What is NIROG?

NIROG was originally created to track and improve the health of Bangladesh factory garment workers, but with the escalation of the Rohingya refugee crisis in 2017, the tablets have been further optimized to use solar powered batteries and to function without constant internet connection. This makes NIROG accessible in remote and rural locations like the Rohingya refugee camps, where the tablets are used offline to collect patient information and are then brought to a nearby town to upload data onto a secure and password protected database that authorized healthcare providers can reference. NIROG provides role-based (layered) access to health professionals for added security. From the health care centers in the Rohingya refugee camps and in the mobile clinics of the garment factories, NIROG securely sends their patients’ medical data to the databases of the Directorate General of Health Services (DGHS), a division of Bangladesh’s Ministry of Health and Family Welfare (MOHFW). This data collection is particularly significant for the Rohingya population, as their health data collection ended in 1982 when Myanmar stripped the ethnic group of citizenship and legal identity (Lifespan).

With the outbreak of the COVID-19 pandemic, NIROG has continued to prove itself essential through its usage to track the spread of COVID-19 in the refugee camps.

NIROG’s built-in systems prevent drug-interaction by making suggestions for contraindicated drugs, making the technology uniquely safe in emergency situations. NIROG is also capable of two-way communication between medical personnel and patients. After RMG workers are screened at their worksites, medical professionals send texts to the patients informing them of diagnosis results and of when the medical team will return to the factory for follow-up care. Patients can also update basic health measures such as blood pressure by sending in a text with their most recent information. This update is programmed to be included in their NIROG profile.

On the EMR tablets, the NIROG software uses the WHO’s current medical classification, the Tenth Revision of the Internal Classification of Diseases (ICD-10), to diagnose and standardize treatment and management protocols for non-communicable diseases. In particular, HAEFA focuses on treating patients suffering from hypertension, diabetes, malnutrition, chronic obstructive pulmonary disease, high-risk pregnancy, anemia, infectious diseases, and cancer.

Empowered with NIROG, HAEFA’s medical teams have provided health screenings, diagnoses, treatments and follow-ups to more than 30,000 RMG factory workers since 2013 and for over 145,000 patient visits from Rohingya refugees since October 9, 2017.

While NIROG is currently used exclusively by HAEFA, several organizations including the Coordination Cell and IOM have expressed interest in using the technology in their health centers as well. Lifespan reported, “Abid was recently approached by other nonprofit and government organizations that provide care in remote regions, and he is collaborating to share the technology free of charge, viewing it as a public health tool rather than an enterprise.”

How do we operate?

When HAEFA’s team arrives on-site, all workers or patients are given an initial screening. This confidential screening includes basic identification (date of birth and gender) and health information (height, weight, vital signs such as blood pressure, blood glucose levels, hemoglobin levels, and heart rate). A medical professional will ask about their health histories including chronic conditions, traumas, illness, infection, injury, and reproductive information. Patients are screened for health behavior patterns, such as smoking and dietary habits, and are also asked about an extensive list of symptoms that can alert our healthcare professionals to conditions such as tuberculosis, typhoid, and heart failure that would require treatment or careful monitoring.

Patients are then given a confidential physical exam, and any impressions and diagnoses are recorded along with treatment recommendations. Our mobile team for initial on-site screening consists of 12 healthcare workers and paramedical staff and 6 physicians. Every hour, 40 workers can receive an initial screening. Afterwards, 2 health workers and 1 physician perform monthly follow-up visits to monitor patients with diagnoses and pregnancies. These patients are scheduled for appointments with healthcare professionals as needed. Pregnant women receive check-ups once a month and then, after reaching weeks 24-26 of the pregnancy, once every two weeks. If complications arise, patients can visit healthcare workers more frequently.

Because this is not a “one and done” program, each patient receives a healthcare card and unique ID number linked to their confidential electronic medical record (EMR), stored in our data servers. Our physicians are able to access these records to help diagnose, monitor, and treat patients remotely. Factory employers are able to monitor treatments and prognoses and can also communicate with our healthcare professionals and health workers through email or mobile phone.

On-site healthcare professionals update EMR automatically through cellphone-based technology. They can also capture and send images and messages concerning symptoms, enabling remote physicians to review files, monitor treatment results, and change treatment regimen in real-time, if needed.

What do we provide?

Health Screening and Treatment

Non-communicable and Chronic diseases

HAEFA provides confidential on-site health screenings and treatment for:

• Diabetes

• Hypertension

• Trauma and injuries

• Arthritis

• Urinary tract infection

• Respiratory infection

• Skin lesions

• Cancer

• Gynecological conditions

• Asthma and chronic lung conditions

• Anemia

• Mental health conditions

• Substance abuse

Maternal Care

By providing high quality ante-natal care, we can reduce the risk of neonatal deaths and decrease the infant mortality rate.

Our on-site health care delivery system includes:

• Ante-natal care

• Routine ante-natal visits and screening for high-risk pregnancy (preeclampsia)

• Screening and treatment for diabetes

• Screening and treatment for hypertension

• Screening and treatment for anemia

• Screening and treatment for STDs

• Screening and treatment for injury or trauma

• Health education and nutrition of pregnant mothers

• Health screening and immunizations

• Safe-delivery practices

• Post-natal care for mother and child

• Family Planning

In addition, HAEFA’s program includes:

• Child day care

• Nutrition education

• Childhood immunizations

• Tetanus vaccinations for adults 

Immunization Program

HAEFA promotes the immunization of children against illnesses that prevent healthy growth and development. Adults also require immunization against tetanus, influenza and pertussis (whooping cough).

Our on-site health care delivery system includes providing immunizations on the recommended schedule for:

• Tetanus toxoid

• Pertussis/Whooping Cough 

• BCG

• Mumps

• Measles

• Rubella

• Chicken Pox

• HPV

• Flu 

Supplements and Deworming

HAEFA recognizes that parasitic infestations are very common problems in conditions of poverty and unsanitary facilities.

Our on-site health care delivery system includes:

• Deworming

• Iron tablets

• Folic acid supplements

• Pre-natal supplements

• Vitamin A supplements

Feminine Health and Education Hygiene

Our health care team provides on-site feminine health and hygiene education and materials.

We provide:

• Alternative menstrual management products

• Family planning education and materials

• Health and nutrition education for pregnant mothers

Nutrition and Health Education

Through education and better health, we intend to break the cycle of poverty, uplifting living conditions for industrial workers and slum dwellers. By making small improvements through nutrition and health education, HAEFA is making sustainable improvements in the lives of garment workers. 

Our health care team provides on-site Health and Nutrition education discussing:

• Drinking water safety

• Nutrition: creating a balanced diet with limited resources

• Occupational safety

• Personal and feminine hygiene

• Relief and rescue

On-Site Training Workshops and Programs are arranged for:

• Local medical, emergency, and paramedical workers and volunteers

• Health educators

• Community Health Workers (CHW)

• Medical and emergency workers

• Administrative and management authorities

On-Site trainings and workshop topics include:

• Health education on breastfeeding exclusively for 5 months, weaning food at 6 months

• Growth monitoring for children under age 3

• Vitamin-A capsule & deworming tablet distribution for children under age 5

• Family planning support and information

• Immunization for children under age 1

• Ante-natal care

• Immunization for pregnant women and adolescent girls

• Post-natal care

• Vitamin-A capsule distribution for post-natal period

• Safe delivery methods and protocols

• Nutrition education focusing on pregnant and lactating mothers

• Water, sanitation and hygiene education

• Health screening methods for anemia, hypertension, diabetes, asthma, high-risk pregnancy, and tuberculosis