Bangladesh

Status: Completed response

As part of the UK Emergency Medical Team, UK-Med has supported international efforts to tackle COVID-19 in the Rohingya refugee camps at Cox’s Bazar, on the South Eastern Bangladesh border with Myanmar.

The highly skilled team responded to a call from the Bangladesh Government to work with the International Organisation of Migration (IOM), the World Health Organization (WHO), Save the Children and the UK Mission to the European Union (UKMIS) to set up and manage three COVID-19 treatment centres.

Cox’s Bazar district is home to Kutapalong, the world’s largest refugee camp. People living there are particularly vulnerable to COVID-19 because of the crowded living conditions and shortage of adequate health care facilities.

The UK EMT team brought significant experience and expertise in outbreak management from responding to previous epidemics, including recent outbreaks of Ebola and measles.

How we helped

Our work in Bangladesh has included:

The response

Creating COVID-19 treatment centres

By mid-August 2020 the UK-EMT and IOM had built, staffed and opened three new severe acute respiratory infection (SARI) isolation and treatment centres (ITCs). They also completed an oxygen assessment and procurement process for all IOM facilities within the camp. They then focused on:

• getting outstanding bed, oxygen and waste disposal capacity running smoothly
• improving the quality of care in the treatment centres and setting up a medical records system
• improving  infection prevention and control, risk communication and community engagement (RCCE), and community health worker skills
• strengthening the local capacity for community case management, active surveillance and home based care through health outreach teams
• training medical staff both within the treatment centres and in primary health care centres and health posts to ensure that all healthcare providers could do so safely.

Developing policies and guidelines 

The UK-EMT team has helped develop clinical guidelines and a complete standard operating procedure (SOP) handbook for use in the SARI ITCs, as well as other learning materials.

They have also adapted WHO COVID-19 resources for the local context, including guidelines on IPC, paediatric care and ambulance decontamination. The team then led on ensuring these guidelines and procedures were followed correctly and consistently by staff.

Training health staff

Training needs assessments were conducted at all three SARI ITCs as well as other IOM health settings. Based on these, UK EMT team members developed and delivered training workshops and seminars on topics including IPC, respiratory care, emergency triage for children and treatment of COVID-19 patients.

The UK EMT also worked closely with medical teams during ward rounds and outpatient consultations, providing direct clinical support, supervision and mentoring.

Supporting key health services

UK-EMT members have also supported the running of sexual and reproductive (SRH) health services for Rohingya refugee families. This included:

• participating in the SRH Working Group
• adapting the Cox’s Bazar maternal health strategy to work within the SARI ITCs
• creating safe spaces within the ITCs for maternal care
• training midwives in IPC.

The team also worked on designing an upscaled version of the existing ambulance dispatch and referral unit, working with IOM to expand the number of ambulances and their coverage. This increased the ability to coordinate and manage COVID-19 patients and contacts across all camps.

What’s next

Four UK-Med team members are scheduled to continue working in Bangladesh until 31 December 2020. They are currently focusing on supporting capacity building at the SARI ITCs and in primary health care and handing over activities to colleagues in-country to guarantee a smooth transition and no loss of services.

Read more about our COVID-19 responses around the world.

Carousel photos: 1), 2) and 3) Building work on the three COVID-19 treatment centres. (IOM/Collis/Penrose). 4) ITC coordinator Mel Johnson discusses the operationalisation of the centres with our IOM team. (IOM/Collis/Penrose). 5) Local Bangladesh healthcare staff. (IOM/Collis/Penrose). 6) Team two outside one of the treatment centres. (UK EMT Team 2). 7) Midwife/nurse Sophia Otieno and nurses carry out a simulation exercise. (UK EMT Team 2). 8) UK EMT team member Franklin Umenze leads resuscitation training. (UK EMT Team 2). 9) IPC Advisor Zipporah Onyancha trains staff in donning and doffing PPE. (UK EMT Team 2).

This project was funded for the first seven months by UK Aid through the Foreign, Commonwealth and Development Office (FCDO), and for a further two months by IoM.

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