Several refugees described the failure of this emergency response mechanism for pregnant people in need of urgent care, particularly during childbirth. Ismail, 31, a healthcare worker on the island said: There are three midwives, but they are not able to handle serious cases. So mostly we must take the pregnant women to a hospital outside of the island which is altogether a five-hour journey by boat and car. The transportation facilities and communication facilities are so poor that the critical patients suffer and as healthcare workers we suffer too. 147 Saber, 35, whose wife Rahina, 26, died in childbirth, said that he believes the additional time required to obtain permission to leave the island may have cost his wife’s life: My wife suffered a lot. This was her third child. The other two were born normally but this time my wife had some complications. When her labor pain started, I rushed her to the healthcare facility. I requested that she be transferred to the mainland hospital because of the complications. They required me to get permission from several authorities, which cost me more than two hours. By the time I arrived at the healthcare facility with the permission paper, my wife had died. If they had taken her to the hospital in Chittagong [north of Cox’s Bazar] on emergency basis by fastest possible means, my wife might have survived. 148 Food Shortages Refugees on Bhasan Char say they have experienced severe food shortages. 149 Several families described borrowing food from others or going hungry for days while awaiting the next supply. Dilroba said: We are suffering due to food shortages. Instead of 2½ sacks of rice, now we are getting only 1½ sacks for 10 family members. We are really worried 147 Human Rights Watch interview with Ismail, Bhasan Char, Bangladesh, April 10, 2021. 148 Human Rights Watch interview with Saber, Bhasan Char, Bangladesh, March 30, 2021. 149 See ICESCR, article 11 (right to adequate food). 45 HUMAN RIGHTS WATCH | JUNE 2021