In July, days of torrential rain triggered 320 landslides in the Bangladeshi camps that house almost 900 000 Rohingya refugees. The mudslides killed 19 people and damaged or destroyed over 3000 of the shelters in which the refugees live.1 For community health workers in these camps, such treacherous conditions are only too familiar.

In April, a report prepared for the United Nations by BRAC University in Dhaka quoted the supervisor of a transport service set up to help pregnant Rohingya women and new mothers access healthcare,2 “When we go to rescue a mother, it is a dangerous situation to bring her on a stretcher because someone’s foot can slip. Sometimes, the wheels of (the) ambulance get stuck into the mud. It happens every day.”

The Muslim Rohingya have been coming to the area of southern Bangladesh called Cox’s Bazar since 1978,3 fleeing persecution in neighbouring Myanmar, which has a Buddhist majority. In 2017, more than 700 000 arrived, and today the area houses 34 camps carved out of hilly terrain on the south east coast. However, the Rohingya are not recognised as refugees by the government of Bangladesh.

Within the refugee camps, 90 health posts, 41 primary healthcare centres, 23 specialised facilities, and three field hospitals are operating.4 Most are run by local or international non-governmental organisations that partner with specialised UN agencies. Over the past few decades, providing adequate healthcare to the Rohingya has been a major undertaking, not least since the onset of the pandemic.5

Delivering care
One of the biggest health challenges has been maternal health—traditional practices restrict women from leaving their homes, transport services in the camps are inconsistent, “roads” are often little more than paths, long distances can discourage walking on uneven terrain, and earthen tracks can quickly turn to mud when it rains.

Malabika Sarker, of the James P Grant School of Public Health at BRAC University, says transport is “one of the ‘most neglected’ issues. Something as simple as the availability of transportation can make such a contribution to the timely delivery of care,” she told The BMJ.

Read more- https://www.bmj.com/content/375/bmj.n2722