icddr,b shares its pre-emptive Rohingya emergency healthcare response insights with partners in Cox’s Bazar

Cox’s Bazar, Bangladesh, 21 March 2019 - Today, icddr,b has organised a dissemination seminar at Long Beach Hotel in Cox’s Bazar to share its emergency healthcare response and pre-emptive oral cholera vaccination measures among the Forcibly Displaced Myanmar Nationals (FDMNs). icddr,b was very quick to respond immediately during the  Rohingya exodus that began in late August of 2017. icddr,b and UNICEF jointly conducted a field assessment in Cox’s Bazar in September 2017, and identified the potential risks of a diarrhoeal disease outbreak and  related mitigation initiatives required. Accordingly, icddr,b partnered with UNICEF to strengthen healthcare services for diarrhoeal disease and malnutrition in the Rohingya community. As described in the seminar, ‘they came with nothing, they had nothing and needed infrastructure, sanitation, shelter, food, non-food items and health care. UNICEF supported the study to evaluate the effectiveness of oral cholera vaccine administered among FDMNs. The resulting work, which prevented a cholera outbreak has been described as ‘the most successful pre-emptive campaign.’

Dr Tahmeed Ahmed, Senior Director, Nutrition and Clinical Services (NCSD) at icddr,b  briefed about the icddr,b-UNICEF partnership to strengthen acute watery diarrhoea treatment and preparedness initiatives, which include - i) training of doctors, nurses, para-medics and community health workers of the Government and NGOs working in the area, ii) Management of diarrhoeal disease and associated malnutrition through five diarrhoeal treatment centres (DTC) in Leda, Shyamlapur, Balukhali, Teknaf, and Ukhia of Cox’s Bazar, and iii) DTC based diarrheal diseases surveillance.

In the seminar, Dr Azharul Islam Khan, Head of Hospitals at icddr,b highlighted the implementation process and experiences in community engagement and the vital role connecting with all elements of the community plays in successful dissemination and implementation. He also explained the importance of oral rehydration solution (ORS) in treatment of diarrhoeal disease and warned about the misuse of unnecessary antibiotics. Dr Azhar said that he will continue to criticise the unnecessary use of antibiotics in the treatment of diarrhoea which leads to anti-biotic resistance.

Dr ASG Faruque, Senior Scientist, NCSD at icddr,b presented on the DTC based diarrhoeal disease surveillance activities, which included the recognition that Cox Bazar was a cholera hotspot and sanitation facilities in the camp created an environment ripe for cholera outbreaks. He reported that a total of 820 health care professionals have been trained by icddr,b on management of diarrhoeal disease, and the diarrhoeal treatment centres have provided care to 6,156 patients comprised Rohingya and host communities. 781 stool specimens were also tested for cholera and found to be negative. This icddr,b-UNICEF collaboration will continue through 2019 with limited scope, however one DTC will remain operational while others will be closed temporarily, only to be opened if there is a surge of patients.

From the Rakhine province of Myanmar, 706,364 people were forcibly displaced and take refuge in Ukhiya and Teknaf Upazila of Cox’s Bazar since the exodus started in late 2017. Initially, there was huge shortage of basic water, sanitation and hygiene components and they Rohingyas were in threats of various enteric infections including cholera. The Government of Bangladesh with technical support from icddr,b and other partner organisations undertook a massive oral cholera vaccination campaign in Teknaf and Ukhiya Upazilla. During October 2017 to December 2018, there were 4 rounds vaccination campaign took places administering 2.2 million doses of oral cholera vaccine among Rohingyas and host community. Led by Dr Firdausi Qadri, Senior Scientist at icddr,b and coordinated by Dr Ashraful Islam Khan, Scientist at icddr,b, 150 staffs were involved in the vaccination campaign undertaking various activities from formulating strategies, providing trainings of government and other partners on implementation of the campaign and administering vaccines.

Dr Ashraful Islam Khan told the audience that the pre-emptive vaccination campaign has prevented an epidemic of cholera in Cox’s Bazar, which was highly anticipated by the global public health community. Historically, cholera outbreaks are common phenomena in humanitarian crisis and have caused thousands of deaths.

Dr Mohammed Abdul Matin, Civil Surgeon, Cox’s Bazar; Brig. General (Retd.) Dr Balwinder Sing, Health Sector Coordinator; Prof. Dr Be-Nazir Ahmed, National Consultant at UNICEF also spoke on the occasion. Representatives from the World Health Organisation, UNICEF and other stakeholders attended the seminar.