Stories from Our Health Clinic Serving Rohingya Refugees

Rohingya refugees living in Cox’s Bazar have survived horrific violence and forced displacement in Myanmar, and are now facing the devastating effects of COVID-19 in the world’s most densely concentrated refugee camp. MedGlobal has been working in Cox’s Bazar since 2017, serving more than 130,000 Rohingya refugees and vulnerable members of the Bangladesh host community alongside dedicated local partners OBAT Helpers and Prantic. Our health clinic provides a wide range of health services, including pediatrics, family planning, women’s health, and management of chronic conditions like diabetes.

Before and during the pandemic, local Rohingya and Bangladeshi health workers have stepped up to serve their communities and help MedGlobal maintain strong core health services.

Here are the stories of 8 of our patients and incredible health workers in the clinic.

1. Meet Dr. Sanzida, who works at the clinic’s emergency room and treats children in the pediatrics department. One of the incredible health workers at our clinic is Dr. Sanzida, who works at the clinic’s emergency room primarily treating burns and cuts. She also treats children in the pediatrics department, counseling them and providing advice about personal hygiene options. Her words say it all:

“Healthcare is one of the most important basic needs for human beings. Rohingya refugees have a right to receive health services.”

2. Meet Yasmin, a 13-year-old patient. In the most densely populated refugee camp in the world, access to health services is critical. Thirteen-year-old Yasmin is one of our patients in Bangladesh. When she came into the clinic after cutting open her foot, she said to the health staff:

“I know doctors here will reduce my pain.”

3. Meet Shahida, a local midwife. Shahida has been working as a midwife in the clinic since 2018. She serves Rohingya refugees, providing critical family planning and reproductive health services to patients. Her outreach, work with, and care for pregnant patients is invaluable. Shahida recently spoke about an increase in requests for family planning services as more information became available within the community:

“Earlier there was some resistance around using family planning methods. Now, with more information, the situation is changing.”

4. Dr. Junayed, a dental surgeon. Dr. Junayed is a dental surgeon working at our Cox’s Bazar health clinic. There are limited dental facilities in the Rohingya refugee camps, so Dr. Junayed attends to patients of all ages facing severe dental problems. His work is critical, and often life-saving. He said:

“We leave the clinic every evening, knowing that tomorrow, another full day awaits us.”

5. Here is Asma and her little brother Ashikur. Our Cox’s Bazar clinic supports Rohingya refugee children like Asma and her baby brother Ashikur with free health services. Our health staff believe that every child deserves healthcare. Asma recently told us:

“My mother always comes to this clinic when Ashikur cries. Magically he stops crying after we visit the clinic.”

6. This is Nasima and her newborn baby. Nasima is a 20-year-old patient at our clinic in Bangladesh. She received health services at our clinic throughout her pregnancy, and now she comes in for postnatal care. Here she is visiting with her 16-day-old baby boy. She said:

“I have visited this clinic during my pregnancy, and doctors here are very supportive. This clinic is very good for babies.”

7. This is Helal, who works in the clinic’s pharmacy. Helal, who is 27-years-old, has been working at the clinic’s pharmacy for the last four years, supporting patients and dispensing medicine. He is passionate about ensuring patient safety:

“I think my role here is really important. I have to explain the doses of medicine properly, otherwise it could be dangerous for patients.”

8. This is Dr. Rahana – a physician serving numerous patients, who is also the Clinic Coordinator. MedGlobal is lucky to have Dr. Rahana oversee the clinic options, as well as serving patients, primarily those who are seeking treatment for non-communicable diseases. She has cared for countless Rohingya refugee patients. Dr. Rahana recently told us:

“Healthcare, like food, water, clothing, shelter, sanitation, and education, is a human right. As a humanitarian healthcare provider, I would like to tell the world: please don’t forget about Rohingya refugees. They need justice. They are in a situation where they have only bad flashbacks.”

Climate Change: Creating and Exacerbating Humanitarian Crises

By Andrew Moran, Policy and Advocacy Intern at MedGlobal

The year 2020 will be remembered as the year COVID-19 swept across the world, crippling health systems and creating economic and political crises. However, the devastating and compounding effects of climate change will undoubtedly define the twenty-first century. One of the predicted effects of a shifting climate will be even higher levels of mass displacement and instability around the world. Refugees, migrants, and other vulnerable populations that lack the resources to withstand climate crises will inevitably suffer the most.

In many regions already facing dire humanitarian crises, heavy rains and longer monsoon seasons are causing historic flooding. The MedGlobal field teams in Bangladesh, Sudan, and Yemen are witnessing this firsthand. In July, one-third of Bangladesh was submerged under water, affecting over 4.7 million people. MedGlobal’s report In the Eye of the Cyclone warns that the 900,000 Rohingya refugees in Cox’s Bazar live in low-lying areas that are prone to flooding and mudslides. This places them at high risk of both displacement and contracting water-borne illnesses. Nationwide flooding in Sudan has created similar dangers. In September, Sudan’s government declared a state of emergency after weeks of deadly flooding physically isolated communities and left half a million people homeless. MedGlobal’s Program Manager for Sudan, Abduelsamad Abdalla Ahmed, reported on the flooding in Khartoum saying:

“The floods in Sudan are the worst they’ve been in thirty years. Not only are the floods displacing and killing people, but we are very worried about an outbreak of diseases. The situation is out of control.”

Widespread flooding in war-torn Yemen, where 80% of the population is in need of humanitarian assistance, has also exacerbated the health crisis. Since 2017, powerful monsoon seasons and massive flooding has contributed to over 2.1 million cases of cholera. Dr. Nahla Arishi, a pediatrician in Aden, noted in MedGlobal’s recent report A Tipping Point for Yemen’s Health System that flooding also hindered the COVID-19 response as many Yemenis misattributed their coronavirus symptoms to flood-related diseases. Like in Bangladesh and Sudan, the people of Yemen have also suffered mass displacement. As of August, over 300,000 people, many of whom were previously displaced and living in extreme poverty, have lost their homes due to flooding. Moving forward, as climate change continues to intensify annual monsoon seasons, once-in-a-century floods may occur every decade and the lives of millions of people may literally be washed away.

A warming planet has also exacerbated food insecurity for millions of people and raised the spectre of entire regions becoming inhospitable. For many crops and livestock, as temperatures rise, the overall production and nutritional quality of the food falls. In 2012, unprecedented droughts among major food exporters caused food prices in several countries in sub-Saharan Africa to double and triple. This has dire consequences for low-income households that often spend up to 75% of their income on food. Furthermore, a report by the World Bank estimates that global crop yields may fall 5% by 2030 which, compounded with the burden of intensified natural disasters and disease outbreaks, will push 100 million people into poverty. Millions more may be forced to abandon their homes as climate change makes them uninhabitable. By the end of the century, heat waves during the summer months may transform parts of the tropics and the Middle East into areas unable to sustain human life. Mass migrations have already begun and over one billion people are expected to be displaced by 2050.

There is no quick, easy, or single solution to avoid the calamitous effects of climate change that we are on course to encounter. It is essential, therefore, to prepare for the mass displacements and humanitarian crises that climate change will create and exacerbate. Many of the countries where MedGlobal works are already grappling with the effects of climate change. While it is critical for the international community to ultimately find the willpower and ingenuity to avert the worst effects of climate change, investing in climate resistant infrastructure, adapting operations, and developing extensive response networks as part of our work is crucial for long-term engagement.

This blog post was written by Andrew Moran, Policy and Advocacy Intern at MedGlobal. Andrew has a BA in Political Science from Yale University.

Rohingya Refugees & COVID-19: Facing the Pandemic in the World’s Most Densely Populated Refugee Camps

As COVID-19 spreads worldwide, it has the most dire impact on vulnerable communities. The camps in Cox’s Bazar, Bangladesh have the highest concentration of refugees in the world, with over 860,000 Rohingya refugees. The living conditions in these camps are grim, with a high population density, poor sanitation facilities and water quality, and lack of medical facilities. Now, we are seeing the beginning of a much-feared COVID-19 outbreak in the Rohingya refugee camps.

MedGlobal details the latest on-the-ground updates and health needs in our new report: Rohingya Refugees & COVID-19: Facing the Pandemic in the World’s Most Densely Populated Refugee Camps.

This report details the latest COVID-19 updates from the Cox’s Bazar camps:

◆ 40 confirmed cases among Rohingya refugees in the camps

◆ 3 deaths from COVID-19 among Rohingya refugees

◆ 1,732 confirmed cases among Cox’s Bazar host community members

◆ 436 tests conducted for Rohingya refugees (only 4.1% of total tests in Cox’s Bazar)

MedGlobal has been working in Cox’s Bazar since 2017, serving more than 112,300 Rohingya refugees and vulnerable members of the Bangladesh host community. Based on our field team’s needs assessments and information from the Health Sector, this report explores key considerations for the COVID-19 response for Rohingya refugees, outlines a table of key needs, and puts forth recommendations. Key local considerations are critical to inform the COVID-19 crisis response, and include Rohingya local knowledge and perceptions, the impact of scaling down other health services, Cox’s Bazar travel limitations, WiFi connectivity restrictions, and monsoon season.

This report identifies several recommendations for how health focused NGOs and international organizations should adapt during the COVID-19 crisis:

Scale up the COVID-19 prevention and response work.
Maintain core health services.
Promote a needs-based reassignment of health workers.
Adapt services to use alternate modalities for care.
Adjust standard clinic operations such as facility mapping for social distance.
Prioritize protection of the most vulnerable.
Expand mental health programming.
Ensure local knowledge and religious beliefs inform the COVID-19 response.
Work to increase community confidence in health services.
Scale up community-based surveillance.

For governments, including donor governments and the Bangladesh host government, this report puts forth the following recommendations:

Allow full access for humanitarians and health workers into the camps.
Improve internet connectivity in the camps.
Improve information sharing processes related to COVID-19 with Rohingya refugees.
Maintain funding for core health services.
Allow flexible funding.
Reiterate that there should be no forced return of refugees.

Rohingya refugees have faced ethnic cleansing, forced displacement, and overcrowded conditions in the world’s largest refugee settlement. Now, they face a COVID-19 outbreak. An immediate and comprehensive response is needed from the international community to stop preventable deaths. These communities must not be forgotten.

Read the entire report here.