An improvised stretcher is being carried across open sewer. Two Rohingya refugees are ferrying an old woman lying on a towel. They are hurrying to the nearest medical facility, squeezing through between cars and tuk-tuks (three-wheeled motorized vehicles). In some parts of the Kutupalong refugee camp, reaching the nearest first aid point means a four-kilometer journey on foot, up and down the hills.

The area has become an enormous shanty town. It is a city of tents housing 500,000 inhabitants, pitched on small hills up to 30 meters high. In it, food vendors, people running improvised mosques and SIM card dealers are taking turns on pumps to get drinking water. In the valleys, garbage-filled puddles are the children’s only playground. A forest and a road mark the camp’s boundaries.

Kutupalong is an open-air prison. “The refugees are not allowed to leave the camp,” reveals Faisal, a human rights activist, as he squeezes through the tents. “You see that this area is just hills and valleys, which get flooded during the rainy season. Families have died here trying to save the few possessions they had.” A small lake has formed where Faisal is pointing, and children are splashing around in the water, while a family is building another tent on the bank. “The camp had existed before, but the latest wave of refugees, that of October 2016, had the highest impact.”

According to UNHCR data, a little over 600,000 people have arrived in Bangladesh since then, but some have said the estimates are too low, with one million being the most likely number. “Everything is lacking In the camps. From medical assistance to schooling, and even food and drinking water. It is an emergency in every respect,” Faisal says, who himself has Rohingya blood. His father left Burma when he was 5 years old. He is 40 now.

Then, over 30 years ago, just as now, the Muslim minority in Myanmar was considered foreign and not officially recognized by the military government in Yangon. “We are witnessing a story that has been going on since 1942, although it was with the 1982 law that prohibited the Rohingya from getting citizenship that the level of violence showed a great escalation,” says Farouk, who lives in a tent in the Kutupalong camp, and shows me his membership card in the National Development Party in Myanmar, to which he used to belong. “They have slowly eliminated civil liberties, while the nationalism that is creeping in has taken on an ethnic connotation.”

The Muslim minority, originating from the Rakhine region, is seen as though they were illegal immigrants. The Rohingya are being accused by Myanmar nationalists of being a result of British colonialism: an ethnicity imported from Bangladesh to meet the need for manual labor. “What the world is witnessing now in Myanmar is genocide, just as Kofi Annan’s commission said,” says Farouk, referring to the February 2017 report issued by the High Representative of the United Nations in Myanmar.

A shadow falls across a tent in the Kutupalong refugee camp. A veiled woman sits down on the dirt floor. Miriam, 14, is from the village of Wet Kyein, a Rohingya and, since Sept. 2, also a refugee. “We were 40 women,” she said, recalling how she was taken prisoner in a raid. “They locked us in a room. They kept us there for five days, and they only let us leave when we looked like we could just be thrown away.”

The stories we have heard show that sexual violence is a practice used regularly by the Myanmar military. Assima, 20, breaks down as she tells her story: “I was taken into the forest and raped. I had a baby who was 1 year and 3 months old. They threw him alive into a mass grave and then they set it on fire.”

At the school set up by Zamman, a 55-year-old former imam, using bamboo and sheets of black plastic, many orphans have found a safe place, away from the terrible memories of their flight. “Among the precepts of Islam, there is the obligation to help the most vulnerable, especially those who are in such a precarious condition,” Zamman says, and introduces the kids to us. Rafiqa is 8 years old, with beautiful long curly hair, and she is still in shock from what she lived through in Myanmar: “I saw my mother and my father being killed by soldiers. I came here with my grandparents and I live with them now.”

Sixty percent of the population of the Rohingya camps are minors. The number of orphans recorded by UNHCR in late October was 40,000. “The high proportion of children, together with the absence of any social safety net, is creating the conditions for a chain of exploitation,” says a source close to the authorities in Dhaka, who asked to remain anonymous. “The streets of Cox’s Bazar are full of minors begging, while in Chittagong cleaning ladies are as young as 10 years old.”

Some NGOs have responded to the risks facing underage Rohingya, and have worked to create safe areas. “Beside a shelter for abused women, employing doctors and psychologists, we have built playhouses for the children,” says Dr. Mahdi, the field operations director of the Health Management BD Foundation, a Bengali NGO. “Every day we assist around 600 minors. We also try to find a place to stay for those who right now are living on the street.”

While the outbreaks of cholera and measles appear to have been successfully contained thanks to the vaccination campaign promoted by the U.N. agencies and the Dhaka government, health problems continue to be the most urgent aspect of the situation. “Hemorrhagic diarrhea, skin diseases, typhoid fever, malnutrition — we keep working to stabilize the situation,” says Dr. Mohammed, who welcomes us into the emergency room of the Ukhia hospital. “Even the most trivial case can become a serious problem out there in the field.”

In Kutupalong, two men are digging a hole on a hill that is being used as a cemetery. The tomb is a small one. The child was only four months old, and pneumothorax killed her during the night. The father is crying, huddled in the shade of a tree. His tears flow and his gaze is empty. “They did not even try to take her to a first aid point,” Faisal says. “The problem is that it often happens that the refugees are faced with emergencies without knowing what to do or where to turn.”

Our tuk-tuk finally leaves the camp behind us, and, after passing through the checkpoint, we feel like we have just fled a prison.