For Muslims displaced by last year's religious violence in western Myanmar, there is no light at the end of the tunnel and the strain is beginning to show.
I have visited the refugee camps on the outskirts of the Rakhine State capital, Sittwe, several times, but this was my first visit in six months and I was struck by several changes, none of them positive.
More than 100,000 people remain homeless after attacks that were at first described as communal clashes. Subsequent violence and burning made it clear, however, that this had been largely an anti-Muslim campaign.
Most of the people in the camps are Rohingya Muslims, an ethnic group largely viewed as illegal immigrants from neighbouring Bangladesh. Their homes were burned down by groups of Buddhists as part of a campaign that Human Rights Watch described as ethnic cleansing.
The only way refugees can leave the camps is by getting on a boat and heading south in the hope of finding a better future in Thailand or Malaysia, but few can afford the bribes that need to be paid along the way. For many Rohingya, there is no choice but to sit and wait for the Myanmar government to decide their fate.
The best they can hope for, at the moment, is for is some sort of more permanent housing to be built by the government. Such shelter has been promised for some time, but not delivered.
In my previous visits there had been a lot more fervor in the camps. People surrounded us, wanting to tell us their often-horrific stories. We were asked to spread the word to the international community.
Those feelings and memories haven't gone away, of course, but this time I was left with the sense that the refugees are understandably being worn down. An air of hopelessness is setting in.
People are hungry, but there is plenty of food around. People are dying, even though there is a hospital just down the road. If you were a Muslim caught up in the violence, your freedoms have now been taken away.
Yet, amid the desperation there are incredible stories of people helping their own. I was fortunate to meet Maung Maung Hla, a health worker who for 30 years was employed by the government to provide assistance at hospitals in Rakhine State.
Ten months ago, the government stopped paying him. Why? Because he's Rohingya. Now, he lives and works in the camps providing what medical assistance he can to those who live there.
There is not enough medicine to go around and not enough room for those who need in-patient treatment in his tiny medical centre.
Buddhist doctors make brief visits from the town and very occasionally a seriously ill patient is allowed to be taken to the main Sittwe hospital for treatment and medication. In some cases, much-needed surgery is denied because the patient is a Muslim.
Maung Maung Hla busily moved from one end of the medical centre to the other. He took the blood pressure of pregnant women, checked the cast on a fisherman's broken leg, and provided what little comfort he could to a man who was bitten by a rabid dog and was having regular seizures.
The man will die soon and should be in a proper hospital. He's not, because of his religion.
I asked Maung Maung Hla why he continued to do this work even though the government has cut him off. He broke down and said his people have no one else to turn to.
The people of these camps are not just being let down by the government of Myanmar, but by governments around the world who continue to trip over themselves in the rush to reap the financial rewards on offer in this evolving democracy.