On the floor of their tiny makeshift home in a refugee camp in Bangladesh, her mother Fatima Begum feeds Sofiya by rubbing her gums with a food paste designed to treat severe malnutrition.
These life-saving packets were provided by the US government, labeled with the logo of USAID – a legacy of the now-defunct organization which was dismantled by the Trump administration in January. With US aid cuts of $8 billion annually, a gaping hole has been left in international aid.
The impact is already being felt in the world’s largest refugee camp in Cox’s Bazar, where UNICEF reports an alarming 11% rise in the number of children with acute malnutrition between January and September this year.
Fatima Begum’s daughter is more than a year old, but looks much younger due to malnutrition. – Salman Saeed/CNN
The remaining USAID supplies are now running out, and Begum says their regular food donations are also decreasing.
“Before, they gave more food, but now they don’t,” Begum said. “They don’t give fruits like before. They don’t give fish. Still, I’m thankful for whatever they give.”
An ethnic Rohingya Muslim, Fatima Begum fled her home in western Myanmar’s Rakhine state in 2017, after the military carried out what the US and UN experts call a genocide. Now, she is crammed alongside 1.2 million Rohingya in sprawling refugee camps in Cox’s Bazar, Bangladesh.
Begum fled one type of hell, only to land in another – now facing a daily battle to keep her baby alive.
Sofiya is currently receiving 2.5 portions of the ready-to-use therapeutic food packets (RUTF) every day, with each one providing 500 calories from the mix of powdered milk, peanuts, vegetable oil and vitamins. Over the past few decades, this simple product has helped to bring millions of children back from the brink of starvation.
As of July this year, UNICEF has had to cut the number of RUTF packets given per child in the camps, to try to stretch resources.
“Cox’s Bazar is ground zero for the impact of budget cuts on people in desperate need,” said United Nations Secretary-General António Guterres after he visited the camps in March, adding that “people will suffer and even people will die.”
US Secretary of State Marco Rubio has repeatedly denied that US aid cutbacks caused any deaths, and has defended the move as a way to cut bureaucracy and prioritize “our national interests.”
But a study published in The Lancet predicts the cuts will result in 14 million deaths over the next five years – and an online impact tracking tool run by a Boston University professor estimates that there are already 88 deaths per hour.
In a statement to CNN, a US State Department spokesperson said the US announced “an additional $60mn in life-saving humanitarian assistance for Rohingya refugees in Bangladesh” in September, including emergency food assistance and RUTF packets.
“The Trump Administration is significantly enhancing the efficiency and strategic impact of foreign assistance programs and continues to deliver life-saving assistance around the world, including to vulnerable populations like the Rohingya refugees while remaining accountable to the American taxpayer,” the spokesperson said.
Funding cliff
The children wasting away, day by day, don’t have time to wait for funding gaps to be filled.
At a nutrition center in Camp 15 of Cox’s Bazar – run by Concern Worldwide, with programs from UNICEF and the World Food Programme (WFP) – babies are measured for malnutrition by wrapping a paper tape measure around their tiny arms.
Chronic malnutrition – or stunting – has remained persistently high in the camps, at around 41%, UNICEF says.
“More and more children are being detected with the severest form of malnutrition, and they are at a risk of mortality because of that,” said Deepika Sharma, the Chief of Nutrition and Child Development in Bangladesh for UNICEF.
As international aid is pulled back from the US, along with reductions from other countries including the UK and France, aid agencies have slashed jobs globally to try to protect frontline operations – including nearly 5,000 job losses at the UN refugee agency, UNHCR.
But life-saving projects are still being impacted, including medical services, food supplies, and vaccine programs. And the coming year looks worse – with many aid agencies facing a “funding cliff” in 2026.
“People are suffering,” said Shamsud Douza, the joint secretary of the Additional Refugee Relief and Repatriation Commissioner (RRRC) Office in Cox’s Bazar. “Humanitarian aid decreased, funding is going down, some people are losing jobs, education programs, everything.”
In August, the Bangladeshi government organized a major conference to try to raise the funds for the Rohingya. And on September 30, the UN held a special conference on the situation in New York.
Deepika Sharma – the chief of child nutrition and development at UNICEF in Bangladesh – says children “will die” if the flow of aid dries up. – Salman Saeed/CNN
Refugees in the camps are living on $12 USD of food per person, per month. The World Food Programme said it has not made any ration cuts so far this year, but faces a $126 million funding gap in the next 12 months.
“The needs of the Rohingya in Bangladesh are outpacing resources at an alarming rate,” Julie Bishop, special envoy of the UN secretary-general on Myanmar, said in New York on September 30. “Without new contributions, food assistance for the entire Rohingya community will come to a complete halt in two months.”
More than 150,000 new Rohingya refugees have arrived in the camps in the past two years, UNHCR says, straining the tight resources. They escaped intense fighting between the Myanmar military and the ethnic Rakhine Arakan Army during the civil war – with both sides linked to alleged atrocities against the Rohingya population.
A lot of the new arrivals are already badly malnourished, as aid provision has largely been cut off for their homes in northern Rakhine – where the military has been accused of using hunger as a weapon of war.
Further south in Sittwe – the capital of Rakhine – hundreds of Rohingya have been living in refugee camps since 2012, after previous violent attacks on their community.
Hla Tin, a 39-year-old Rohingya living in a Sittwe camp, told CNN that they haven’t received any aid in the camps since June – suggesting that the situation there is even more dire than in Cox’s Bazar. The humanitarian need inside Myanmar is only 12% funded, according to the UN.
Hla Tin has five children, and the youngest two are both suffering from malnutrition.
“These days due to lack of nutritious food, both elderly people and children get sick more easily,” Hla Tin said.
Among 432 families in the camp, over 300 are not eating regular meals, and people are getting into debt taking loans to buy food, he said.
“I would like to call on the international community and organizations to not turn a blind eye to us, but to help us,” he said.
Back in the bamboo and tarpaulin tents which blanket the hillsides of Cox’s Bazar, refugee Mariam Khatun dresses her three small children and prepares a meal – these daily tasks the only thing keeping her going since the death of her eldest daughter, Estafa.
She was a bright student, so her family sent 7-year-old Estafa to private lessons to learn Arabic – hoping that this would give her a chance to leave the camp one day and find a better future.
But things started to change this year when budgets were slashed.
“We can’t afford to educate our children. Access to medicine has decreased compared to before,” Khatun said. “If there is no budget in the future… we will suffer even more.”
In the camps, 48 health facilities, along with 11 primary health care centers, have been directly affected by the US government cuts, aid agencies say.
“We see long queues now in our hospitals, people waiting for treatments,” said Hasina Rahman, the Bangladesh country director for the International Rescue Committee (IRC). “Services have been restricted and are limited now in the camps, and that is creating a massive impact.”
Mariam Khatun’s 7-year-old daughter died in February. She blames a lack of medical aid in the camps. – Salman Saeed/CNN
In February, Khatun says Estafa became suddenly ill with stomach pains, so they took her to a camp hospital, and she was then transferred to a bigger facility where she received treatment.
“My child suffered and died in pain,” Khatun said, as tears rolled down her face.
The cause of death was “aspiration pneumonia and encephalitis,” according to a death certificate seen by CNN.
The grieving mother blames a lack of medical care for her child’s death – although the medical team which treated her told CNN that there was no link between her death and the funding cuts.
But tragedies like these also reflect the vulnerability of this refugee population – with the overall reduction in support causing a cascade effect for those already living on a knife edge of survival.
“This is basically a catastrophe in the making,” Rahman, from the IRC, added.
“Before, we used to get support from America,” Mariam Khatun said. “We want their help again.”
For more CNN news and newsletters create an account at CNN.com
