A combination of cyclone Amphan, monsoon rains and the Eid festivities have hindered operations in Bangladesh’s Cox’s Bazar, limiting the development of much-needed support facilities for COVID-19, according to HelpAge International.
The monsoon season means that the camps are being hit by heavy rains whilst preparing for the weekend’s Eid festivities, slowing COVID-19 preparations at a time when the virus is starting to spread in the camps, exposing older people to risk.
“The combined impact of Cyclone Amphan, seasonal monsoons and the Eid festivities have seriously delayed COVID-19 preparation in Cox’s Bazar, putting thousands of older people at risk. There are inadequate isolation and quarantine facilities in the camps where over-crowding means that older people are simply unable to self-isolate,” said Jahangir Alam, country director of Bangladesh for HelpAge International.
“Eid is normally a spiritual time for celebration and community, when families come together to celebrate. 2020 is very different and is traumatising older people who are under stress, unable to self-isolate in the camps and struggle to access the support services they would normally rely on because of the coronavirus lockdown.
“Many older people suffer from chronic diseases and are particularly at risk. They need access to medicine, health screening and nutritious food and should not be put at further risk by having to travel around the camp to try and access this.”
Impact of Cyclone Amphan and Seasonal Monsoons
Many Rohyinga houses were destroyed or partially damaged in 34 camps in Cox’s Bazar when Cyclone Amphan hit on the night of 20/21 May.
Every monsoon season always creates a huge challenge for the home support services HelpAge provides for older people, but this has been made much harder in 2020 because of the restrictions caused by the COVID-19 lockdown.
Humanitarian agencies have been quick to engage in repairing and rebuilding temporary shelters, but continuous monsoon rains are expected, testing the frail structures and exposing more people to risk and unable to self-isolate.
Increase in cases
Cox’s Bazar has gone from zero to 13 positive cases of COVID-19 within a week – but limited testing facilities mean the number could be much higher.
Lockdown and isolation are very hard to enforce in such an over-crowded space which is problematic when the numbers are going up. If positive cases continue to rise, there is a very real likelihood that the authorities will increase restrictions on those entering the camps which will create significant challenges for older people to access humanitarian services.
In spite of the heavy rains and the threat of Cyclone Amphan, people have been crowding into the markets to buy food and goods for the Eid celebrations.
This has made it impossible to enforce physical distancing in the markets next to the camps at a time when COVID-19 is starting to spread.
Many of those working for humanitarian agencies have returned to their families for Eid but they will be expected to go into quarantine for 14 days on their return, slowing down any COVID-19 preparations.
At the beginning of COVID-19 outbreak in Bangladesh in mid-March, the Government suspended most of the services apart from emergencies such as health, nutrition, food and fire wood. Eid festivities have limited the deliveries of these vital services and supplied that are needed in the camps.
There is not enough capacity for testing for COVID-19 in the camps so the number of positive cases may be much higher than is currently reported.
From a population of one million Rohingya refugees and 300,000 Bangladeshis, no more than twenty people a day can be tested in two booths run by MSF and the government.
The World Health Organisation and other agencies have committed to opening another three testing booths but this will still limit testing to a maximum of fifty people a day which is disproportionate to the size of the population and will not be enough if the virus starts to spread more rapidly.
Many older people cannot access the testing facilities, especially if they have mobility issues, and it is difficult for them to queue. As such, there needs to be facilities for testing in people’s homes.
Isolation and Quarantine
With an average of five to six people living in every house or shelter in the Cox’s Bazar camps, it is simply not possible for older people to isolate themselves at home.
There are, however, insufficient isolation and quarantine centres in the camps for the scale of threat posed by the virus. Many humanitarian agencies are struggling to build more isolation and quarantine centres in the camp area and work has been delayed because of cyclone Amphan and the Eid holidays.
Many older people are also worried about discrimination if they have to go into isolation and they are concerned that they won’t be able to access their medicines for their chronic diseases and will lose access to their carers.
Insufficient Home Support for Older People
HelpAge provides services for older people in six of the Rohyinga camps, delivering medicine, nutritious food supplements, medication and psycho-social support to people in their homes.
The usual delivery of hot meals to older people by HelpAge has had to stop since lockdown was introduced two months ago, leaving many older people suffering from acute malnourishment.
Most of the older people in the camps suffer from chronic disease and rely on home-based outreach services to deliver medicine and psychosocial support. Their mental health is often at risk and it is virtually impossible to provide support services during lockdown to older people who usually do not even access to mobile networks or the ability to access online health services.
HelpAge International works with older people in six of the Cox’s Bazar camps and has secured funding from the UK Department for International Development to protect older people during the COVID-19 pandemic. All HelpAge staff have remained on site during Eid so that they will not have to go into quarantine and can continue to provide much-needed support to older people.