Over 13,000 people have been registered by the United Nations refugee agency, UNHCR, as new arrivals so far in 2018.
Cyclone season will begin in October. Most buildings in the camps, including medical facilities, are extremely vulnerable to cyclone damage. And cyclones also bring heavy rains that could cause further flooding and landslides.
There are concerns about whether there are enough inpatient beds to meet the needs of the Rohingya and Bangladeshi population in the area, and referrals may become more difficult if movement restrictions on Rohingya patients increase.
NUMBER OF HEALTH FACILITIES: 4 inpatient health facilities (hospitals), 5 primary health centres, 8 health posts and 1 outbreak response centre (details below).
NUMBER OF STAFF: More than 2,000 MSF staff and over 1,000 volunteers continue to respond to the health and water and sanitation needs of the Rohingya refugees and host communities.
NUMBER OF PATIENTS: Between August 2017 and the end of September 2018, our teams have carried out 843,800 outpatient consultations and 15,434 admissions.
MAIN MORBIDITIES: Respiratory infections, diarrheal diseases and skin diseases.
WATER AND SANITATION: Activities include drilling boreholes, setting up water distribution systems, desludging old latrines, bucket chlorination and distributing domestic water filters.
OUTREACH: Outreach teams focus on health promotion in both refugee and host communities, investigating possible outbreaks, conducting vaccination campaigns and maintaining links with community and other organisations.
SEXUAL AND GENDER-BASED VIOLENCE (SGBV)
Progress has been made in putting in place sexual and gender-based violence (SGBV) prevention, mitigation and response mechanisms, but coverage and service delivery remains patchy.
MSF teams continue to provide support and treatment to victims of sexual violence at our health facilities. Since August 2017, MSF has treated more than 600 patients, who have reported experiencing sexual violence both in Myanmar and in the camps.
MSF’s services include psychosocial care, treatment for sexually-transmitted infections (STIs) and menstrual regulation (Bangladeshi medical term for termination of unplanned pregnancies). Post-exposure prophylaxis is also provided where possible.
Water and Sanitation
Given the scale of the water and sanitation needs, MSF’s water and sanitation response has shifted to focus on larger projects to distribute clean, treated water, and the management of waste from latrines. Maintenance of existing facilities, chlorination points and distribution of aquafilters also continues.
While the distribution of aquafilters to patients leaving the hospital and identified vulnerable households continue, other activities will gradually be phased out as MSF focuses on the development of water distribution systems. Several systems are already in operation.
One of the systems under construction is a solar-powered water network to bring clean, chlorinated water to 81,000 refugees. This system will allow for “in-line chlorination”, meaning the water is treated as soon as it is pumped out of the borehole. The chlorine in the water ensures that the water is safe while it is stored in the large water-tanks (between 75,000 and 90,000 litres each). Once the water is collected from taps near people’s shelters, the chlorine will also keep the water safe as it is stored in the household.