment," she said.
Among unregistered asylum seekers referred to UNHCR by MSF in the past year, 156 were denied admission or registration, and 32 faced threats of arrest.
She further noted that Rohingyas typically seek public healthcare facilities only when their illness is severe.
MSF Regional Director Paul Brockmann called for nations, including Malaysia, to give a form of status so that the Rohingyas would not have to live in the shadows and could seek employment.
This would subsequently enable them to have access to the healthcare system.
He added that MSF is actively engaging with the Health Ministry, and he hoped to meet the ministry next week to discuss healthcare accessibility.
MSF Deputy Medical Director Mohana Amirtharajah called for Malaysia to develop health insurance schemes that could be integrated with the existing healthcare system for Rohingyas to access affordable healthcare.
"Malaysia has a well-developed, high-quality healthcare system, and obviously, preventative care is cheaper than treating health complications.
"So what we're seeking are ways for the Rohingya population, both the documented and undocumented, to access that health system.
"We do provide some provision of care, but only primary care, so we're looking to have some kind of insurance-like schemes that could conceivably be affordable to the community," she said, adding that the community also needs access to employment to be able to pay into any scheme.