Nearly two years after they began crossing into Bangladesh after fleeing horrific violence and persecution in Myanmar, more than 700,000 Rohingya people are still trapped in precarious living conditions in refugee camps near the border. Denied access to health care for years in Myanmar, many of them still have trouble reaching the services they need. The influx of refugees has also strained Bangladeshi health services. In Ukhia, Bangladesh, Doctors Without Borders/Médecins Sans Frontières (MSF) runs the Goyalmara Green Roof hospital, where a team provides specialized care to mothers and children, Rohingya and Bangladeshi alike.
Inside the neonatal intensive care unit, a newborn baby is struggling to breathe. MSF nurse supervisor Gaziur Rahman and his colleagues get to work. The baby’s young Rohingya parents haven’t even had a chance to name the infant girl. Rahman is helped by a team of nurses who take turns carrying out bag-valve mask ventilation, a method of squeezing a bag to help a baby breathe in oxygen. A digital pulse oximeter displays her heart rate and blood oxygen levels; the reading of 60 to 70 percent oxygen level does not augur well.
Ten minutes pass. Rahman looks determined but does not want to give the baby’s parents false hope. He speaks softly: “The prognosis does not look good.”
Twenty-five miles away in the town of Cox’s Bazar, MSF medical coordinator Jessica Patti is facing another challenge. It’s not enough to open a hospital and wait for the patients to arrive—before they can come they have to know it’s there. MSF staff have been increasing their efforts to raise awareness about the Goyalmara hospital amongst other humanitarian organizations providing aid in the region.
“The first 28 days for newborns are critical—they need both preventive and curative medical care,” says Patti. “Unfortunately, lack of health care facilities for both refugees and Bangladeshi citizens can mean newborns are extremely susceptible to death in their first month. We opened Goyalmara hospital to focus on neonatal and pediatric care, and we want unwell newborns to be referred here from other hospitals in order to receive specialized care.”
Referrals are critical to saving lives. Take eclampsia, a condition in which a pregnant mother suffering from high blood pressure gets convulsions which can prove deadly to both mother and child. Rohingya women prefer to give birth in the private spaces of their house, with assistance from trusted traditional birth attendants. But when urgent complications occur, such as eclampsia, the time it takes to travel from the refugee settlements to a basic health outpost and then on to a dedicated maternity hospital can mean the difference between life and death. If patients are transferred directly to Goyalmara from other health facilities, says Patti, more lives can be saved.