August 2017 marked the start of more than 700,000 Rohingya refugees fleeing violence in Myanmar for safety in Bangladesh, joining those who had fled the country previously. Today, nearly one million Rohingya refugees live in camps and makeshift settlements across Cox’s Bazar.
Between August 2017 and December 2018, teams of Médecins Sans Frontières / Doctors Without Borders (MSF) have provided one million medical consultations to refugees and the local community. MSF medical coordinator Jessica Patti describes what our teams found and where we plan to focus our efforts next.Almost 9 percent (92,766) of our 1.05 million consultations were for acute watery diarrhea, most of them children under five, who are particularly vulnerable to the condition, and who can die if it goes untreated. While severe cases need to be admitted to hospital, most people can go home after being properly rehydrated.
Diarrhoea is related to the poor and overcrowded living conditions in the camps. Often refugees live in small shelters built from bamboo and plastic sheeting and shared with many family members. Clean drinking water and well-maintained latrines are key factors in preventing diarrhoea, and health promotion activities focusing on improving hygiene are crucial.
Poor living conditions are also behind all the other main diseases we treat. These are upper and lower respiratory tract infections; skin diseases; and fevers of unknown origin, which can be hard to diagnose when laboratory services are not widely available.People need more space in the camps. This would mitigate the spread of some viral infections. The simple practice of washing one’s hands with soap and water would help to prevent many of the skin conditions we treat, such as fungus and scabies. But when you live in a refugee settlement, where clean water is scarce, washing one’s hands isn’t so simple. That’s why water and sanitation activities have been such an important part of MSF’s work. So far, our teams have distributed 87.8 million litres of clean water in the camps.
At the start of our emergency response, we treated some people for violence-related injuries suffered in Myanmar, and basic healthcare was much needed. Today, the patients we treat for violence are more often injured in incidents happening in the community or family, and events of sexual gender based violence. The major needs are for secondary healthcare, including non-communicable diseases. As at the beginning of the emergency, though now for different reasons, sexual violence remains an important focus. A number of women arrive at our facilities with sexually transmitted infections that have gone untreated for a long time.
MSF’s continued presence in the Cox’s Bazar is also leading to an increase in consultations for members of the local Bangladeshi community, particularly in those health facilities that are not located in the middle of the camps.