COVID-19 makes it to the camps - as well as a cyclone!

Quarantine unit at Medair Camp 20-Ext Health Clinic

You may have heard media reports two weeks ago confirming the first positive COVID-19 case in a Rohingya refugee in the camps. Yesterday's update confirmed 30 cases in the camps. These refugees  are in isolation facilities that were set up a few weeks ago.

It is nothing short of a miracle that the first case in the camp surfaced only recently which allowed time for preliminary preparation and a lot of awareness raising around COVID-19 prevention. We continue to pray for miraculous intervention for minimal community transmission and low mortality rates as cases are identified and tracking of contacts happens (this is being done by Rohingya volunteers). There are a number of factors that drive Rohingya to not want to report illness, including a history of disappearances of ill people in Myanmar. As you can imagine, this doesn't help the situation. And NGOs working at protection issues in the camps are really working to alleviate such fears. All such factors point to the devastating potential of the virus in the camps!

International NGOs started scrambling to put isolation units in place as soon as the COVID-19 outbreak started spreading around the world. There are a number of challenges to the implementation of such a plan, not least of which is simply finding space in the overcrowded camps. The capacity of the combined isolation facilities set up in different locations inside the refugee camp is somewhere between 500 and 1000 beds at this point. However, this will continue to grow. 

While a lot of preparation has been done to face the challenge of COVID-19 in the camps, challenges remain. There are NGO staff who are testing positive for the virus (amazingly few cases up to now). This past week was the Eid holiday (the end of the month of Ramadan fasting for Muslims), and there was very little testing going on in Bangladesh as a whole. And coordination can be a problem between different units and different organizations. 

Medair health activities are going like gangbusters. Apart from the normal (and now COVID-19) health services provided in the two health posts run by Medair, the team is assisting the International Office for Migration (IOM - the UN entity financing much of Medair's health work) in the creation of a quarantine center where refugees suspected of having the virus would be brought until their test results are conclusive (then refugees positive for the virus would be moved to the aforementioned isolation units). 

The use of PPE at the Clinic

In addition to providing health services to the quarantine unit Medair is working to provide Isolation Kits for persons under quarantine or in home isolation. Designated health staff will be responsible for providing home-based care visits to those in home isolation in our catchment areas and will receive the isolation kits comprised of a washable cloth mask, a surgical mask, a bar of soap, household detergent (for disinfection), hand sanitizer, sanitary pads, a leaflet on home-based care, a bucket to put everything in and a bag into which the bucket and all supplier are put. 

We have a new Medair colleague who is a specialist in isolation who just entered Bangladesh a little over 2 weeks ago. He spent 14 days in self-isolation in Dhaka before coming overland to Cox's Bazar to join the team this past weekend. Stephen Chua is a Malaysian who gained expertise and experience in isolation techniques while fighting the Ebola virus in the DR Congo. He has been seconded to UNHCR by Medair and is focusing on the isolation units. There is another Medair staff with expertise in palliative care who will likely be seconded to IOM in the near future. She may work remotely for a time. 

We continue to have 4 international staff and around 200 national staff working in Bangladesh. Our national staff are mainly working from home (except for those providing the reduced essential services in the camps). Our international staff face the challenges of unrelenting work load combined with a pretty severe lockdown that limits their ability to get out of their rooms. The stress that both national and international staff feel, and the risk they run of contracting the virus, are constant prayer concerns for us. Comparatively speaking (even though many of our national staff express dismay at the fact that the US accounts for 1/3 of all coronavirus deaths in the world), we feel that we are living the life of a constant vacation compared to our colleagues in Bangladesh. We continue to work remotely with our teams from our home in Minneapolis. 

If the challenge of COVID-19 added to the stress of refugee life wasn't enough, 10 days ago a super cyclone (terminology for a hurricane in Asia) began to form in the Bay of Bengal off the shores of India and Bangladesh. As it approached landfall, it had wind speeds over 125 mph. Thankfully, it diminished in power a bit before hitting land on the 20th. It was still a devastating storm, and 6 persons lost their lives in Bangladesh.  The storm made landfall on the opposite side of Bangladesh from the refugee  camps, however it hit both India and Bangladesh and between the two countries around 4,000,000 people were evacuated from low lying coastlands and islands. The loss of life was minimal but the storm did significant damage. In the camps there were some landslides, and around 40 houses were destroyed. But it could have been worse. We thank God for His providence in again averting a direct hit on the camps. 

We want to thank those of you who gave to Medair in response to our last blog, those who have written to us expressing your concern and prayer support for the Rohingya, and those who have contacted us personally. All of these expressions of your support come straight from the heart of God who has loved the Rohingya since the beginning of time - and who desires a future with hope for them. We cannot thank you enough!

Praise for: 

• the fact that cyclone Amphan was not a direct hit on the camps
• the experience the Bangladeshi government has with cyclones - about 30-40 years ago a similarly devastating cyclone killed 100,000 people!
• the commitment of our international and national staff members in the face of COVID-19
• the situation in the camps being as good as it is! – even if we do now have confirmed cases

Prayer for: 

• COVID-19 preparation in the camps to continue to move forward and coordination to improve
• Stephen's adjustment to Bangladesh and his contribution to improving isolation units
• Christine getting a new passport and both of us getting Bangladeshi visas in order to return
• Opportunities to step back from the stress of work and get much needed breaks for our key international and national staff
• Protection from the virus for NGO staff serving the refugees - this is the front line of the front lines!