Around a million Rohingya in the refugee camps in Cox's Bazar, along with aid workers, are likely to be among the worst sufferers if coronavirus spreads in the region, feared experts.
Lack of medical facilities, extremely unhygienic living conditions, and population density of the camps can cause havoc in case of a virus outbreak, they said.
Catalin Bercaru, spokesperson for the World Health Organisation (WHO) in Bangladesh, said refugees across the globe, including in Bangladesh, live in overcrowded camps or settlements that pose a greater risk of infection from communicable diseases like Covid-19.
Tariq Adnan, communication officer of Médecins Sans Frontières (MSF) in Bangladesh, said the Rohingyas already live in unsanitary conditions and their access to healthcare is severely compromised. Therefore, it is more difficult to implement preventive measures there.
Noting that there was no reported case of Covid-19 infection in the camps, the international organisations – the United Nations High Commissioner for Refugees (UNHCR), WHO, and MSF -- emphasised on equipping local hospitals with adequate resources and expanding test facilities to tackle the potential outbreak.
Mostafa Mohammad Sazzad Hossain, assistant communication officer of UNHCR, said any coronavirus suspect at the Rohingya camps would be kept in temporary isolated areas until referred to pre-identified isolation units.
At present, only the Institute of Epidemiology, Disease Control and Research (IEDCR) in Dhaka has the capacity to identify Covid-19 infection. No other healthcare facility in the country is equipped to diagnose Covid-19.
PREPARATION SO FAR
Mahbub Alam Talukder, refugee, relief and repatriation commissioner in Cox's Bazar, said they were raising awareness in the camps and monitoring the situation.
"We have banned new foreigners from entering the camps and are discouraging aid workers from entering the camps unless it is extremely necessary," he said.
Besides, Rohingya community leaders are going door to door and advising everyone to maintain cleanliness and basic hygiene in the camps.
Razia Sultana, a Rohingya lawyer, educator and human rights activist, said they were engaging women to educate families about maintaining basic hygiene.
"Rohingya women mostly stay at home and look after their families. They are now educating their family members to wash their hands at least three to four times a day," she said.
Yassin Abdumonab, inhabitant of Kutupalong camp and a teacher by profession, said announcements were made describing the symptoms of coronavirus infection and preventive measures.
Meanwhile, Cox's Bazar Sadar Hospital set up a five-bed isolation ward if anyone is found to be Covid-19 infected.
Two 50-bed isolation wards were also established in Ramu and Chakaria upazila health complexes.
However, none of these wards have "negative air pressure", a technique to allow airflow inside the wards.
WHAT NEEDS TO BE DONE ACCORDING TO GLOBAL GUIDELINES?
There is a need to routinely and randomly test people from different communities to get the real picture, experts say.
Prof Muzaherul Huq, former regional advisor of WHO's South East Asia region, said, "What happened in China, South Korea, and other countries is an indication that there are 10-15 times more patients than reported.
"The government should take more drastic measures. We need strict monitoring to ensure proper quarantine. There should be arrangements to treat people at facilities and Intensive Care Units should be prepared."
SHORTAGE OF MEDICAL SUPPLIES MAY OCCUR
According to MSF spokesperson Tariq, aid workers are also apprehensive about a future shortage of medical supplies.
There is global pressure on the production of some medical supplies, particularly on specialised personal protective equipment for healthcare workers, he said.
"Our projects are still able to continue medical activities, but ascertaining future supplies of certain key items -- such as surgical masks, swabs, and gloves -- is of concern. There is also a risk of supply shortages due to lack of production of generic drugs and difficulties in importing essential drugs (such as antibiotics and antiretroviral drugs) due to lockdowns, reduced production of basic products, exportation stops or repurposing or stocking of drugs and material for Covid-19."
Amidst a global shortage of supplies for Covid-19 preparedness and response, WHO says that they have been accelerating their preparations to tackle a potential outbreak.
"However, requirements were pre-empting, supplies have been already prepositioned and more already have been ordered. Coordination amongst partners is underway on having supplies stocked to be made available as and when required," said WHO's Bangladesh spokesperson Catalin.
International organisations are also providing training to their staff members and community medical workers stationed in Cox's Bazar. Community health workers, medical professionals, and aid workers are being trained on Infection Prevention and Control in accordance with WHO guidelines.
"Preparedness measures have been put in place and a National Response Plan has been completed by the government," said UNHCR's Mostafa.
"Furthermore, humanitarian agencies are finalising a multi-sector response plan and a specific health sector response plan in Cox's Bazar, in support with the government."