Icddr,b and UNICEF on Sunday jointly organised a dissemination seminar to highlight the activities of the project titled “Emergency Healthcare (Acute Watery Diarrhoea-AWD preparedness and response) and Sentinel Cholera Surveillance in Forcibly Displaced Myanmar Nationals (FDMN) camps and host communities in Cox's Bazar.”
The seminar was held at Long Beach Hotel, Cox’s Bazar and was attended by a diverse group of stakeholders, including government officials, development partners and NGOs.
Dr Baharul Alam, co-principal investigator and Head of Hospitals at icddr,b, presented the project's overview and informed about a rapid joint field assessment conducted by icddr,b and UNICEF after the Rohingya population fled persecution in Myanmar and sought refuge in Bangladesh in August 2017.
The project aims to prevent diarrheal outbreaks through disease surveillance, treatment, capacity building and vaccination. icddr,b established five diarrheal treatment centres (DTC) in Teknaf with UNICEF's support, which helped manage an AWD outbreak in September 2019.
Since 2018, icddr,b has trained 2,000 healthcare providers with the collaboration of UNICEF and the World Health Organization (WHO).
The Leda DTC continues to operate, treating around 3,500 patients yearly and participating in the joint assessment team led by WHO.
Dr ASG Faruque, emeritus scientist at icddr,b presented the findings of the DTC-based diarrhoeal diseases surveillance and informed that FDMN children had shown significant improvements in stunting, underweight, and wasting.
Over the last five years, chlorinated tap water, use of toilets, ORS and vaccination coverage have also increased significantly in the Rohingya communities.
Dr Ashraful Islam Khan, Scientist at icddr,b presented on the cholera sentinel surveillance, which has been underway in partnership with the Institute of Epidemiology, Disease Control and Research (IEDCR) and supported by UNICEF.
He informed that the surveillance has been instrumental in finding appropriate strategies and providing necessary directives for controlling cholera outbreaks in the camps.
Dr Firdausi Qadri, Acting Senior Director, Infectious Disease Division at icddr,b, presented the success of oral cholera vaccination campaigns in a complex humanitarian crisis setting in Cox's Bazar. She informed that seven rounds of cholera vaccination campaigns in the Rohingya camps have resulted in high levels of coverage, reaching 100% in some settings.
About 900,000 Rohingya people received 3,765,499 vaccine doses, and 528,297 individuals living in close proximity to the FDMNs in the host communities received 895,688 doses of OCVs.
The vaccine was well accepted, demonstrating the feasibility of delivering oral cholera vaccine (OCV) in complex refugee settings.
She said, “These oral cholera vaccination campaigns among Rohingya and the host population have been successful in preventing cholera outbreaks and epidemics in the area, as evidenced by the absence of major outbreaks. This has been achieved by the dynamic leadership and support from RRRC, CDC-DGHS, IEDCR, WHO, UNICEF, and other partners.”
The presentations were followed by remarks from Dr Mainul Hasan, Health Specialist at UNICEF and Dr Jorge Martínez, WHO, Cox’s Bazar, as well as speeches from special guests, Dr Md Mahbubur Rahman, Civil Surgeon, Cox's Bazar and Mohammed Miznur Rahman, Refugee, Relief and Repatriation Commissioner, Government of Bangladesh, and the Chair Dr Tahmeed Ahmed, Executive Director at icddr,b.
Dr Hasan appreciated icddr,b and said, “UNICEF is proud to be a part of this successful journey of controlling acute watery diarrhoeal disease in the Rohingya setting. The works need to be continued, and we believe we will be able to keep the diseases checked together.”
Dr Martinez, in his address, highlighted the importance of disease surveillance, vaccination and other measures and requested icddr,b to explore ways to help strengthen local capacities in Cox’s Bazar for rapid diagnosis of diseases.
Dr Tahmeed Ahmed commended the collaborative efforts of the government and development partners, stating, "The collaborative effort not only prevented any diarrhoeal outbreaks from occurring and saving lives, but it also generated a great deal of evidence that will be useful in other parts of the world for managing humanitarian crises."
Despite the success so far, it is clear that sustained efforts are needed to prevent future outbreaks in the camp settings. Along with vaccination, strong and sustainable water, sanitation and hygiene intervention, a comprehensive surveillance system, and proper case management are necessary to prevent diarrhoeal outbreaks in humanitarian crisis settings.
The successful vaccination campaigns demonstrate the importance of a multi-sectoral approach in addressing the complex health challenges faced in refugee camps.
The partnerships and collaboration between humanitarian organisations, local authorities, and the community have been essential in achieving these results.