In Cox’s Bazar, we provide support through three hospitals, four health centers and two specialized health clinics. In addition, two standalone isolation and treatment centers for severe acute respiratory tract infections (SARI) are ready to be activated if necessary. Inpatient and outpatient services include emergency and intensive care, pediatric care, obstetrics, and sexual and reproductive health care, as well as victims of sexual violence and patients with noncommunicable diseases. We also provide water and sanitation activities for people in the camps.
In 2020, MSF ran 12 facilities in Cox’s Bazar district, offering health care to both Rohingya and host communities. In three of these facilities, we set up dedicated isolation and treatment centers for severe acute respiratory tract infections. In six others, we adapted areas to treat potential COVID-19 patients. Movement restrictions and other measures imposed by the authorities because of the pandemic reduced the presence of humanitarian workers and disrupted access to healthcare for Rohingya and Bangladeshi communities.
The movement restrictions also led to increased challenges for the community, humanitarian organizations, and the authorities. MSF observed a sustained drop of around 50 percent in outpatient consultations and a similar decrease in the number of refugees arriving with acute respiratory tract problems. This indicated that patients with COVID-19-related symptoms were not comfortable seeking care.
The restrictions, the need for staffing of COVID-19 related activities, as well as the protection of staff members from infection, forced us to scale down routine vaccinations and community surveillance. We had to completely suspend other activities, such as regular outreach, community engagement, and hygiene promotion, as only Rohingya volunteers were allowed to raise awareness of health issues inside the camps. We supported public efforts to reduce transmission risks and our teams distributed nearly 300,000 face masks in Ukhiya.
In March 2021, a massive fire broke out in Cox's Bazar. According to initial estimates from the United Nations, 15 people have lost their lives in the blaze, 560 people have been injured, and some 45,000 people have been displaced. MSF’s Balukhali clinic was completely destroyed by the flames. Fortunately, all patients and staff were evacuated from the clinic before the fire intensified.
This was not the first time fire has struck Kutupalong camp, devastating the lives of many Rohingya families. Their shelters are built with temporary and flimsy materials, which make it easy for fire to spread rapidly across this "mega camp" made up of 26 smaller camps. Conditions there are deteriorating, with people suffering from reduced access to health care, increased violence, and inadequate living conditions.
MSF runs two urban clinics in Kamrangirchar district in the capital, Dhaka, where we provide reproductive health care as well as medical and psychological treatment for sexual and gender-based violence. We also provide occupational health services, which include treatment for workers diagnosed with occupational diseases, as well as preventive care and risk assessment in factories.
Our medical assistance is tailored to the needs of people working in extremely hazardous conditions. In 2020, our teams conducted almost 5,000 consultations for factory workers. Additionally, our mobile clinics brought health care–including tetanus vaccinations─to tannery workers in Savar subdistrict.