This time last year Kathleen Shields, a paedatric nurse from Manchester, was about to board a plane from Manchester airport with charity UK-Med to support the UK Emergency Medical Team response to an outbreak of diphtheria spreading through Rohingya refugee camps in Bangladesh. This formed part of the overall British aid response to the refugee crisis.

 

Over a million Rohingya refugees have fled violence in Myanmar in successive waves of displacement since the early 1990s. The latest exodus began in August 2017, when violence broke out in Myanmar’s Rakhine State, driving more than 723,000 to seek refuge in Bangladesh. The vast majority reaching Bangladesh were women and children, with more than 40% under the age of 12.

 

Kathleen reflects, “I had mixed feelings of excitement and nervousness. I felt very lucky to have the opportunity to be able to deploy with UKEMT and was excited to put some of our training into practice. Thankfully I had met some of the team before on various UKMED training exercises which helped with the nervousness however there were lots of new faces I needed to get to know quickly, we were going to be working as a team soon! I was nervous due to the aniticipation of what to expect at the other end- I have never worked in a refugee camp before and wondered about what sort of conditions our patients would be living in and the conditions we would be working in. I had also never looked after a patient with diphtheria before so everyone was reading up on treatment guidelines etc.

 

My role was working as a paediatric emergency nurse within the UKEMT team. My main tasks involved preparing the treatment centre for patients requiring antitoxin treatment, assisted with assessing patients, administering the diphtheria antitoxin/antibiotics, other medications etc. and closely monitoring the patients throughout. I also engaged with the project on a wider aspect, as did all team members, and as a consequence was involved with data collection in order to monitor the progression of the outbreak, maintaining infection control procedures, initiating contact tracing, maintaining cold chain etc.

 

I thoroughly enjoyed working with the local team. They welcomed us into their department and looked after us incredibly well. We complimented each other; sharing knowledge, skills and training in order to provide high quality care for our patients. It was a great privilege to be a small part of the hard work they do day to day.”

 

Haphazard development of the camps resulted in overcrowded conditions with poor sanitation facilities, factors which contributed to the spreading of the infectious respiratory disease. At the request of the Government of Bangladesh and the World Health Organisation, the UKEMT deployed a clinical team in two waves to support the existing response, with the first wave flying out on 28th December 2017.

 

Hundreds of thousands of refugees remain in the camps, living in harsh conditions. The rate of new cases diphtheria cases has slowed with 4 probable and 12 suspected reported at the start of December 2018.