Movement restrictions come at a cost
While some restrictions to minimize movement are necessary to limit the spread of COVID-19, they are affecting access to the health system in Cox’s Bazar. Travel restrictions mean it is much harder for patients with “invisible” illnesses to prove they are sick and travel to facilities. Patients living with psychiatric disorders, HIV, or noncommunicable diseases such as diabetes need regular medication. They might appear healthy but face serious risks if their medical treatment is interrupted.
Finding transport to access health facilities is a massive challenge. One of our patients recently arrived at an MSF hospital in tears. She was afraid she would be turned away; it had taken her five days to arrange transport, and had to travel on multiple tuk-tuks [auto rickshaw taxis] for around five hours just to get to our hospital.
These restrictions affect our staff, too. Over the last couple of weeks, MSF has set up a fleet of buses across Cox’s Bazar, shuttling hundreds of staff who live further away from their homes to MSF’s hospitals and clinics—a huge and time-consuming daily logistical exercise. And while Bangladeshi nationals form the majority of our staff, restrictions on travel into Bangladesh mean that one-third of our international emergency staff are currently stuck outside the country.
Keeping health workers safe
Health care staff are at a higher risk of contracting COVID-19, and must feel safe and protected to do their job. Across the world, we have witnessed inspiring displays of solidarity with frontline workers, but we also see fear driving stigmatizing and cruel behavior. Some of our staff have received verbal abuse or threats by communities fearful of COVID-19 and others are facing eviction by landlords unwilling to house frontline staff.
Ultimately, our ability to respond to COVID-19 is limited by the availability of essential personal protective equipment (or PPE, such as masks, gowns, goggles, and gloves), as well as medical supplies including oxygen. We have strict minimum standards for PPE to ensure our staff are protected. However, global shortages of personal protective equipment are a serious concern, including in Bangladesh.