Experiences of children's self-wetting (including incontinence) in Cox's Bazar's Rohingya refugee camps, Bangladesh

Self-wetting, including incontinence, affects people of all ages, ethnicities, and cultural backgrounds, and can have a significant negative impact on quality of life. We thus explored the attitudes towards self-wetting and experiences of children (ages five to 11), their caregivers, and humanitarian experts in the Rohingya refugee camps in Coxs Bazar, Bangladesh. We purposively selected participants from two camps where our partner organisation, World Vision Bangladesh - Coxs Bazar, works. We conducted Key Informant Interviews (KIIs) with community members and camp officials, Story Book (SB) sessions with Rohingya children and in-depth Interviews (IDIs) with caregivers of children who participated in the SB sessions, as well as surveying the communal toilets used by children of the caregivers. Self-wetting was commonly seen among the children. Due to self-wetting, children were likely to feel embarrassed, upset and uncomfortable, and frightened to use the toilet at night; many also indicated that they would be punished by their caregivers for self-wetting. Key informants indicated that caregivers have difficulty handling childrens self-wetting because they have a limited amount of clothing, pillows, and blankets, and difficulty cleaning these items. In the sanitation survey it was evident that the toilets are not appropriate and/or accessible for children. Children in the Rohingya camps studied self-wet due to both urinary incontinence (when unable to reach a toilet in time) and because the sanitation facilities offered are inappropriate. They are teased by their peers and punished by their caregivers. The lives of children who self-wet in these camps could be improved by increasing awareness on self-wetting to decrease stigma and ease the concerns of caregivers, as well as increasing the number of toilets, ensuring they are well-lit, providing child-friendly toilets and cubicles, fixing the roads/paths that lead to sanitation to facilities and increasing the provision of relevant continence management materials.