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MSF in Bangladesh, 2004
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MSF's work in Bangladesh takes place in three districts that make up the Chittagong Hill Tracts region, an isolated area near the country's borders with Myanmar (Burma) and India, in which the need for medical aid is tremendous.
Government policies and insurgent groups have inflicted discrimination, deprivation and marginalization on the region's indigenous people, resulting in decades of conflict and massive displacement. Moreover, public health care services are scarce, and few other NGOs are present. Since 1999, MSF has a wide network of clinics, malaria-treatment sites and healtheducation outreach posts in the northern part of Khagrachari district. Recently, the organization extended its activities to the neighboring Rangamati district. The Chittagong Hill Tracts, unlike other parts of Bangladesh, are hard hit by malaria, which produces high rates of illness and death.
MSF treats people with malaria using highly effective artemisinin-based combination therapy (ACT). The organization is conducting research on the effectiveness of various treatment regimes, and its studies have shown that resistance to chloroquine, the government's current first-line treatment for falciparum malaria, is as high as 40 percent. As a result, MSF is actively advocating for a change in the treatment protocol and the introduction of ACT as the first-line treatment in Bangladesh.
Beside running two standing clinics in Khagrachari, the MSF team uses three mobile clinics to bring health care to remote villages. Many of these areas are so difficult to access that MSF staff must reach them by foot or by boat. Rapid diagnostic tests for malaria and subsequent treatment are also offered in a number of "malaria field sites" and health-education outreach teams visit villages that are near the clinics. The outreach workers promote the clinics and use games and drama to increase awareness of health topics such as malaria prevention, prenatal care and basic hygiene. In December 2003, MSF started a second project in the Bandarban district that also employs a mobile clinic, several malaria field sites and health-education activities in remote villages.
By June 2004, with the malaria season approaching its peak, more than 8,600 medical consultations had been conducted in MSF's health facilities.
MSF has worked in Bangladesh since 1985.