Health and Education for All (HAEFA) is committed to providing medical care to vulnerable and at risk populations in Bangladesh. Our first initiative, Health on Wheels, focuses on bringing primary care to disadvantaged women, children, and workers in the garment industry. By making small improvements in dietary practices, –by providing iron supplements and furnishing menstrual hygiene education - Health on Wheels is making sustainable improvements in the lives of garment workers. HAEFA is also one of the leading organizations focusing its attention on the crisis of the Rohingya, the victims of ethnic cleansing in Myanmar. The Rohingya have faced unspeakable atrocities at the hands of the government of Myanmar and need medical attention to address the effects of these attacks, of displacement, and of living for decades as a persecuted minority without access to healthcare. HAEFA has set up two health centers in Cox’s Bazar, Bangladesh, in Kutupalong and in Balukhali, to treat the Rohingya patients in the refugee camps. Using its original, paperless EMR system called NIROG (from the Bangla word for “absence of disease” or “good health”), HAEFA is able to track patient records without electricity or internet.
HAEFA has a strong foundation for its work in the Rohingya camps and in the garment industry, and a model for delivering healthcare that is proven to work efficiently and well. With a small team of medical doctors and the help of many donors, HAEFA has made real contributions to the health of the displaced Rohingya people and garment workers. However, there are still ongoing projects and goals that HAEFA plans to achieve. In addition to its ongoing healthcare work, HAEFA has plans to expand the use of NIROG to other health providers in the Rohingya camps, to develop an antibiotic resistance protocol, to create an insulin service at its health centers, and to conduct cervical cancer screenings of Rohingya women. As HAEFA refines its system and expands its objectives and capacity, another goal has become to broaden the use of the NIROG system across health centers in Bangladesh. Conversations are in the works for HAEFA’s methods to be implemented on a larger scale in Bangladesh.
–Cervical cancer screening–
HAEFA is planning to conduct cervical cancer screenings in three sub-districts in Bangladesh in collaboration with Brown University. Beginning in July of 2019, HAEFA aims to screen 60,000 women in the Kurigram district over the next two years, and 7,000 women will be screened in the Rohingya camps within one year. Cervical cancer screenings are crucial in the Rohingya population, due to the massive number of sexual assaults that occurred during the attacks against the Rohingya in August of 2017 putting women at higher risk for cervical cancer.
–Insulin for diabetic patients–
Many Rohingya patients have tested positive for diabetes and are receiving oral antidiabetic therapy (Metformin) from HAEFA. However, a significant number of diabetic patients do not respond to Metformin and require insulin. HAEFA plans to create an insulin service at its locations in the camps to make treatment for diabetes more efficient and accessible to the population. This is now a possibility because HAEFA recently obtained electricity at its centers and is planning to purchase two refrigerators to store insulin.
–Prevention of antibiotic resistance–
As the Rohingya are a floating population, there is no consistent supervision for antibiotic treatments. Resistance to antibiotics is a real risk in the refugee camps and can lead to more disease including multidrug-resistant (MDR) TB. HAEFA plans to combat this problem by creating an antibiotic resistance program, developed by Dr. Anais Ovalle. This protocol, which comes after the hypertension and diabetes protocol developed by HAEFA already in use by IOM, will be presented to IOM, WHO, UNHCR, and the Government of Bangladesh’s Ministry of Health once completed.
–Sharing of patient data among treatment providers in the camps–
The data and medical records of the patients treated by various health centers in the camps are currently not linked in any way between health providers. Having a system that shares the data of different treatment providers electronically would improve organization and patient care in the camps. HAEFA’s paperless EMR system, NIROG, is an ideal tool for this. HAEFA is in discussion with the Coordination Cell, IOM, and other organizations about bringing NIROG and training on how to use it to their health centers.