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Rohingya Refugee Crisis in Cox’s Bazar District, Bangladesh: Health Sector Bulletin No. 15, Reporting period: April to June 2021

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Situation Report
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1.4M PEOPLE IN NEED

889,708 REFUGEES

1.4M PEOPLE TARGETED PARTNERS

80 PARTNERS

HIGHLIGHTS HEALTH SECTOR

  • In Bangladesh overall, quarter two was characterized by a surge in COVID-19 infections. Similarly, a significant surge in infections was recorded in the Rohingya refugee/Forcibly Displaced Myanmar Nationals (FDMN) camps.

  • Among the Rohingya refugees, 1,368 (47 percentfemale, 53 percent-male) new infections were recorded during the reporting period, compared to 74 in the first quarter. Testing rate increased by 29 percent due to an increase in testing sites and use of Antigen Rapid Diagnostic Tests (Ag-RDT) in some facilities.

  • Health sector partners, at the request of government, scaled up operational capacity at the 11 Severe Acute Respiratory Infection Isolation and Treatment Centres (SARI ITCs) in the refugee camps.
    They activated 87 additional COVID-19 case management beds, bringing the total to 572 beds by the end of June. In addition, approximately 400 additional standby beds were available to be activated based on epidemiological indications.

  • A decline in Out Patient Department (OPD) consultation among Rohingya refugees and host communities was recorded towards the end of the quarter. Facility-based delivery rate sustained at 67 percent in June 2021. Month-by-month, utilization slightly declined, most likely due to movement restrictions related to COVID-19 control measures.

Situation update

As per UNHCR registration data, the Rohingya population in Cox’s Bazar campsis estimated at 889,704 people (52 percentwomen and girls, and 52 percent-children). Persons with disabilities constitute around one percent. The average household size is 4.7 persons per household

The second quarter of 2021 was characterized by an increase in COVID-19 infections. The increase was first observed among host communities followed by the camps where a rising infection was also observed by epidemiological week 14. Like elsewhere, COVID-19 infections in the camps rose dramatically in April and May 2021. The trend stabilized in June. Results for SARS-Cov-2 genomic sequencing for samples from the camps were not available as of the end of June. At national level, the Delta variant has been shown to play a significant role in transmission. With improved access to testing services due to increased sentinel sites, from 33 to 35, and use of Ag RDTs, more cases and contacts were identified. In quarter two, 14,427 (47 percentfemale, 53 percent-male) tests were conducted amongst the Rohingya, up from 11,143 in the first quarter.

By the end of June, partners supporting SARI ITCs (UNHCR/RI, UNHCR/FH/MTI, IOM, SCI, MSF, UNICEF/ICDDRB, Hope Foundation, IFRC/BDRCS) had expanded total active bed capacity to 572. While bed occupancy peaked in June with individual SARI ITCs at times reaching 90 percent, the majority of the SARI ITC admissions were mild cases. Another 10 to 13 percent were moderate and seven to 10 percent were severe while over one percent were critical. These numbers indicate that home isolation, rather than institutional isolation for mild cases from both the Rohingya and host community would free up substantial bed capacity which could be focussed more on moderate and severe cases, in line with the national clinical case management guidelines. The Health Sector will continue to engage with stakeholders on developing this further. At present, home isolation for Rohingya/FDMN is not permitted.

Although cumulative quarterly OPD consultations have remained steady (835,672 in quarter one against 903,951 in quarter two), a monthly analysis showed a decline in May and June after a peak in April. Despite health services being exempted from movement restrictions, the trend suggests that other factors, likely including transportation and access issues, may be affecting health seeking behaviour. Unrestricted access continues to be required for all components of the health response. In addition, continued community engagement is needed to address information gaps and fears in a timely fashion.