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.

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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

HAEFA Commitment to Support Mental Health and Reduce Stigma

HAEFA, in collaboration with Project HOPE and partners at the National Institute of Mental Health, and BSMMU, Dhaka, has been implementing “HERO-BANGLADESH,” an online Mental Health and Resiliency Training of the Trainers (TOT) for frontline healthcare workers including physicians, nurses, paramedics of Bangladesh since November 2021.

This Mental Health TOT was inaugurated by the Honorable Minister Dr. Dipu Moni, MP, Ministry of Education on November 25, 2021. Other dignitaries present at the occasion were Prof. Dr. Robed Amin, Line Director, NCD, DGHS, as well as national mental health specialists Prof. Dr. Mohit Kamal, Dr. Mekhala Sarkar, and other mental health experts and enthusiasts from the USA and Bangladesh. The session was moderated by Prof. Dr. Ruhul Abid and other volunteer physicians, trainers, and management staff of HAEFA. This online, live, interactive training course has two modules: Module 1 : Overview of Stress; and Module 2: Management of Stress and Building Resilience.

It is a Free of Cost two-day course with two-hour per day, led by the mental health experts of BSMMU, NIMH, and volunteer physicians and enthusiasts of Bangladesh and the USA.

After completing both modules, trainers get a "Training Completion Certificate" and other training materials. Participants of the TOT will then conduct cascading trainings to share mental health resources within their networks. HERO-BANGLADESH is aiming to train 3,000 healthcare workers by April 2022.

The primary goal is to ensure this information is disseminated as widely as possible throughout Bangladesh.

As of April 2022, HAEFA and partners have trained 434 health care providers, public health and humanitarian workers, and other professionals as trainers for the HERO-Bangladesh Mental Health and Resilience curriculum in collaboration with project HOPE.

Through the ToT model, over 5,295 individuals have received cascading training. Thank you to the many partners (NIMH, BSMMU, DGHS, DMCH) who made this program a success!

Violent Repression of the Rohingya population officially recognized as genocide

In March 2022, U.S. Secretary of State Antony Blinken officially declared the violent persecution of the largely Muslim Rohingya population in Myanmar as genocide.

This is only the 8th instance since the Holocaust that the U.S. has declared the crime of genocide. In a speech at the U.S. Holocaust Memorial Museum, Blinken stated that this determination was due to Myanmar’s military brutal and systematic persecution of the ethnic minority, including confirmed accounts of mass atrocities on civilians.

The declaration was celebrated by human rights groups as they emphasized the necessity of the determination to be followed by concrete actions to seek justice and hold the Burmese military accountable for their crimes.

Bliken echoed this goal stating, “As we lay the foundation for future accountability, we’re also working to stop the military’s ongoing atrocities, and support the people of Burma as they strive to put the country back on the path to democracy.”

To learn more, click here and here

Dr. Ruhul Abid, nominated for the 2020 Nobel Peace Prize

Dr. Ruhul Abid, Associate Professor of Surgery (Research) at Brown University’s Warren Alpert Medical School, and his non-profit organization Health and Education for All (HAEFA) was nominated for the 2020 Nobel Peace Prize.

HAEFA provides humanitarian aid and free health care at Rohingya refugee camps. Ruhul Abid is one of 318 candidates in the world to receive a nomination for the 2020 Nobel Peace Prize for his nonprofit organization Health and Education for All. In 2020, the nonprofit has partnered with other organizations to combat COVID-19 in refugee camps.

Dr. Abid founded HAEFA in 2012 with the mission to “serve the underprivileged and displaced peoples and bring them under universal health coverage.” When covid first emerged in 2020, HAEFA shifted its efforts to provide emergency care within the refugee camps; over 70,000 U.S. dollars were raised to supply personal protective equipment to medical professionals working in Bangladesh, including over 10,000 KN95 masks and essential inhalers. The organization also distributed hygiene packets for high-risk refugees, cloth masks, thermometers, and toiletries.

Additionally, HAEFA collaborated with the Watson Institute for International and Public Affairs and Project HOPE, to develop the program “Training of Trainers” which provided three, four-day, online training sessions for COVID-19 competency.

Congratulations to Dr. Abid and all the incredible work he does!

To learn more, click here and here!

During Ramadam 2022, HAEFA Delivers Emergency Food Packages to 750 Families

Due to COVID-19 lockdowns and joblessness, 24.5 million people and almost 500,000 families went below the poverty line in Bangladesh in 2021. Like Ramadan in 2021, HEAFA and generous donors raised funds to deliver emergency food packages containing a 15-day food supply for families. Overall, HAEFA was able to help 750 underserved families in 5 districts of Bangladesh.

Thank you to all who supported this important cause!

Interview with Dr. Susan Cu-Uvin

Last January, Susan Cu-Uvin returned to the U.S. from Kurigram, Bangladesh, where she had been in the process of training hundreds of workers to perform cervical cancer screening and to provide some of the screenings herself. The 62-year old doctor joined Health and Education for All (HAEFA) in October 2019 in partnership with Dr. Ruhul Abid to lead the cervical cancer screening program in Kurigram, a district in northern Bangladesh. “Ruhul is relentless,” she laughed. “I am over-committed with many other countries, but he convinced me that there’s a lot of work that needs to be done in Bangladesh.”

Originally from the Philippines, Cu-Uvin did not plan to become a doctor. In fact, she asked her friends to not invite her to any career information sessions or talks because she thought it would not be inspirational. Coming from a conservative Chinese family, the expectation was that after completing her education, she would get married and have children. But Cu-Uvin did not want that. “I asked my mother, ‘After high school, what’s the longest possible course (of education) in the world?’ She said, ‘Medicine.’”

Cu-Uvin wanted to build on the healthcare services HAEFA already offered to garment factory workers throughout Bangladesh by adding cervical cancer screening. The program proved a success, leading to their successful application for a grant from the United Nations Population Fund. With the grant, the two doctors were able to  shift their focus and perform population-based screening, which allowed for follow-ups with patients and opportunities to improve the screening process. But with population-based screening, they also had to define a location to provide the services to. “I didn’t want to go and work in places where they already have cervical cancer screening access,” said Cu-Uvin. She thought, “Let’s choose a place… in Bangladesh where there are no current services right now.”

Kurigram, located in northern Bangladesh, is one of the poorest sub-districts in the country and had little to no cervical cancer screening available. Cu-Uvin and Abid were able to secure the grant for the district and moved forward with the initiative.

The population-based screening in Kurigram required a different approach than with the garment factory workers. Rather than waiting for women to go to the facilities, Cu-Uvin and Abid started a massive campaign, using field workers to go to the communities to help prospective patients learn about the importance of cervical cancer screening. “In low-income countries, (patients) come in with advanced cervical cancer,” Cu-Uvin said. “There is really nothing much more that you can do, except for palliative care, and it’s a death sentence for many of them.” The best course of action, she continued, is to identify those with pre-cancerous symptoms and treat it before it advances to cancer. But it is not easy to start a program from scratch.

Apart from carrying out training on how to utilize the technology and on communicating with patients, the two doctors had to ensure that the rooms had internet access and all the necessary materials, including tables and chairs. One of the locations was so far away that it required two flights, a three-hour drive, nearly two hours of travel by boat, and miles of walking to get there. “We had to hire a horse and a cart to carry all our supplies to reach the community where we were going to do the screening,” said Cu-Uvin. “It’s logistically very challenging, but it’s worth it.” The program in Kurigram was so successful that even with all the trained staff, they had to implement a limit of 200 patients per day.

With any project, Cu-Uvin noted, there are successes and failures. Recognizing the urgency of the Rohingya refugee crisis, Cu-Uvin and Abid wanted to bring the program to the camps in Cox’s Bazar, a city located on the southeast coast of Bangladesh. HAEFA had already been providing services to about 60,000 people in the community and had built a good reputation for primary care and prevention. Believing that their success with the garment factory workers and the communities in Kurigram would transfer over to the camps, they mapped the same program to the refugees. As before, Cu-Uvin ensured privacy for the patients. The room had no windows and a single fan was brought in to try to give some air flow. It began well. When they set up the facility and took in their first two patients, there had been a long line of women. But after the two, the line disappeared. “We forgot the difference in culture and messaging,” Cu-Uvin said. “It was a total failure… we had all our instruments, we had all the capability, but we didn’t get (the patients).”

With the screenings for the garment factory workers, it was successful in part because the female workers were financially independent, contributing money to the family, and were thus empowered to make decisions about their own health. In Kurigram, HAEFA had worked closely with the Surgeon General and community leaders, both of whom had large influence over the community. “In the Rohingya camps, we learned that we should have gone to the imam first,” Cu-Uvin said. “If we had the support of the imam, the imam would have gotten the support of the husbands, who literally control the lives of their wives.”

“We were too cocky,” she continued. “We thought that if we brought modern technology and experts, and (if) we offer free health care, that they would come, but we forgot all about cultural differences and… the little empowerment of the women in that setting.” Due to the ongoing health crisis with covid-19, Cu-Uvin and her team has not yet been able to return to the camps to offer the services again. Reflecting on the project, Cu-Uvin hoped that HAEFA will be able to utilize what it has learned to better market the program. “The successes are easy to take, but the failures are really the ones that will make you more successful,” she said.

Her resilience has carried through with her throughout her life. As with medicine, Cu-Uvin did not fall into her current specialty. After graduating from medical school, she wanted to be a pediatric surgeon. However, in the 70s and 80s, surgery was dominated by men. In one interview, the doctors refused to train her, citing that she would probably get married and never use her skills. “And that was the end of my interview,” said Cu-Uvin, “So I thought, what’s the next surgical specialty that would probably be more welcoming for me?” She found obstetrics and gynecology.

Her work extends beyond cervical cancer screening. In fact, much of Cu-Uvin’s research is on HIV. In the 80s, Cu-Uvin began receiving female HIV-infected patients. She was at a loss. When the epidemic hit, it was widely considered a disease that affected gay men and injection drug users, and much of the activism against HIV was on behalf of gay men. It was during this that Cu-Uvin met Charles Carpenter, a leading researcher of HIV and the founder of the first women’s HIV clinic in Rhode Island. “He said if it reaches gay men, if it reaches drug users, it will reach women,” said Cu-Uvin, “And nobody is studying women.”

Inspired by Carpenter, Cu-Uvin applied for the Rhodes AIDS Foundation grant to come to the U.S. to study with Carpenter for three months. The three months then turned into a three-year fellowship on HIV. It was a tough decision. At the time, her mentors in Ob-Gyn discouraged her, saying it would be the “death knell” of her career. There was no cure or vaccine for the disease, and most of the patients were dying in their 30s. The women who were pregnant were having abortions because it was not yet known how severe the mother to child transmission would be. “But Dr. Carpenter was very convincing, or I was stupid, naïve, or stubborn,” she continued, “I said, ‘Okay, death knell of my career, but I will take the fellowship anyway.’ And here I am, 29 years after, still doing HIV and women care.”

And she has done so. Apart from her work with HAEFA, Cu-Uvin is a professor of Obstetrics and Gynecology at the Alpert School of Medicine as well as a professor of Health Services at the Policy and Practice at the School of Public Health at Brown University. She is also the director of the Brown Global Health Initiative and the director of the Providence/Boston Center for AIDS Research. Even with all the accolades, Cu-Uvin still believes in the importance of following your heart. “It may be the wrong or the right thing,” she said. “As long as you can correct your course, that’s the most important thing… You have to go do what you want to do.”

Interview with Grants and Finance Director Mir Hushna

As one of Brown University’s 2020 iProv Summer Fellows with HAEFA, Ingrid Ren has worked as an accounting intern with the grants and finance director, Mir Hushna. Ingrid reflects on her summer of remote work and the plethora of phone calls that helped build a successful working relationship and made her feel connected to the work she was doing.

At our first Zoom meeting with HAEFA, volunteer coordinator Phoebe Keenan said to me, “Ingrid, Dr. Abid is really, really excited to have you on board to do tax and finance work for us this summer.” The other interns and I chuckled, amused at the dissonance between excitement and accounting work, but honestly, I was a little excited, too.

In my initial interview with Dr. Abid a month earlier, I had told him that my past work experience includes volunteering as an income tax preparer in Great Falls, Montana through the Tax Help Montana program. Intrigued, he said he wanted an intern to help work with HAEFA’s grants and finance director, Mir Hushna, to complete accounting work.

In an introductory Zoom meeting with Mir set up by Phoebe, I arrived late, having slept past my early morning alarm to accommodate for the fact that the three of us lived in three time zones across nine hours. Embarrassed of my state of fatigue and disarray, I kept my camera turned off, with only Phoebe visible, smiling happily at Mir and me. After explaining that my summer tasks would include reconciling HAEFA’s accounts ( matching up income and expenses from bank statements) and preparing an annual tax return, we reached a lull in the conversation. Simultaneously straightforward and generous in his wanting to be helpful, Mir said, “Ingrid, ask a question.” Caught off guard, I laughed nervously, which wasn’t a question.

Since that meeting, I have had many calls with Mir to give updates on my work progress. He ends every call by saying sincerely, “Any question you have, please ask me.”  Eventually, I asked about his past and learned about his professional experiences.

Mir grew up in Bangladesh and, although his father worked as an accountant for a manufacturing company, he never thought he would follow the same path. He told me, “I was always fascinated by operation and management jobs,” leading him to earn a Master’s in business administration. 

After graduating, he accepted a job at an international organization where he worked as an operations manager. The organization worked for the US Marines, leading a team of doctors and nurses to distribute food packages and medical assistance to an isolated island. Due to the inaccessible nature of the island, they had to constantly fly by helicopter to reach their various destinations. The first time he flew to the island, he remembers that all he could think about was the terrifying possibility that he could be abandoned there with no way to leave. But as a young, recent graduate, he also loved the challenges. He repeatedly described his experiences with the job and of riding in helicopters as thrilling, laughing reminiscently almost in disbelief at his past, in the way that adults do when wrapped up in nostalgia. When this organization’s accountant resigned, Mir took over as finance manager and was surprised to find that the position suited him well. 

In 1996, Mir immigrated to the United States where he found work through a temp agency with MCI Communications, at the time AT&T’s competitor, to reconcile accounts. In 1998, when MCI was acquired by Worldcom, Mir took a job working with the American Red Cross’ disaster accounting unit. Since then, he has expanded his work experience with non profits, worked as a CFO, been an overseas finance manager, provided specialty knowledge in nonprofit grants and contracts, and audited federal grants for USAID internationally.

In 2014, an uncle of a friend who was a board member with HAEFA reached out to Mir. At the time, HAEFA had only been founded two years prior, and they needed help with financial and grants management, leading Mir to begin working with HAEFA.

Finally, I asked Mir if his experience managing personal finances and those of nonprofits has given him insight to provide financial advice. “Yes, of course,” he said emphatically. “First, understand exactly what you’re going to do with your money. This is your hard earned money, and you can’t jump without knowing what’s below. Second, have a budget. If you don’t have the capacity, don’t do it. If someone asks for $100,000, and you only have $80,000, then give $60,000.”

Aside from supporting HAEFA’s financial side, Mir is constantly busy. Dr. Abid, laughing good-naturedly, had told me in my initial interview, “Sometimes he disappears.” Currently living in Atlanta, Georgia, he operates a grocery store as well as a meat processing factory, and he manages finances for an Arizona-based organization.

Sometimes, Mir and I have up to five quick phone calls in one day to make sure we are on the same page and, of course, to ask and answer questions. But in the moments between our work talk, he has shown me small details from his personal life that make him seem more real and more tangible, despite the remoteness of the work. At one point, during an evening phone call, he put his son, a rising high school senior who hoped to volunteer with HAEFA, on the phone to talk to me briefly about my current work experience. Afterwards Mir thanked me, saying in a very dad-like manner, “I just saw him there walking around.” 

In other instances, he asks me about the weather where I live in California or tells me that he spent one and a half hours earlier that morning working in his beloved garden. He tells me the story of working as a grants auditor in Angola, where in order to learn sufficient Portuguese for a presentation, he went to live in a rural part of the country for a month where few spoke English. He keeps me updated on his local businesses, informing me that he’s in the process of developing an online platform to streamline deliveries for his grocery store and that he needs to check in on the meat processing factory in preparation for the upcoming Muslim holiday Eid al-Adha.

Mir is always gracious, thanking me for easing his own workload and encouraging me by saying, “Fantastic” when I take a chance and share a new idea. He makes it clear that this is a team effort. 

Despite the distance and the fact that I will likely never meet him in person, our frequent phone calls help me get to know Mir and feel connected to my work. In the age of Zoom and remote technology, phone calls have begun to replace my comfort for texting by giving me a chance to rest my eyes and breathe. 

URGENT: COVID-19 in Rohingya Refugee Camps

COVID-19 Inside the Rohingya Refugee Camps

Two cases of COVID-19 were confirmed in the Rohingya camps on May 15th, 2020. 1,900 Rohingya refugees are being isolated for testing. HAEFA and other aid agencies are doing everything they can to curb a massive outbreak of COVID-19 in the camps, but the conditions in the camps make this nearly impossible. ⁣

The virus is already spreading in the largest refugee camp in the world. As of May 18th, there are now six confirmed cases of COVID-19 in the Rohingya refugee camps. This number may be underestimated due to lack of testing.

To add to this devastation, Super Cyclone Amphan is currently approaching Bangladesh from the Bay of Bengal. The super cyclone is due to sweep through the Cox’s Bazar region on May 20th, putting the local population and the 1+ million Rohingya refugees in a region vulnerable to landslides in serious danger. ⁣

To contribute to HAEFA’s COVID-19 response, you can donate at haefa.org/donatetohaefa. Donations support funding PPE for our healthcare workers in the Rohingya camps. Donations are matched by a Geneva-based company up to $10,000, so for every $1 you donate, $2 will go towards protecting Rohingya refugees from COVID-19!

HAEFA responses in Rohingya camps

Content written by Students for HAEFA, Phoebe Kennan and Jenna Mullen.

Training-of-Trainers Program in Collaboration with Brown University and Project Hope

HAEFA’s COVID-19 Training-of-Trainers

In response to the COVID-19 pandemic, Brown University undergraduate Jenna Mullen sourced and coordinated a 4-day COVID-19 training program for healthcare workers administered by Brown University and Project HOPE, facilitated by HAEFA. Utilizing a Training of Trainers model, 75 healthcare workers in the camps and in Dhaka from over 20 different organizations were directly trained. The next wave of training facilitated by HAEFA will prepare 3,000 healthcare workers to combat COVID-19 efficiently and protect themselves.

HAEFA partnered with Brown University's Watson Institute and Project HOPE which recently collaborated to develop a COVID-19 training program for health workers in high-risk countries. Project HOPE previously provided support to frontline workers in China, North Macedonia, Kosovo, Colombia, Indonesia and Ethiopia. Project HOPE was one of the few humanitarian organizations with a response team on the ground in China. HAEFA’s healthcare workforce received this training along with health workers from 20 distinct organizations. HAEFA’s physicians, MATS, midwives, lab technologists, health workers, IT, project coordinators, and the COO all participated in the training. This COVID-19 ToT training was conducted online for Ukhiya and Cox's Bazar government and non-governmental physicians, nurses and other health workers (as well as 8 Divisional Advisors, Bangabandhu Sheikh Mujib Medical University (BSMMU), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDRB), National Heart Foundation (NHF), Kurmitol Hospital, and Kuwait Bangladesh Hospital).

Training taught and evaluated core competencies, including biology and transmission mechanisms; infection prevention and control; contact tracing; screening and triage; diagnosis and management; stabilization and resuscitation; health facility operations and surge capacity; and risk communication and public health messaging. The program used the Training-of-Trainers model to engage master trainers and coach new trainers.  

The ToT training was a 4-day program, including 3 hours per day, administered via Zoom. Training was conducted the week of the 19th of April starting at 6pm Bangladesh Standard Time (according to overall group preferences).

The schedule for the program was as follows:

Day 1– Monday, April 20, 2020

7am EST– Intro/ Background Module (Presented by Dr. Foggle)

8am EST– IPC (Presented by Dr. Foggle)

9am EST– Case Exercise (Presented by Dr. Foggle)

Day 2– Tuesday, April 21, 2020

7am EST– Surveillance (Presented by Dr. Karim)

8am EST– Screening/Triage (Presented by Dr. Karim)

9am EST– Case Exercise (Presented by Dr. Karim)

Day 3– Wednesday, April 22, 2020

7am EST– Stabilization/Resuscitation (Presented by Dr. Aluisio)

8am EST– Diagnosis/Management (Presented by Dr. Aluisio)

9am EST– Case Exercise (Presented by Dr. Aluisio)

Day 4– Thursday, April 23, 2020

7am EST– Surge Capacity (Presented by Dr. Aung)

8am EST– Risk Communication (Presented by Dr. Aung)

9am EST– Case Exercise (Presented by Dr. Aung)

We hope this program will exponentially increase the number of healthcare professionals are trained and prepared to deal with this crisis and reduce its impact in Bangladesh.

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Population Density in Rohingya Refugee Camps

 

Population Density Comparisons

 
 

 

Rohingya refugee camps are 6 times more dense than New York City, the densest city in the US. This dramatic difference is further exacerbated by the fact that Rohingya shelters only have one floor compared to high-rises prevalent in major US cities. In Rohingya camps, on average, 6 people share a single room in a  shelter/ home. Flattening the curve in refugee camps will be ineffective due to these conditions. COVID-19 will spread through the population extremely quickly, the already limited health force will be overwhelmed and mortality rates will be extraordinarily high.⁣

 

⁣Please consider liking and sharing our page or donating if you can (http://haefa.org/donatetohaefa). ⁣

 

A Geneva based company will be matching all donations up to $10,000 so for every $1 you donate, $2 will go towards protecting Rohingya refugees from COVID-19!⁣

Graphics designed by Brown University Student, Jenna Mullen. Content written by Students for HAEFA, Jenna Mullen and Phoebe Kennan.

Vulnerability of Rohingya refugees to COVID-19

UPDATE: The first case of Coronavirus was confirmed in Cox’s Bazar, dangerously close to the refugee camps where HAEFA operates. A disastrous mass outbreak is quickly approaching the camps, with consequences for over a million vulnerable refugees living there.

Rohingya refugees have high rates of non-communicable and chronic diseases which put them at high risk for COVID-19 severe illness, hospitalization and mortality.

  • In 1983, the Myanmar Citizenship Law stripped Rohingya people of their citizenship. This means that the Rohingya have been denied healthcare for nearly 40 years.

  • 22.8% of the Rohingya refugee population in the Cox’s Bazar refugee camps is considered “at-risk,” translating to nearly 200,000 "at-risk" people living in under 13 square kilometers.

  • Underlying conditions such as respiratory infections, hypertension, diabetes, and age above 65 years increase the risk of COVID-19 severe infection, hospitalization and mortality.

HAEFA’s medical professionals have been working hard to support this population, but a COVID-19 outbreak in the camps would be devastating. We need to protect these healthcare professionals– the first responders in this crisis– with protective equipment and gear. If these workers become sick, it will have devastating consequences for the health of the Rohingya population and the containment of COVID-19.

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HAEFA’s medical staff urgently need funds for gloves, masks, and protective equipment to care for the Rohingya community in Bangladesh. To support their work and help combat the spread of COVID-19 in the largest refugee camp in the world, donate today at http://haefa.org/donatetohaefa.

Graphic designed by Brown University undergraduate, Jenna Mullen. Content written by Students for HAEFA, Jenna Mullen and Phoebe Kennan.

HAEFA's response to COVID-19

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Above is HAEFA’s referral pathway for COVID-19 patients within the Rohingya refugee camps, and images from a factory in Dhaka that is preparing small scale PPE gown manufacturing for Bangladesh because worldwide production is not meeting the demands.

HAEFA’s healthcare professionals are working to reduce transmission of COVID-19 within the Rohingya Refugee camps and to screen, test, and refer patients who are symptomatic. The Rohingya camps are extremely vulnerable to the spread of COVID-19 due to overcrowding, unhygienic conditions, and poor nutrition.

HAEFA is raising money for buying PPE for the medical professionals who are taking care of the ICU/Quarantine Patients, and N95 masks for the regular medical professionals (including doctors, nurses, medical assistants, and ward boys) who are taking care of the admitted and out-patients in the hospitals, clinics, and in the Rohingya refugee (FDMN) camps in Bangladesh.

Today HAEFA has procured 500 N95 masks in Dhaka which will be distributed as follows: 300 to Dhaka Medical College Hospital, the largest hospital in the country, and 200 to HAEFA medical teams in the Rohingya camps. We have placed orders for 5000 N95 masks from Shenzhen China to be shipped from Hong Kong to Dhaka by March 31.

You can become a supporter and help HAEFA protect the medical professionals of Bangladesh– the frontline fighters to save lives during this coronavirus pandemic!

Your donation of $6 will buy 50 pairs of hand gloves, $20 can help purchase 10 N95 masks, and $25 can help purchase 1 full set of PPE (including gown, mask, cap, protective goggles, and shoe covers).

Bangladesh Development Initiative (BDI) International Conference

On March 22, 2019, our co-founder, Dr. Ruhul Abid, represented HAEFA at the Bangladesh Development Initiative (BDI) International Conference, which took place at Yale School of Management. BDI is a USA-based non-profit organization and takes a broad view of development and includes professionals from various disciplines who are involved in supporting social development initiatives in Bangladesh. The BDI 2019 conference featured critical thinkers, change makers, thought leaders, young scholars, experienced educators, eminent journalists, lawyers and human right activists, development specialists, NGO representatives, practitioners, and students. The goal of the conference was to create an inviting space for discussions on diverse issues that are relevant to the future development of Bangladesh.

This year, the conference included a plenary session on the Rohingya refugee crisis, a humanitarian disaster that has affected Bangladesh on many fronts, central to our focus at HAEFA. As part of the crisis, Bangladesh has hosted today nearly a million oppressed and desperate people from neighboring country Myanmar.

Dr. Abid was a panelist for the discussion titled, “Multiple Perspectives on the Rohinga Crisis.” During his presentation, Dr. Abid provided an overview of the two 22-member teams that have been serving in Kutupalong (Camp 1W) and Balukhali (Camp 9). Dr. Abid informed the audience that the total patients seen to date are more than 78,000 through the on-site mobile health care delivery system. He also explained the sophisticated cell phone-based m-Health and electronic medical record (EMR) software to coordinate screening test results, diagnosis, and treatment regime with HAEFA physicians. The panel concluded with a Q&A discussion. For more information about the 2019 BDI conference, please visit the BDI website