In an exclusive interview recently with the Dhaka Tribune's Humayun Kabir Bhuiyan, Magali Roudaut, the country chief of MSF in Bangladesh, talks about the different health challenges faced by Rohingya refugees in the country, and how the organization provides services to both the refugees and the host communities
The mental health and physical wellbeing of hundreds of thousands of Rohingyas living in overcrowded refugee settlements in Cox’s Bazar remain a serious cause for concern, Magali Roudaut, the Bangladesh country representative of Médecins Sans Frontières (MSF), has said.
“Mental health continues to be a significant concern. Many of our Rohingya patients experience flashbacks, generalized anxiety, panic attacks, recurring nightmares and insomnia, as well as illnesses such as post traumatic stress disorder and major depression. We are also seeing more chronic mental health problems and psychiatric needs,” she said.
“The result of trauma experienced in Myanmar, a lack of livelihood opportunities, and concerns about their future impacts their mental health wellbeing,” said Roudaut, a French national.
Médecins Sans Frontières, which means Doctors Without Borders in English, is a Geneva-based international independent medical humanitarian organization. They have been providing services in the refugee camps since the latest episode of Rohingya crisis began in August 2017.
“As well as providing mental health services to Rohingya refugees, a significant portion of MSF’s mental health activities serve local communities around the refugee settlements, ensuring that the mental health needs of the local population are also addressed. From late August 2017 till February 2019, we have conducted 23,751 individual mental health consultations and 37,202 group consultations for mental health,” she added.
Asked about the challenges to their physical health, Roudaut said: “Overcrowded living spaces in the camps and bad quality water contribute to the risk of disease outbreaks in the camps. Many of these contagious diseases can be easily prevented through vaccination.”
Currently, children until two years of age are receiving routine vaccinations, but older children have not been systematically vaccinated and remain vulnerable to preventable diseases, like measles or diphtheria, she said, stressing the need for inclusion of all children above two in the routine vaccination program.
“Access to chlorinated water for Rohingyas and local communities is important to prevent water-borne diseases, like diarrhoea, respiratory tract infections, and skin conditions,” said the MSF country chief.
The availability of secondary healthcare services – including long-term treatment for non-communicable diseases and adequate qualitative surgical services – remains a challenge, she said.
“Furthermore, incidences of chronic diseases like diabetes and high blood pressure are common amongst our patients – particularly the elderly. Patients who need urgent medical care for chronic diseases are stabilised at our health facilities and then referred to other medical organizations for longer-term care,” she added.
Responding to a question, Roudaut warned that the lack of safe water in the settlements could lead to the spread of water-borne diseases, adding that adequate provision of water and sanitation facilities, according to international humanitarian standards, is critical in preventing outbreaks of diseases.
“MSF has undertaken the construction of a water distribution network to supply safe, chlorinated water to households in the camp,” she said, stating that MSF would continue addressing the health gaps in Cox’s Bazar.
Detailing her organization’s services for the Rohingyas and host communities, Roudaut said: “Between late August 2017 and February 2019, our teams provided more that 1.2 million outpatient consultations and 20,525 inpatient admissions in the Cox’s Bazar area. Our health facilities currently include three hospitals with inpatient services, four primary health centres, one specialised clinic, two health posts, and one standby outbreak response centre.”
She added that MSF has been working in Bangladesh since 1992, and has been present at Kutupalong in Cox’s Bazar since 2009, long before the most recent influx of Rohingya refugees in August 2017.
“We provide free-of-cost healthcare for both Bangladeshi citizens and the Rohingya population,” she added.
Outside Cox’s Bazar, Roudaut said that MSF has been working in Kamrangirchar—one of the largest slums of the country located in Dhaka district—supporting the vulnerable population, providing medical services for factory workers, sexual and reproductive health care, including consultations on sexual and gender-based violence, plus mental health services.
When asked about the funding of MSF, the Bangladesh country chief said that the Geneva-based organization raises most of its funds from private sources, which helps ensure operational independence and flexibility.
“More than five million individual donors around the world provide more than 90% of our funding. In 2017, 96% of MSF’s income came from private sources. More than 6.3 million individual donors and private foundations worldwide made this possible,” she said.
“Being independent from political, economic, and religious interests means that we are able to directly deliver humanitarian assistance based on our evaluation of medical needs, in coordination with the Ministry of Health and Family Welfare of the Government of Bangladesh,” she added.
Roudaut continued, “MSF is an international independent medical humanitarian organization. MSF is registered under the NGO Affairs Bureau of Bangladesh and works by complying with its rules and regulations. We have been working in Cox’s Bazar, likewise, since 2007, to provide healthcare for both the Bangladeshi and refugee populations.”
“We work closely with relevant authorities—including Refugee Relief Repatriation Commission (RRRC), Deputy Commissioner’s office, Ministry of Health and Family Welfare, and NGO Affairs Bureau—while responding to the medical needs of the population we serve,” she said, adding that MSF was providing training and support for local hospitals and staff in Bangladesh, including Cox’s Bazar, in order to build capacity and improve access to affordable and quality healthcare.
Asked about the expansion of MSF activities, the organization’s country chief said: “We continue to meet the needs of the vulnerable population in the Kamrangirchar project. We will keep on monitoring and assessing medical needs for MSF interventions and are always ready to respond to emergencies as they occur. We will keep our long-term collaboration with the Ministry of Health in Bangladesh to ensure coordinated medical responses.”