Alex Jin
HAEFA - May Newsletter 2023
HAEFA - May Newsletter 2023

Student-Led Teach-In Session at George Washington University Medical School

On May 7th, 2024, HAEFA’s George Washington Medical School chapter hosted its inaugural meeting. The meeting was presented under a teach-in format with multiple speakers composed entirely of student leadership from the organization. The teach-in topics were the HAEFA’s humanitarian and clinical services using the electronic medical record (EMR) system for the rural and underserved populations in Kurigram, Noakhali, and Cox’s Bazar districts of Bangladesh. A major focus of the topics was also on the Rohingya FDMN/refugee crisis and HAEFA’s intervention within the camps.

The six student presenters were as follows: Ishan Abdullah, Meagan Mitchell, Abdulla Ali, William Huang, Hannaka Spillman,& Omar Saadi. Highlighted during the meeting were HAEFA’s innovative see-and-treat approach for cervical cancer, community-based tuberculosis screening and treatment workflow, COVID-19 management, natural disaster aid, and the implementation of NIROG in remote and underserved areas of Bangladesh. After discussing HAEFA’s role, the goals of the student organization were reviewed, and upcoming opportunities for new members were revealed.

The talk was concluded with a reminder about how the plight of globally disadvantaged populations vastly extends past their media exposure and the duty of students today in educating themselves and others to ensure these people are continuously given the support they need, The student organization has two fundraisers planned for the upcoming months and hopes to host another dedicated teach-in session focused on HAEFA’s disaster response within refugee camps. 



HAEFA's Fight Against Tuberculosis

Tuberculosis (TB), caused by the bacterium Mycobacterium tuberculosis, is a highly contagious disease that most often affects the lungs. It’s spread through the air when people with lung TB cough, sneeze, or spit, and it only takes a few germs to become infected. Despite being preventable and curable, 1.5 million people die from TB each year – making it the world’s top infectious killer (WHO, 2023). Bangladesh is among the 30 countries with the highest burden of TB in the world, making it a major public health concern that disproportionately impacts marginalized and vulnerable communities. 

Estimated TB incidence in 2021, for countries with at least 100 000 incident cases (WHO)

The eight countries with the highest number of cases and that accounted for 2/3 of global cases in 2021, are labelled.

TB in the Rohingya Refugee Camps

TB poses an even greater risk for the Rohingya refugees due to their living conditions and minimal access to adequate sanitation, water, nutrition, and healthcare. Furthermore, “the prevalence of TB is higher in the camps as they are densely populated and overcrowded,” says Dr. Shajjad Hossain, TB Coordinator.

Camp 9

To address this, HAEFA and Partners in Health and Development (PHD) as UNFPA Implementing Partners have established a Tuberculosis screening program. The project began in Oct. 2023, under HGSP (Health and Gender Support), with the goal to increase early diagnosis and provide appropriate treatment for vulnerable populations in Cox’s Bazar. 

Project Overview

The project is implemented by three Special Community Facilitator Supervisors and 15 Special Community Facilitators (SCF) alongside 182 Community Health Workers (CHW) from PHD. The CHWs go door-to-door, screening every member of the community using an online screening questionnaire. TB symptoms are recorded, such as a persistent cough, night sweats, and fever. If the patient is flagged by the system as a presumptive case, the SCFs will collect a cough sample to confirm the diagnosis. 

Refresher training for CHW

A Special Community Facilitator (SCF) counsels a family on TB screening

Screening is optimized through an online data entry system

Currently, testing is only available at the Bangladesh Rural Advancement Committee (BRAC) and WHO facilities, but HAEFA is currently working to establish a TB diagnosis corner at Camp 9, using the laboratory's new LED Fluorescence Microscope. Upon confirmation of positive TB, BRAC provides a 6-month course of treatment. HAEFA is responsible for ensuring the patients’ health and treatment compliance, completing three patient follow-ups at 2, 3, and 6 months. 

LED fluorescence microscope at Camp 9 

Project Targets

HAEFA aims to screen 70,000 individuals by June 2024, split equally between the host community and the FDMN population. As of March 15th, 51,944 Bangladeshi and 25,723 FDMN have been screened, identifying 184 and 80 presumptive cases respectively. 

While HAEFA is well on its way to achieving the target, the program still faces challenges due to cultural misconceptions. During Ramadan, many individuals refuse to provide a cough sample, thinking that it will break their fast. To address this, community engagement initiatives have been implemented; HAEFA staff have made multiple visits to Mosques within the FDMN camps to increase TB screening awareness and transmit accurate information. 

“We visit the mosques to raise awareness among the Rohingya community about tuberculosis screening and sputum testing. With Camp Majhi's assistance, we were able to initially persuade the Imam, which made it simpler to inform the community about the significance of tuberculosis screening and to reassure them that sputum collection does not conflict with Ramadan,” says Jahidul Islam.

Dr. Jahidul Islam (left) and Dr. Asif Mazumder (right) speak at the Balukhali camp 09 Jame Masjid

Jahidul Islam (left) and Dr. Shajjad Hossain (right) speak at the Kutupalong camp 1w Lambasiya Jame Masjid

This initiative is part of HAEFA’s commitment to ensuring the health and resilience of vulnerable communities. Overall, the program stands as a significant contribution to furthering the goal of eradicating Tuberculosis worldwide. 

To read more about HAEFA’s projects, click here

An Inside Look: Working at the FDMN Camp Health Posts

Background

In October 2017, Myanmar’s Rakhine state launched a brutal attack on the Rohingya community, a primarily Muslim ethnic minority. This forced hundreds of thousands to flee to neighboring Bangladesh, specifically the southeastern district of Cox’s Bazar. Seven years since the crackdown, the population has reached nearly one million people, making it one of the world's largest and most densely populated refugee camps. Officially defined as “Forcibly Displaced Myanmar Nationals” (FDMNs), the Rohingya people are not recognized as citizens in either country, making them the largest stateless population in the world. 

Since the beginning of the crisis, HAEFA has operated two health posts within the camps, in Kutupalong and Balukhali (Camp 1W and 9 respectively). These camps have grown and adapted throughout the years, making improvements to best serve the community within the resource-limited environment.  

Boys stand outside HAEFA’s Health Post at Camp 9

Waiting room of the 1W Health Post

An insider’s view

I spoke with Dr. Fairuz Homayara Faria and Mst. Afroza Akter, to gain an inside view on what it’s like to work at these health posts. 

Dr. Fairuz Homayara Faria works as one of the two medical officers at Camp 9. Throughout the day, she counsels patients on everything from hypertension and diabetes to family planning and maternal care. Reflecting on her start at HAEFA, she recounts, “I joined HAEFA in 2021 when the pandemic was going on. It was quite a risky job but I did it anyway. I always wanted to work in this region. I had an interest in refugee camps and I always wanted to see what kind of experience they have here.” 

Dr. Fairuz Homayara Faria enters information in NIROG

When asked about what makes the Health Posts unique, she notes HAEFA’s emphasis on non-communicable disease (NCD) screening. Before seeing the physician, all patients have their vitals measured to be screened for NCDs like hypertension and diabetes.

Additionally, most prescriptions are limited to 7 days, ensuring that the patients return and are assessed weekly, to best monitor and manage their condition. Dr. Faria explains that “weekly check-ups and blood sugar monitoring don’t happen in all facilities. We have a very good follow-up system here.” HAEFA’s routine care is aided by the use of NIROG, a digitalized electronic medical record system.

She also notes how HAEFA prioritizes personalized and private consultations; “Other health workers or clinics don’t provide this kind of counseling.” 

All patients are screened for NCDs

Patient at camp 9 holds his Health record book and NIROG ID card

However, the job is not short of challenges. Dr. Faria tells me that the hardest part of her job is navigating cultural and communication barriers. “They are very stubborn about about follow-up and medicine intake.”

Akter, who has been working with HAEFA for two years, expands upon these challenges. Working as a Midwife, she counsels every female patient of reproductive age on the importance of family planning. She helps them navigate contraceptive use, providing different options such as condoms, injectable contraceptives, and oral contraceptives. This is an essential role within the camps, as the high rate of pregnancy and population growth is straining the already limited resources. Akter reiterates the complicated cultural barriers stating that, “it’s very difficult to convince them because they are very conservative.”

Midwife Mst. Afroza Akter

All women are counseled on family planning

More than half of all Rohingya refugees in Bangladesh (52 percent) are children

Despite facing obstacles, both women remain committed to serving this population and have undoubtedly made a positive impact. Akter mentions that while slow, she is noticing a greater awareness of family planning, with “more Rohingya taking contraceptives.”

Additionally, Dr. Faria notes that HAEFA’s service is appreciated by the community. “The patients that get treated here are very happy and have expressed so much gratitude.”

In the future, Dr. Faria hopes to return to hospital work but adds: “I have enjoyed working here for the past three years. … I will remember this experience for the rest of my life.” Akter also positively reflects on working at HAEFA, telling me that “the whole team is like a family.”

The clinical team at Camp 1W

To read more about HAEFA’s work in the FDMN camps, click here.

Introducing NIROG Plus

Empowering primary healthcare through digitalization

HAEFA has successfully developed NIROG Plus, an updated Electronic Medical Record (EMR) system aimed at enhancing primary patient care across all eight Upazilas (sub-districts) of Cox's Bazar. The HIPAA-compliant software records encrypted patient data providing doctors with a modern resource ensuring accurate diagnosis, treatment, and follow-up care. The updated version features a streamlined interface with improved order entry systems, real-time data tracking, and encoded analysis capabilities which will improve the quality and efficiency of patient care. 


Project Description

The project launched in May 2023 with the primary goal of establishing accessible and routine Non-communicable disease (NCD) screening. To date, a total of 66 EMR systems have been established (four at main health centers and 62 at community clinics in the Ukhiya and Moheshkhali Upazilas). Furthermore, HAEFA has provided all equipment needed for NCD screening, including digital blood pressure monitors, glucose meters, height and weight measuring apparatuses, etc. 

Mr. Mahfuzar Rahman registers a patient in NIROG Plus

Emphasizing preventative care and increasing access

With this expansion in modern recording technology, HAEFA ensures NCD screening at every level. The Community Healthcare Providers (CHCP) stationed at community clinics can now use NIROG Plus to assess patients’ hypertension and diabetes status, as well as cardiovascular risk.

If the patient is flagged by the system, they are referred to the Upazila Health Complex for diagnosis and treatment. This removes the need for physicians on-site and reduces the overall healthcare system burden by prioritizing continuous and local care. Dr. Asif Mazumder, EMR supervisor explains, “Early identification and intervention are now possible by data analysis, which is the cornerstone of preventive healthcare.”  

Dr. Shajjad Hossain, Medical Officer at HAEFA’s 1W Health Post further elaborates on the project’s importance. “NCD Screening allows healthcare providers to identify individuals who are at a higher risk of developing NCDs and provide them with guidance on lifestyle modifications and preventive measures. Moreover, healthcare providers can allocate resources efficiently, ensuring that those with the highest risk receive timely appropriate care and management. This will also help in reducing healthcare costs in the long run by preventing complications that would require expensive treatments.” - Dr. Shajjad Hossain

Dr. Shajjad Hossain (left) Dr. Asif Mazumder (right)

Furthermore, NIROG Plus lowers barriers to access. “This makes it easy for individuals with limited time and resources to access quality health support. They can just go to the community clinic instead of traveling far to the Upaliza’s Health Complex.” says Saim Khan, Chief Coordinator, HAEFA Cox's Bazar. 

Taking blood pressure to screen for hypertension

Screening blood glucose can help identify patients with metabolic diseases like diabetes

Committed to constant improvement

While NIROG Plus is a major advancement in HAEFA’s EMR technology, there is still room for improvement. Currently, data from 66 community clinics is synced every day, creating speed and bandwidth constraints. Therefore, the HAEFA IT team is working hard to improve syncing capabilities to ensure stable and rapid data recording. 

Every patient is assigned a unique ID number

Height and weight is recorded to calculate BMI and assess cardiovascular risk


Influencing national health infrastucture

The potential for this technology is immense. The Bangladesh healthcare system is still in its infancy and lags behind many other countries. A comprehensive and translatable medical record system is not well established and is almost non-existent in rural and isolated communities. By securely storing information, NIROG Plus removes the burden of manually tracking patient data and allows physicians to consult records and trends to better inform treatment decisions. Furthermore, the records can be utilized across various healthcare levels ensuring continuity of care and longitudinal management.

Dr. Mazumder states, “My strong belief is that NIROG Plus will be the stepping stone of the much-needed digital data management system that should have been established long before within Bangladesh’s healthcare system.”

To read more about NIROG, click here.

The Women Behind HAEFA's Cervical Cancer Screening Program

In honor of International Women’s Day, HAEFA would like to highlight the incredible team of female physicians and community facilitators working on Cervical Cancer Screening. This program is advancing women’s health, promoting equality, and saving lives.

The physician team. Left to right: Dr. Farah Naz, Dr. Rubaiya Shafrin, Dr. Rituproma debnath, Dr. Tasnim Jahan, Dr. Chitralekha Kar, Dr. Arpa Mollik, Dr. Nishita Paul. Not pictured: Dr. Zerin Tasnova

Overview

Cervical cancer is a significant global health concern, including in Bangladesh, where it leads to the death of approximately 6,000 women each year. Early detection can prevent this disease, but a lack of public knowledge and screening contributes to its high prevalence in the country.

In 2020, the district of Cox’s Bazar had little to no infrastructure dedicated to cervical cancer screening. Thanks to HAEFA’s efforts, free Visual Inspection by Acetic Acid (VIA) screening has now been established across every Upazila (sub-district) in Cox’s Bazar, each staffed with one medical officer (featured above) and three community facilitators.

“Wherever you go, you can find a facility with a VIA center.”

- Dr. Chitralekha Kar

Furthermore, HAEFA is committed to increasing accessibility. While VIA screening is available at the Upazila Health complexes, many women are unable to travel there due to time and resource limitations. Therefore, HEAFA implements VIA camps at the 66 community clinics in Cox’s Bazar, targeting rural and underserved populations. At each camp, up to one hundred women can be screened. 

Women wait to be screened at Matabar Para Community Clinic

Overcoming Challenges

While incredible progress has been made in improving women’s health the project still faces certain challenges. The physicians state that cultural barriers and misconceptions are the biggest obstacles, as well as implementing HAEFA’s single visit “See-and-Treat method” which consists of VIA screening and thermocoagulation if the VIA is positive.

“Women's health is still neglected. Most of the women need their husband’s permission to come to the hospital. Even if they come to the hospital, they can’t freely do any kind of investigation, even VIA which we provide free of charge. For example, after we counsel them they say, let me talk with my in-laws. If they permit me I will come again.”

- Dr. Rubaiya Shafrin

“As now we are doing see-and-treat, many do not want to do thermocoagulation, just because of cultural beliefs and their husband's beliefs. They fear they won't be able to have children or there will be some problem in their sexual life, and that’s the primary thing for which their husband needs them.”

- Dr. Chitralekha kar

The physicians also note personal experiences navigating sexism and discrimination as a doctor.

“It’s a common practice in our country to call us nurses. I am the team leader, but the person responsible for the community clinic asked me, who is the person in charge? I want to talk to him. When I tried to talk with him, his reply was simple, he said I want to talk with the male member of your team. That's it.

- Dr. Rubaiya Shafrin

Our Impact

Despite these challenges, these physicians showcase their dedication and resilience by continuing to serve patients every day.

“We can proudly say that the total 8 of the upazilas are doing their screening every single day. It’s free for all, open for all, no matter if you are Bangladeshi or FDMN.

- Dr. Rubaiya Shafrin

“[Our patients] were diagnosed with cervical cancer and now they are cancer free. This is a great achievement.”

- Dr. Tasnim Toma

“When you see moms bringing their daughters to get the Cervical cancer (HPV) vaccine, it feels good that we are working not only to detect the cancer, but we are also preventing it, creating a generation based awareness of which maybe we will see the effect in the near future.”

- Dr. Rubaiya Shafrin

A mother attends a VIA camp at her community clinic

HAEFA is creating generation based awareness to prevent cervical cancer in the future

The author would also like to recognize Dr. Nilufar Parveen who oversees the program as the National Clinical Coordinator, Dr. Susan Cu-Uvin who spearheaded the program, and the many community facilitators who are the key members of the program, working within the community to raise awareness, empower individuals, and bridge healthcare gaps. 

Additionally, in honor of International Women’s Day, we would like to recognize all the women who work and support HAEFA - we could not do it without you. 

HGSP all team meeting

To learn more about our Cervical Cancer screening program, click here

To meet one of our Community Facilitators, click here

Meet Amena Akter: A Dedicated Community Facilitator

Amena Akter, HAEFA community facilitator

Amena Akter, originally from Ukhiya, Cox's Bazar, embodies a commitment to community engagement and social impact. With a Bachelor's degree in English from Cox's Bazar Government College and a background in science from Ukhiya Government High School, Amena's journey has been characterized by her passion for driving positive change.

Before working with HEAFA, Amena worked as a Community Mobilizer at the Danish Refugee Council (DRC) and Center Facilitator at Young Power in Social Action (YPSA). She gained immense experience in grassroots mobilization and community engagement, actively raising awareness about gender-based violence, fostering resilience and cooperation, and empowering individuals through access to essential resources and skills.

In February 2022, Amena joined Health and Education for All as a Community Facilitator. In this ongoing role, she works to increase access to cervical cancer screening and treatment, collaborating closely with physicians and community members to bridge gaps in healthcare and education.  

"Empowering communities is essential for fostering long-term resilience and growth. I believe in the power of community-driven initiatives to create meaningful impact."

She’s excited to continue working with HAEFA stating, “I am eager to continue my journey of making a difference, empowering communities, and contributing to a brighter, more equitable future.”

Learn more about HAEFA’s work in cervical cancer screening here.

New Child Play Corners Enhance Patient Experience

Health and Education for All (HAEFA) has established new Child Play Corners at the Kutupalong Camp 1W and Balukhali Camp 9 Health Posts, enhancing the healthcare experience. 

Children play at the new child-play corner in Camp 9

Children can now safely play in the designated and child friendly space while their guardians wait for treatment in the waiting room. This thoughtful addition not only ensures a stress-free experience for guardians, but also creates a playful and nurturing space for the children. HAEFA continues to prioritize holistic well-being, making every visit to the health posts a positive and inclusive experience. 

These health post upgrades were featured in the Jan. 2024 Health Sector Bulletin for Cox’s Bazar District. See the post here.

New Cervical Cancer Screening Training and Research Center

The cervical Cancer Screening Training and Research Center of Dhaka Medical College Hospital (DMCH), was inaugurated on February 20th, 2023, with the aim to become the regional training hub for cervical cancer in Bangladesh, providing training to providers from various districts and upazilas of Bangladesh.

The opening ceremony was graced by esteemed guests, including the Director General of Health Services (DGHS), Professor Dr. Abul Basar Mohammad Khurshid Alam (DG), and Additional Director General (Administration), Professor Dr. Ahmedul Kabir (ADG), who joined in the ribbon cutting ceremony to officially launch the center. The center has also received support from Brown University Global Health Initiative, Health and Education for All (HAEFA), and the United Nations Population Fund (UNFPA)'s technical facilitators, who are providing their expertise to ensure the center's success.

The center has also received support from the Brown University Global Health Initiative and the United Nations Population Fund (UNFPA)'s technical facilitators, who are providing their expertise to ensure the success of the center. In addition, these organizations are also involved in capacity building and strengthening public healthcare facilities for cervical cancer in nine upazilas of Kurigram District and six upazilas of Cox’s Bazar District. The center's primary focus is on capacity building and training of service providers to improve the quality of cervical cancer screening and treatment in Bangladesh. By providing a centralized location for training, the center will be able to offer accessible and effective services to those in need.

Read more about it here!


HAEFA, Beyond Borders - June/July 2023

ARTICLES

HIGHLIGHTS

UPDATES

SPOTLIGHTS

EDUCATION

RETROSPECT

ARTICLES HIGHLIGHTS UPDATES SPOTLIGHTS EDUCATION RETROSPECT

ARTICLES

Dr. Ruhul Abid's Journey in Establishing and Advancing HAEFA

Dr. Ruhul Abid, a professor at Brown University, co-founder and president of HAEFA and a Nobel Peace Prize nominee, discusses his journey into public health, providing aid to some of the world’s most vulnerable people, and what he is planning next for HAEFA.

By Ishaan Rahman

Health and Education for All (HAEFA) is a 501(c)(3) nonprofit organization founded in 2012 to address glaring inequalities in healthcare access in Bangladesh. In our interview, Dr. Ruhul Abid, the president and co-founder of the organization and associate professor at the Brown University Warren Alpert School of Medicine, reflected on his path into public health and his work with HAEFA.

Starting out in Public Healthcare

As a newly registered physician, Dr. Abid started his career working for Duncan Brothers, a British tea company, instead of a traditional hospital setting. Dr. Abid's initial exposure to community health was in offering healthcare screening, ensuring effective vaccination among the tea garden workers - raising its coverage from 5% to 97% - and providing routine healthcare services to the organization's employees.

“We developed antenatal checkup, screening for hypertension and diabetes using the community [health workers] in the tea-producing estates...this was often in remote places for the tea pluckers (workers) and their families,” he explained. Through this, he learned how to manage a team, motivate the staff to deliver optimum services and distribute (often limited) resources. "My experience in public health and medical fields proved invaluable in my ability to address the key questions - what are the primary issues? What resources are at disposal? What gaps are there?” He went on. “[My three years at Duncan Brothers] resonated with me in the later part of my life as well."

Building a Team

After moving to the United States and working as a fellow and then faculty at Harvard Medical School, Dr. Abid started thinking about how to give back to the community in Bangladesh. HAEFA resulted from this, an organization co-founded with his colleague at Harvard Medical School, Dr. Rosemary Duda, to provide free healthcare and education to those who needed it most, ranging from garment workers to refugees.

His initial team included many undergraduate and medical students from Harvard University, MIT and Brown University. “I always had some connection with the students,” Dr. Abid says.

Supporting Bangladeshi Garment Workers

The collapse of the Rana Plaza in Dhaka in 2013, which resulted in the tragic death of over 1,100 garment workers, gave Dr. Abid’s new project a renewed sense of urgency and importance. Around a month after the collapse, Dr. Abid visited Bangladesh to investigate the garment workers’ health and safety needs in a workplace prioritizing labor efficiency over wellbeing. “Healthcare was very much neglected,” he sadly remarked.

This became HAEFA’s first major project. A team, including Dr. Abid himself, his daughter, Dr. Duda, undergraduates and medical students, made the trip to Bangladesh. He also contacted colleagues from Dhaka Medical College, which sent physician interns to help. HAEFA’s vital work with the garment workers included screening for non-communicable diseases such as anemia, hypertension, diabetes and asthma. Alongside local healthcare workers, HAEFA also provided health education on safety and personal hygiene. The initial funding for this project came out-of-pocket from Dr. Abid and Dr. Duda.

Early during the project's initial phase, HAEFA encountered a new obstacle. Paper medical records proved too disorganized to keep track of as more patients showed up for screenings. As a solution, “We developed electronic health records (EHR) which could screen one patient in seven minutes,” Dr. Abid said. These efficient tests included BMI, blood pressure, heart rate, on-site hemoglobin, blood glucose monitoring and more. Recognizing the success of this process, the Bangladeshi government provided funds that allowed HAEFA to screen an additional 6,000 patients. The UK’s Department for International Development (DFID) also supported their work.

In 2019, Dr. Abid and his colleagues published key demographic and health data for almost 2,000 Bangladeshi garment workers in the International Health Journal. The research suggested substantial improvement in health screening services when coupled with the use of an electronic medical record (EMR) system.

Raising Awareness in the U.S.

Short on funds, HAEFA worked tirelessly to raise awareness of its work back in the U.S., fundraising at student organizations, churches, mosques, cultural centers and more. Some committed students at Brown University even sold Valentine's Day flowers to raise funds.

HAEFA entered the Grand Challenges Canada competition in 2017, which was sponsored by the Bill and Melinda Gates Foundation and the Canadian government to address global concerns. Dr. Abid joined, displaying HAEFA’s cutting-edge electronic health record (EHR), named NIROG (well-being in Bangla), and screening programs.

“Out of 900 or so organizations worldwide, there were only 43 that received funding and HAEFA was one of them,” Dr. Abid proudly states. The fund alone allowed for the screening of an additional 12,000 patients and arranging new equipment in Bangladesh. However, the "name and fame" that HAEFA acquired from this competition was even more valuable. Dr. Abid proclaimed, "HAEFA became stronger as an organization and in its endeavor."

Facing the Rohingya Crisis

The influx of Rohingya refugees created a new public health crisis at Bangladesh’s doorstep. Wasting no time, Dr. Abid and his team, including fellow Brown University Professor, Dr. E. Jane Carter, traveled to the Cox’s Bazar district in Bangladesh. After receiving approval from the Bangladeshi government to provide healthcare within the refugee camps, HAEFA encountered a new challenge. The electronic patient records, vital to their success with garment workers, would not be workable due to the lack of electricity and internet within the camps. Dr. Abid worked around this barrier by bringing large batteries charged with solar energy.

On the issue of building trust with a persecuted minority, Dr. Abid’s answer was simple: show them results they can understand. Keeping reliable records of their health screening was key to this. Crucially, though, a medium was needed between the volunteers and the Rohingya. “Another thing we did is to include a Rohingya interpreter beside our doctors…that helped us and helped the doctors explain the results and give medicine,” he elaborated. HAEFA volunteers also attended community meetings with their local leaders and Imams.

Tackling the Pandemic

The pandemic dramatically changed HAEFA’s priorities and how they would continue to operate in Bangladesh. First and foremost, Dr. Abid wanted to ensure the safety of refugees from the contagious coronavirus. HAEFA became the first organization to provide refugees and healthcare providers in the hyperdense camps with free masks and hand sanitizer. Additionally, HAEFA educated local healthcare workers in official training programs on the correct protocol to keep people safe. “The pandemic changed us totally, expanding our horizon,” Dr. Abid says.

HAEFA, in collaboration with the Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare (MoHFW), Brown University, Project HOPE and USAID/Save the Children, developed and launched an Advanced COVD-19 Clinical Management Certification Course for the physicians of Bangladesh in 2021. More than 6,000 physicians have already been trained and certified (by DGHS, Brown University, Project HOPE and HAEFA) through this interactive online course. Another significant contribution of HAEFA during the pandemic was its successful development and training of a Training of the Trainer (TOT) Mental Health Support and Resilience Course for the health workers in Bangladesh in 2021-2022. This Mental Health TOT was a joint collaboration between HAEFA and Project HOPE and has provided support to more than 7,000 health and other workers during the pandemic. 

Looking to the Future

Dr. Abid and HAEFA have ambitious plans for expansion of the organization and communities that will be helped. So far, they have planned to start operations in another district, Noakhali. Furthermore, HAEFA seeks to cooperate with Bangladesh’s government to improve clinical research.

In 2020, Dr. Abid’s work in Bangladesh had earned HAEFA and himself the ultimate recognition: a nomination for the Nobel Peace Prize. Ultimately, what started as a small, self-funded organization has become a leader in Bangladesh's public health initiative. HAEFA’s story not only shines light on the obstacles faced towards achieving healthcare justice but also emphasizes the need to address deep-seeded problems within all global communities.

The Rohingya Crisis: Desperation and Hope in the Face of RATION Cuts

Funding cuts by the World Food Programme have left Rohingya refugees with just $0.27 per day for food, entrenching them deeper into this humanitarian crisis. With severe malnutrition, impaired development and increased mortality rates looming, urgent global action is needed to address the dire situation and secure the physical and mental wellbeing of the world's most persecuted minority.

By Raihana Mehreen

The United Nations (UN) has played a crucial role in providing humanitarian aid to the Rohingya. One of the UN's key organizations, the World Food Programme (WFP), operates globally to offer food support to the disadvantaged. At the beginning of 2023, the Rohingya refugees received a monthly food ration of $12 per person, which barely sufficed in meeting their daily needs and, in March, this amount was reduced to $10 (1). On June 1, due to a funding shortfall of $56 million, the WFP implemented a second round of cuts. Each individual is now allocated $8 per month, equivalent to a mere $0.27 per day (1) - within three months, the meager amount of food that the Rohingya did receive decreased by one-third.

Genocidal attacks caused the mass exodus of the predominantly-Muslim Rohingya to Bangladesh in 2016 and 2017 - close to a million now reside in Cox’s Bazar. Already facing decades of persecution, acute trauma and deprivation, health indicators for this displaced population were poor, even before the cuts in early 2023. 45% of families did not have an appropriate diet; 40% of children experienced stunted growth, and more than 50% suffered from anemia (1). Not only so, 20% of Rohingya children under five were malnourished and, consequently, 12% suffered from severe stunting (2). UN experts have warned that the food aid cuts will particularly impact vulnerable populations, including women, especially those who are pregnant and/or breastfeeding, adolescent girls and children (1). The consequences of the reductions are predictable - malnutrition, impaired child development and an increase in infant mortality (1), greatly diminish the potential of future generations of Rohingya. Further exacerbating their formidable living conditions, Cyclone Mocha had struck western Myanmar in May 2023, causing extensive damage to the shelters of around 40,000 refugees.

Growing desperation among the Rohingya has driven them to undertake perilous sea journeys across the Bay of Bengal and the Andaman Sea, hoping to find a better life and reunite with family in other countries. In 2022, over 3,000 Rohingya attempted this voyage on 39 boats. By the end of the year, approximately 160 individuals were still at sea, while an estimated 350 people had either lost their lives or had gone missing (3). Of the 3,040 individuals who disembarked in 2022, 32% arrived in Myanmar, 25% in Malaysia, 24% in Indonesia, 10% back in Bangladesh, 5% in Thailand and 3% in Sri Lanka (3). Those intercepted in Myanmar were arrested and sentenced for violating the 1949 Registration Act or the 1947 Immigration Act that resulted in, respectively, two or five years of imprisonment (3). The new round of cuts may further sway the Rohingya to make the difficult choice of risking their lives to the dangers of the sea, including sailing on rickety boats and being assailed by traffickers and smugglers (1).

Bangladesh has demonstrated remarkable commitment in supporting the Rohingya population since the early 1990s, and particularly after the significant influx in 2017. The Bangladeshi government, along with international organizations and NGOs, has been actively involved in providing humanitarian assistance to the refugees, including food, clean water, healthcare services, emergency relief supplies and education. The Rohingya were deprived of any systematic health care or immunizations since their citizenship was revoked in 1982. In September 2017, responding swiftly to reports of polio and measles outbreaks in the camps, the Bangladeshi government promptly administered emergency vaccines (4). Despite being the most densely-populated country in the world (excluding city-states and small countries), with 1,141 people per square kilometer, Bangladesh has even allocated land to build camps to accommodate the 1.1 million refugees in Cox's Bazar. Kutupalong and Balukhali, HAEFA’s main provision sites, are among the largest refugee settlements in the world.

The utter magnitude of the Rohingya population and the refugee crisis, however, has put immense pressure on Bangladesh's resources and infrastructure. The nation has one of the highest poverty rates in the world; about 31% of the population live below the national poverty line of about $2 per day (4). Recognizing these limitations, Bangladesh has collaborated with international organizations, including UN agencies such as the International Organization for Migration (IOM) and the United Nations High Commissioner for Refugees (UNHCR), intending to identify sustainable, long-term solutions and engaged in diplomatic efforts to address the root causes of the crisis in the attempt to secure the safe and voluntary repatriation of the refugees and ensure accountability for human rights violations.

In addition to the obvious physical ramifications of starvation, the cuts entail a profound mental toll, exacerbating the marginalized state of the Rohingya community and perpetuating cycles of poverty and despair. Amidst this chaos, however, HAEFA stands as a beacon of hope and resilience. HAEFA has established free medical clinics to serve the Rohingya, and on-site providers have cared for over 275,000 patients since October 2017. The dedicated healthcare teams work tirelessly, facing overwhelming challenges, overflowing clinics and relentless heat. Using a portable, innovative, solar-powered electronic medical record system, NIROG (“wellbeing” in Bangla), HAEFA's healthcare workers record patient information on handheld tablets and provide laminated ID cards for systematic record retrieval. This unique approach allows the  organization to cater to a significantly larger number of patients which would not have been possible otherwise. HAEFA is the most trusted name in providing quality primary healthcare to this marginalized population due to their effective use of advanced and unique technology, systematic evaluation and the inclusion of human touch in the care of every single patient (4). HAEFA has also established referral systems for various healthcare needs, such as tuberculosis (TB) diagnosis and treatment, safe delivery for pregnant women and malnutrition treatment. The efficient medical teams also provide the host community with quality healthcare as the refugee camp formations make it difficult for the neighboring residents to access care. As the world's largest humanitarian crisis unfolds, HAEFA's goals become more crucial than ever, and as the crisis continues, HAEFA also collaborates with relevant agencies to ensure patients receive specialized care, recognizing the need to build an effective healthcare system to address the long-term needs of the refugees. The Rohingya, scarred by violence and displacement, depend on such organizations to not only heal their physical wounds but also to experience a glimmer of humanity.

This critical situation demands immediate and urgent action from all stakeholders involved. The UN is responsible for securing funding and reinstating food rations in their entirety. The global community must attempt to reinstate the Rohingya's fundamental human rights and implement repatriation to their homeland. We can only aspire to achieve justice and pave the way for a better, safer future for the Rohingya through collective efforts from the UN, international donors and Bangladesh's governing bodies. Undoubtedly, HAEFA stands in solidarity with the Rohingya community as well as with other groups of underserved people in Bangladesh.

We can only aspire

to achieve justice and pave the way for a better, safer future for the Rohingya through collective efforts…

References

(1) UN News, "UN in Bangladesh announces devastating new round of rations cuts for Rohingya refugees," UN News, 25 June 2023. [Online]. Available: https://news.un.org/en/story/2023/06/1137252.

(2) Jason Patinkin, "Rohingya Refugees Facing Malnutrition," VOA News, 17 May 2018. [Online]. Available: https://www.voanews.com/a/rohingya-refugees-facing-malnutrition/4377429.html.

(3) The UN Refugee Agency, “Protection at Sea in South-East Asia - 2022 in Review,” The UN Refugee Agency, 17 January 2023. [Online]. Available: https://data.unhcr.org/en/documents/details/98170.

(4) E. Jane Carter and Ruhul Abid, “A People Without a Country,” Brown Medicine Magazine, February 2018. [Online]. Available: https://medicine.at.brown.edu/article/a-people-without-country/.

HIGHLIGHTS

Brown University and HAEFA Teams Visit District Hospital and FDMN Camp

On May 7, Dr. Susan Cu-Uvin (Professor of Obstetrics and Gynecology, Brown University), Dr. Ruhul Abid (President/Founder, HAEFA and Associate Professor, Brown University), Mr. Monjur Iqbal (Project Director, HAEFA), Dr. Sharmin Sultana (National Clinical Coordinator, HAEFA) and Ms. Raisa Iftikhar (HR Coordinator/Research Assistant, HAEFA) visited the district hospital in Cox’s Bazar. The team met with the assistant superintendents to discuss potential areas for collaboration and methods to enhance the delivery of healthcare services in the facilities.

Dr. Abid and Mr. Iqbal, accompanied by Mr. Md. Mamunur Rashid (Project Coordinator, HAEFA), then visited Mr. Mizanur Rahman, the Refugee Relief and Repatriation Commissioner (RRRC), who is also the Additional Secretary of the Ministry of Disaster Management and Relief (MoDMR), at his office, where Dr. Abu Toha (Health Coordinator, Office of RRRC) was also present. In the meeting, they discussed the overall condition of HAEFA’s health facility at the FDMN Rohingya Camp in Ukhiya as well as fund facilities.

The HAEFA team also visited the Upazila Health Complexes (UHC) in Ukhiya, Maheshkhali, Chakaria and Pekua to observe Non-Communicable Disease Corners that help rural patients with high blood pressure.

Dr. Cu-Uvin and the HAEFA team, including Mr. Saiful Alam (IT Manager, HAEFA), also visited an FDMN Camp in Cox’s Bazar. The team evaluated the quality of services provided to the Rohingya refugees, observed the facilities and engaged with the staff.

Bangladesh's WHO Representatives Visit FDMN Camp

On May 11, Dr. Aroti Singh, Public Health Response Officer and Dr. Raisul Islam, NCD Officer, from the World Health Organization, visited HAEFA’s health post in Kutupalong (Camp 1W) to assess the response to the services provided to the FDMN population.

UPDATES

Comprehensive Healthcare for the Rohingya/FDMNs

Since establishing refugee camps in Cox's Bazar, HAEFA's healthcare providers have offered free medical care to the Rohingya and Forcibly Displaced Myanmar Nationals (FDMNs). HAEFA has significantly expanded its services over the past six years, focusing especially on providing medical attention in Kutupalong (Camp 1W), Balukhali (Camp 9) and Bhashan Char (FDMN). On-site healthcare services for acute and chronic health conditions include maternal and preventive care, family planning and breastfeeding, health screenings, nutrition education, hygiene and feminine health, immunization programs for children and adults and medication distribution. Blood tests to assess the quantity of red blood cells, white blood cells and platelets (CBC with ESR), urine tests to check for abnormalities of the urinary system (Urine R/M/E) and lipid profile testing to measure blood cholesterol levels are just a few of the many tests performed in the NCD Pathological Laboratories.

MAY 2023

Kutupalong (Camp 1W)

  • 2,882 patients received healthcare services.

  • 154 lab tests were performed by the semi-automated NCD Pathological Laboratory.

  • 141 patients received family planning services.

Balukhali (Camp 9)

  • 2,202 patients received healthcare services.

  • 259 lab tests were performed by the semi-automated NCD Pathological Laboratory.

  • 227 patients received family planning services.

Bhashan Char (FDMN)

  • 1,997 patients received healthcare services.

Host Community

  • 31 patients received family planning services.

This chart displays the number of patients that received healthcare services by location in May 2023.

This chart displays the number of patients that underwent laboratory tests by location in May 2023.

This chart displays the number of patients that received family planning services by location in May 2023.

JUNE 2023

Kutupalong (Camp 1W)

  • 2,998 patients received healthcare services.

  • 162 lab tests were performed by the semi-automated NCD Pathological Laboratory.

  • 132 patients received family planning services.

Balukhali (Camp 09)

  • 2,271 patients received healthcare services.

  • 242 lab tests were performed by the semi-automated NCD Pathological Laboratory.

  • 201 patients received family planning services.

Bhashan Char (FDMN)

  • 1,368 patients received healthcare services.

Host Community

  • 27 patients received family planning services.

This chart displays the number of patients that received healthcare services by location in June 2023.

This chart displays the number of patients that underwent laboratory tests by location in June 2023.

This chart displays the number of patients that received family planning services by location in June 2023.

Cervical Cancer Screening Project

There were 5,100 cervical cancer deaths in Bangladesh in 2019, approximately 6.33 deaths per 100,000 women per year. Early detection greatly improves the chances of successful treatment of pre-cancers and cancer and regular screenings prevent cervical cancers and save lives. Cervical cancer is the second most common type of cancer in females in Bangladesh. Apart from regular screenings, which include only screenings and, if needed, referrals, HAEFA also conducts an innovative single-visit See-and-Treat Program to diagnose and treat cervical cancer in its early stages by means of Visual Inspection with Acetic Acid (VIA). This method involves a vaginal speculum exam in which a health care provider applies diluted 3-5% acetic acid (vinegar) to the cervix. A colposcopy is then performed, in which a lighted, magnifying instrument - a colposcope - is used to examine the cervix, vagina and vulva for signs of disease. For those who are VIA-positive, thermocoagulation (using heat to destroy tissue by means of a mobile, reusable, battery-operated handheld device - a thermocoagulator) is a potential treatment. Due to this method, the implementation of NIROG (the electronic health record system for hypertension, diabetes and gestational HTN/DM), HAEFA was awarded the Stars in Global Health by the Grand Challenges Canada in 2018.

Since October 2019, HAEFA has been practicing the See-and-Treat initiative in three sub-districts of Kurigram: Ulipur, Chilmari and Nageshwari. In the past four years, 66,973 have been screened and, among them, 695 were positive. As of 2022, the program has expanded to all nine Upazila Health Complexes (UHCs) and six camps in Kurigram. Recently, HAEFA expanded the screening program to Cox’s Bazar - currently, HAEFA screens women in seven VIA centers (Sadar Hospital, MCWC, Ramu UHC, Moheshkhali UHC, Chakaria UHC, Pekua UHC and Kutubdia UHC) and 11 VIA camps. HAEFA hopes to bridge the gap in diagnosis and care for the many Bangladeshi women at risk of and suffering from cervical cancer through this initiative.

MAY 2023

  • 402 women received regular screenings in Kurigram UHCs - one was VIA-positive, and referred for further investigation and treatment.

  • 966+ women underwent the See-and-Treat Approach in Ulipur, Chilmari and Nageshwari UHCs - seven were VIA-positive, two received thermocoagulation and six underwent biopsies.

  • 1,447 women received screenings at Cox’s Bazar’s VIA centers. 36 were VIA-positive, and referred for further investigation. The CC CXB team, led by Dr. Susan Cu-Uvin (Professor of Obstetrics and Gynecology, Brown University), organized hands-on screenings for VIA-positive patients, from May 7-11; 55 colposcopies and five thermocoagulations were performed at Cox’s Bazar Sadar Hospital, Pekua and Chakaria UHC.

JUNE 2023

  • 360 women received regular screenings in Kurigram UHCs - one was VIA-positive, and referred for further investigation and treatment.

  • 930 women underwent the See-and-Treat Approach in Ulipur, Chilmari and Nageshwari UHCs - 16 were VIA-positive, 16 colposcopies were performed and 11 underwent biopsies.

  • 1,257 women received screenings at Cox’s Bazar’s VIA centers. 12 were VIA-positive, and referred for further investigation. Four colposcopies were performed at Cox’s Bazar Sadar Hospital. The Cox’s Bazar team also followed up with previously-identified cancer patients and referred them to Chattogram Medical College and the National Institute of Cancer Research & Hospital (NICRH), in Dhaka, for further treatment.

Mobile Health Clinics for Host Communities

As the FDMN camp is enclosed with wire fencing, the surrounding host communities have limited access to health clinics, which provide free medical screenings, treatment and follow-ups, in Kutupalong and Balukhali. To help these neighboring residents access care, HAEFA has initiated a weekly Mobile Health Clinic, comprising a Medical Officer, Medical Assistant, Lab Technologist, Midwife and Dispenser. More than 40 patients were treated on opening day in June 2022. Free services include screening and treatment for non-communicable chronic diseases (NCDS), like hypertension, diabetes, asthma and malnutrition, communicable diseases and family planning services. This program aims to improve the quality of life and engender hope for disadvantaged, vulnerable populations.

MAY 2023

174+ host community members received healthcare services at AKNC High School, on the 22nd, and Phalong Model High School, on the 31st, in Ukhiya.

JUNE 2023

141 host community members received healthcare services at Sonarpara High School, on the 12th, and AKNC High School, on the 15th, in Ukhiya.

SPOTLIGHTS

Meet HAEFA's New Editorial Staff!

Raihana Mehreen is the Editor-in-Chief, and joined HAEFA in 2019. She lives in Massachusetts, USA, graduated from Boston University with a degree in neuroscience and public health and is working at WellSense Health Plan.

Sajia Haque is an Associate Editor, as well as the Intern Coordinator for HAEFA, and joined in 2021. She lives in Dhaka, Bangladesh and is a fifth-year medical student at Holy Family Red Crescent Medical College.

Ishan Abdullah is an Associate Editor, and joined HAEFA in 2019. Based in Washington, DC, USA, he is a first-year medical student at the George Washington University School of Medicine and Health Sciences.

Areeb Uzzaman is an Article and Interview Contributor, and joined HAEFA in 2020. He lives in Maryland, USA, and is pursuing an undergraduate degree in international business at the University of Maryland, College Park.

From left to right: Raihana Mehreen, Sajia Haque, Ishan Abdullah and Areeb Uzzaman.

Meet Md. Saiful Alam Sarker, IT Manager!

Evolving over 12 years, Mr. Md. Saiful Alam’s career - which started at a multinational company in Dhaka - culminated in his current role at HAEFA, which began in October 2021, as the IT Manager for the Cervical Cancer Screening Project in Cox's Bazar. His impact has been instrumental in developing the organization's information technology infrastructure, benefiting medical teams that have cared for over 275,000 Rohingya refugees since 2017. “Prior to joining HAEFA, I held the position of System Administrator at various private organizations. I underwent training, gradually building my expertise and advancing in the IT field through diligent efforts, continuous learning and practical experience,” Mr. Alam elaborates.

Mr. Alam was born and raised in Cumilla. His father, now retired, was a manager at Grameen Bank and his mother is a government service holder. Several years ago, when his father fell ill, the family needed to make important decisions regarding treatment. The elder of two brothers, Mr. Alam felt responsible for taking care of his parents, especially because his family always relied on him to make critical decisions, so he aimed to do well professionally. After acquiring an MBA from the University of South Asia (UNISA) in Dhaka and accumulating a decade of IT experience, Mr. Alam is adept at system design and productivity enhancement. He has gained extensive experience in various programming languages and web technologies and has completed CCNA and Windows Server Administration courses, and his toolbelt facilitated notable achievements at HAEFA, including the transition to cloud computing and training initiatives. He relays, “Overall, my passion for technology, the transformative impact of IT in various domains and the guidance from mentors have all shaped my interest and pursuit of a career in IT.” Mr. Alam's passion for the field and its societal impact align with his goals at HAEFA, where he aims to establish a robust IT department. He is currently involved in the upcoming NIROG Plus project, and is aiming for nationwide implementation. Beyond his professional life, Mr. Alam is a family man - a loving husband and father of three who cherishes quality time with loved ones - and enjoys intellectual pursuits, such as reading and staying up-to-date with technological advancements, and sports, especially cricket and football, and watching movies.

Mr. Alam’s IT journey showcases his belief in technology's transformative potential. His hands-on work ethic, communication and reliability underscore his commitment to HAEFA, demonstrating a blend of dedication, ambition and technological prowess.  Characterized by a passion for leveraging the field to yield positive societal change, Mr. Alam views technology as a revolutionary force that can elevate health and educational outcomes for underprivileged communities - naturally, Mr. Alam is an invaluable asset. “Since joining HAEFA, my experience in humanitarian work has been truly eye-opening. I am grateful for the opportunity to contribute to meaningful initiatives and make a positive impact,” he proudly states.

EDUCATION

A Quick Overview of HAEFA's Services

Retrospect

Ignited Tears: Recounts of a Rohingya Camp Fire

Please help us raise awareness about the plights of the Rohingya by liking, commenting on and sharing this video. Your support can make a difference.

This video illustrates some of the challenges faced by Rohingya refugees after a devastating fire blazed through their camp in March 2023. HAEFA members were on the ground to offer medical and logistical aid and document their stories and needs.

STAFF

Raihana Mehreen

Editor-in-Chief

Ishan Abdullah and Sajia Haque

Associate Editors

Areeb Uzzaman

Article and Interview Contributor

CONNECT

HAEFA has offered free healthcare services to disadvantaged populations in Bangladesh, including RMG workers and Rohingya refugees, and is actively engaged in various initiatives like COVID-19 response, immunization programs and maternal care.

Do you want to help as well?

Volunteer or donate, and follow HAEFA on social media.

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HAEFA - May Newsletter 2023

Cyclone Mocha Pummels Bangladesh Coastline, Causes Extensive Damage

Cyclone Mocha pummelled the coastline of Bangladesh on the night of Sunday, May 14, 2023, wreaking widespread destruction. The violent storm left its mark on a staggering 2,548 shelters across 33 Rohingya refugee camps in the Ukhiya and Teknaf Upazilas of Cox's Bazar. This resulted in the complete annihilation of approximately 278 residences.

According to an official report from the Refugee Relief and Repatriation Commissioner's Office, issued on the same day, 1,611 Rohingya refugees have been impacted, with seven injuries reported. Balukhali Camp 9 in Ukhiya bore the brunt of the storm, witnessing damage to around 485 shelters. In a preemptive move to ensure the safety of the Rohingya refugees, 3,031 individuals were relocated owing to the impending threat of landslides and torrential rain brought on by the cyclone. The HAEFA Health Post, a crucial healthcare facility in Balukhali Camp 09, also suffered considerable damage during the calamity.

We remain steadfast in our efforts to address immediate needs and assist those impacted in navigating the aftermath of this tragic event. Our team is engaged in a thorough assessment of the damage to facilitate quick repairs. Our medical personnel are working tirelessly to provide crucial aid and support to the Rohingya refugees affected by this disaster.

Embers and Ashes: Rohingya Refugees Confront Devastating Fire Incident

In this edition of our newsletter, we bring you a poignant video that offers a window into the trials faced by Rohingya refugees following a catastrophic fire in March 2023. Our dedicated team members were at the epicenter of this crisis, providing crucial medical aid and logistical support and capturing the stories and urgent needs of those affected.

On the 5th of March, 2023, a ferocious inferno decimated the Balukhali camp in Ukhiya, within the Cox's Bazar district of Bangladesh. This resulted in a staggering 12,000 displaced Rohingya individuals left without the security of their homes. Responding swiftly to this crisis, members of HAEFA launched into action to treat burn victims and spearhead the reconstruction of destroyed shelters. In the wake of the fire, nearly 2,000 shelters were laid to waste, including mosques, health centers, and schools.

We implore you to watch, engage with, and share this video, amplifying awareness and garnering support for the Rohingya community during this trying period. Together, we can forge a profound difference!

Link: https://youtu.be/D9emi6cqU54

May 2023 Update: HAEFA's Comprehensive Healthcare Services in Bangladesh

Health and Education have provided the following healthcare services and initiatives for All (HAEFA) across Bangladesh:

  • Between November 2019 and April 2023, HAEFA screened 65,543 women (aged 30-60 years) for early-stage cervical cancer across nine Upazilas in Kurigram.

  • From July 2021 to April 2023, 43,506 women (aged 30-60 years) in six Upazilas of Cox's Bazar were screened for early-stage cervical cancer.

  • HAEFA extended free medical care to 272,728 Rohingya refugees and Bangladeshi nationals in Ukhiya, Cox's Bazar, between October 2017 and April 2023.

  • In Bhashan Char, Noakhali, 49,425 Rohingya refugees and local Bangladeshis on the island have received free medical care since November 2020.

  • Since 2022, more than 4,000 Bangladeshi nationals in Ukhiya have benefited from free medical services provided by HAEFA's Mobile Medical Clinics.

  • HAEFA's NCD-based Path Lab in camps 09 and 1w performed 10,320 diagnostic lab tests since January 2022.

  • In partnership with Project HOPE, over 6,000 healthcare providers underwent Mental Health Support and Resilience Training as part of the Train the Trainer (ToT) program.

  • An Advanced COVID-19 Clinical Management Certification course, jointly offered with DGHS, Brown University CHRHS, Project HOPE, USAID, and SCiB, has trained more than 3,000 physicians online via the DGHS, MoHFW website.

  • From 2019 to date, more than 40 students (grades six through twelve) from Bhawal Mirzapur Hazi Jamir Uddin School And College have been awarded annual merit scholarships. This initiative is a collaboration between HAEFA and the M A Malek Education Scholarship Foundation.

HAEFA's Unwavering Commitment: Comprehensive Healthcare for the Rohingya FDMN/Refugees

Since its inception in October 2017, HAEFA's dedicated healthcare professionals have unwaveringly provided complimentary medical care and medications to the Rohingya FDMNs. In April 2023 alone, we extended free healthcare and diagnostic services to over 5,020 individuals.

  • At Kutupalong (Camp 1W):

    • A total of 2,249 patients benefited from comprehensive healthcare services.

    • HAEFA's semi-automated NCD Pathological Laboratory performed 131 laboratory tests.

  • At Balukhali (Camp 09):

    • More than 1,494 patients received healthcare services.

    • Our semi-automated NCD Pathological Laboratory carried out 202 laboratory tests.

  • At the FDMN Rohingya Camp in Bhashan Char:

    • More than 1,285 patients availed themselves of the HAEFA Medical Check-Up and Treatment services.

HAEFA's Vigilant Efforts in Cervical Cancer Screening and Intervention

In the Kurigram District, HAEFA's vigilant initiative has empowered more than 680 women with cervical cancer screenings conducted at the Upazila Health Complexes (UHCs). Initial screenings revealed sixteen VIA-positive cases, leading to immediate referrals for comprehensive investigations and subsequent treatment.

In April 2023, HAEFA expanded its efforts to seven VIA centers (Sadar Hospital, MCWC, Ramu UHC, Moheshkhali UHC, Chakaria UHC, Pekua UHC, and Kutubdia UHC), conducting screenings for over 620 women. Fourteen cases tested positive during the initial VIA screening, prompting immediate referrals for detailed examination.

The team further coordinated a series of colposcopies at Cox's Bazar Sadar Hospital, resulting in eleven colposcopies and four thermocoagulations. Not losing sight of those already identified, the Cox's Bazar Project team maintained continuous follow-ups with previous cancer patients, facilitating their referrals to Chattogram Medical College and the National Institute of Cancer Research & Hospital (NICRH), Mohakhali, Dhaka, for advanced treatment and care.

HAEFA Newsletter Editorial Board

Editor: Nairita Ahsan Faruqui

Associate Editor: Raihana Mehreen

Associate Editor: Dr. Kaniz Ferdouse Mou

Contributors of the May Newsletter:

Sajia Haque

Brown Univeristy Students Host a Teach-In Panel

On Thursday, September 15, 2022, Brown University students organized and hosted an educational panel event titled “The Rohingya Persecution: A 21st Century Genocide trial”.  The event was moderated by Alex Jin and began with a brief overview of the crisis by Leyla Giordano and Madison Bates. This was followed by presentations from our experts, Dr. Abid and Dr. Cu-Uvin, who highlighted the persecution’s history, NIROG, and the cervical cancer screening program. The event concluded with a student panel featuring medical students Imshan Dhrolia and Logan Brich. They reflected on their research and experiences working with this population and responded to moderator and audience questions. 

Alex and Leyla organized the event with support from Kethu Manokaran. 

Thank you to everyone involved!

Dr. Abid speaking about HAEFA’s work

 

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