Working 'on the ground' to tackle diphtheria in RohingyaLondon School of Hygiene & Tropical Medicine https://lshtm.ac.uk/themes/custom/lshtm/images/lshtm-logo-black.png Monday 22 January 2018
The cramped Rohingya refugee camps in Bangladesh are the perfect environment for the transmission of respiratory infections such as diphtheria. It’s no surprise that the disease, which can cause airway obstruction, damage the heart and sometimes cause death, has been sweeping through these camps for a few months now.
Many non governmental organisations have responded to this crisis. I first arrived there on the 31st December 2017 as part of the UK Emergency Medical Team, a collaborative partnership led by the Department for International Development, to provide the official UK response to sudden onset medical humanitarian disasters and outbreaks.
The journey to the camp is a challenging one as our local driver navigates through the narrow streets and crazy traffic of Cox’s Bazar. We leave the town and head south to the refugee camps. Cox’s Bazar has one of the longest beaches in the world and the first part of the journey takes us along a most beautiful coastal road.
As we make our way inland the landscape changes to bustling villages and refugee camps. The crisis has led to more than 650,000 refugees fleeing Myanmar and crossing the border into south-east Bangladesh. Nearing our destination we pass the field hospitals, community clinics, Primary Health Care Centres and Diphtheria Treatment Centres (DTC) that have sprung up to support the health care needs of this vulnerable population. These refugees are particularly at risk because they are not vaccinated against this disease, they live in crowded conditions and have limited access to health care.
When our team, consisting of doctors, nurses and paramedics, first arrives in the DTC, the doctor in charge is keen to show us how well the centre runs. This centre has only been open for about a week and is already seeing quite a few orange patients - people who are probable diphtheria cases that could be treated by oral antibiotics. They have had to transfer several sicker cases to a neigbouring DTC which has the capability to treat these patients with diphtheria anti toxin. Our task on this mission is to augment the capability of the local staff so that the centre can start giving this life saving treatment. My role is to lead and coordinate the Leda Diphtheria Treatment Centre which is situated in Leda makeshift refugee camp.
The doctor in charge takes us to a small viewing platform of the surrounding camp. I am surprised that I can not see the borders of the camp. It is massive – a sea of makeshift tents covering the nearby hills.
As I walk around the DTC, I hear high-spirited children shouting “how are you?: and “what’s your name?”. They are all smiling and curious as to what we are doing here. At a distance I can hear children reading and am told that these children are at a small safe place which UNICEF has created for children to play and learn.
There is a constant odour of sewage and rubbish within the camps and occasionally cooking smells from little make shift shops selling food.
Being here has given me just a glimpse of what everyday life is like for these refugees, who have fled violence in Myanmar and arrived to find these desperate conditions. By improving the care for patients with diphtheria over the next few weeks, our aim is to improve the lives of these people who have suffered so much.
The UK Emergency Medical Team is a collaborative partnership led by the Department for International Development working together with the UK Fire Service, UK-Med and Handicapped International. Funded by the UK government and accredited by the World Health Organisation, it provides the official UK response to sudden onset medical humanitarian disasters and outbreaks.
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