While the distribution of aquafilters to patients leaving the hospital and identified vulnerable households continue, other activities will be gradually phased out as MSF focuses on the development of water distribution systems. Several systems are already in operation. One of the systems under construction is a solar-powered water networks to bring clean, chlorinated water to 81,000 refugees.
The system will allow for “in-line chlorination” which means that water is treated as soon as it is pumped out of the borehole. The chlorine in the water ensures that the water is safe while it is stored in the large water tanks (between 75,000 and 90,000 liters each). Once the water is collected from taps near people’s shelters, the chlorine keeps the water safe as it is stored in the household.
MSF health facilities and activities in Cox’s Bazar district
MSF operates four hospital-level inpatient facilities in the Cox’s Bazar district: Kutupalong IPD, Balukhali IPD, the Hospital on the Hill (Kutupalong-Balukhali mega-camp), and Goyalmara Mother and Child Hospital between Moynarghona and Unchiprang camps.
Goyalmara Mother and Child Hospital and Kutupalong IPD are located just outside of the camps and serve both camp and host populations. Indeed, 40 per cent of patients at Goyalmara are from the host community.
The four hospital-level facilities offer a range of services including:
- Emergency, outpatient departments and inpatient departments, and isolation beds/wards,
- Sexual and reproductive health services, including maternity, neonatal and pediatric facilities,
- Mental health services,
- Sexual and gender violence services, and
- Laboratory services.
Goyalmara Mother and Child Hospital and Kutupalong IPDs are located just outside of the camps and serve both camp and host populations. 40 percent of patients at Goyalmara are from the host community.
Rubber Garden outbreak response center was, until recently, used as a diphtheria treatment center, as well as treating acute watery diarrhea (AWD). Over the last two months, the number of diphtheria patients has dropped to just two to three per day, making it no longer necessary for a separate diphtheria center. Patients will just be treated in isolation areas of MSF hospitals. AWD patients have also been referred. Rubber Garden will be reactivated in the case of an outbreak.
Primary Health Centers (PHCs)
MSF operates five primary health centers in the camps south of the Kutupalong-Balukhali mega-camp (in Hakimpara, Jamtoli, Moynarghona, Unchiprang, and Nayapara camps).
These PHCs are outpatient facilities that provide primary health care, as well as 24-hour emergency and ambulance referral, mental health, and SGBV services. Each PHC sees 200 to 300 patients a day.
Medical teams at Hakimpara, Jamtoli, and Moynarghona PHCs are revising protocol to focus on constantly improving the quality of care. MSF teams are also working with local communities and health facilities to improve outbreak readiness and infection prevention and control.
Unchiprang PHC was damaged by strong winds earlier in the year but has now been repaired. At Nayapara PHC, construction has begun on a maternity facility. Nayapara PHC will also start a mobile clinic program in October to bring health care closer to where people live.'
Health posts/outpatient departments (OPDs) and mobile clinic
MSF runs eight health posts/OPDs in Kutupalong-Balukhali camp. They provide basic primary health care, including vaccinations, and sexual and reproductive health and mental health services. Some also provide follow-up for non-communicable diseases (NCD) patients. NCDs currently being treated include hypertension, diabetes, chronic obstructive pulmonary disease, asthma, and epilepsy.
The mobile clinic that was providing screening, consultations, and referral at the Sabrang entry point, where many refugees arrived last year, is on standby as very few people are arriving at this point. An MSF social worker continues to monitor the situation and the mobile clinic can be reactivated quickly if needed.
Rubber Garden multi-outbreak response center
Rubber Garden outbreak response center is now an emergency facility that can be activated in case of an outbreak of a communicable disease like cholera or diphtheria. It has a capacity of 100 beds. It is one of the few dedicated facilities that would be available in the case of an outbreak, as finding space to implement isolation and treatment activities in the Kutupalong-Balukhali mega-camp is extremely challenging.
Supporting existing government health facilities
In Cox’s Bazar town, MSF is starting construction at Sadar Hospital, one of the main hospitals in the town. MSF is building a brand new waste management area for the hospital to improve infection prevention and control. The hospital serves both host and Rohingya populations. In addition, MSF is supporting mental health services at Ukhiya Upazila Health Complex in Ukhiya town, near the largest of the refugee camps. In August, MSF also donated and installed an x-ray machine at the Teknaf Upazila Health Complex and provided staff training.
Other projects in Bangladesh
In Kamrangirchar, a slum in the capital, Dhaka, MSF runs an occupational health program for local factory workers. The team also provides medical and psychological support to victims of sexual violence and intimate partner violence, and reproductive health care to adolescent girls, carrying out antenatal consultations and assisting deliveries. In addition, MSF offers family planning sessions and individual mental health consultations.
Doctors Without Borders/Médecins Sans Frontières (MSF) first established projects in Bangladesh in 1985 and has had a continuous presence in the country since 1992. Before August 2017, MSF had one project in Kutupalong in Cox’s Bazar and one in Kamrangirchar, a slum area of the capital, Dhaka. After more than 700,000 Rohingya refugees fled violence in Myanmar in August 2017, MSF launched additional emergency projects.