Connecting needs and services in Cox’s Bazar, Bangladesh

Cox's Bazar, 25 September 2017

Ridwan Khatun’s family fled Rakhine state, Myanmar six days ago. His father, mother and four older siblings arrived in Kutapalong settlement, near Cox’s Bazar in Bangladesh, tired and weak.

Six-month-old Ridwan was particularly affected. According to his mother Johra, Ridwan can’t stop coughing, has a fever and is suffering shortness of breath. “For three days we moved with no food. He has been shivering nonstop” she says. “He also cannot urinate.”

WHO SEARO/ M Vurens van Es

Thanks to a functioning referral system, he has a fighting chance. On 22 September a mobile medical team operating near Ridwan’s hut referred him to Ukhiya Upazila Health Complex, a secondary facility on the settlement’s fringe. He is now being shifted to the District Hospital to receive comprehensive care, including for suspected malnutrition.

That is according to plan. As Dr N Paranietheran, WHO Representative to Bangladesh says, amid the challenges, referral systems are working. “Mobile medical teams are serving a vital role in meeting the basic needs of an immensely vulnerable population. But as with Ridwan, they are also providing the critical first step in a referral chain that is delivering tertiary and more specialist services to those that require them,” he says. “Though needs are immense, health services delivery is dynamic, as it must be.”

Misbah Uddin Ahmed, Upazila Health and Family Planning Officer of Ukhiya, is the first point of contact for patients referred from settlements. His resolve is steadfast. “Many patients are coming here after being sent by mobile medical teams. We are providing services free of cost for the newly arrived population. It’s a big challenge we face,” he says, explaining how the facility has increased bed capacity in recent days, and plans to expand further.

In support of the Ministry of Health and Family Welfare’s emergency response, WHO has mobilized just over USD one million. WHO requires an additional USD 5.3 million for the next six months to support essential services for the affected people like Ridwan, and to prevent and respond to potential disease outbreaks.

Dr Roderico Ofrin, Regional Emergency Director, says the surging of health workers from other facilities has been of vital assistance. “Doctors, midwives, health assistants and family planning inspectors are providing much-needed services on the ground, both at pre-existing facilities and in mobile medical teams. That must continue and adapt as health needs evolve,” he says. “Responsiveness and flexibility are key to meeting what is an immensely challenging scenario.”

Action will be ongoing. As Nipa Akhtar, Senior Staff Nurse at the Rohingya surgery ward in Cox’s Bazar District Hospital says, the resolve to push-on and provide life-saving services has high-level backing. “The government is fully behind this,” she says. “Referral systems are functioning, both from settlements in Ukhiya and Teknaf.”

WHO is providing immediate and ongoing support. “The health and wellbeing of the people now gathered in Cox’s Bazar is extremely vulnerable,” says Dr Poonam Khetrapal Singh, Regional Director for WHO South-East Asia. “It is essential that people in the settlements can access the services they need, when they need them. We are working with the Ministry to help make this happen, and are mobilizing life-saving resources accordingly.”

Ridwan is expected to make a full recovery. He is being treated for respiratory infection at Cox’s Bazar District Hospital. He is adequately nourished.

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