Author: Chonchol Mahmud

HAEFA Newsletter – October 2021

Cervical Cancer Screening


Kurigram: 
  • In 9 UHCs of Kurigram, a total number of 5500+ patients were screened. VIA-positive patients were treated.
  • The HAEFA team was proud to see their work in action when chemotherapy was started on the first patient with advanced lesion in Dhaka this month.

Cox’s Bazar:

  • In 5 VIA centers of Cox’s Bazar, a total number of 1700+ patients were screened.
  • Among the VIA-positive patients, 11 patients were referred  to Cox’s Bazar Sadar Hospital for further investigation and treatment.

Online Training on VIA Counseling

  • The HAEFA Cox’s Bazar team organized an online training on VIA Counseling for their newly joined eighteen Community Health Facilitators (CHF) on 28 September, 2021. 
  • The CHFs were trained with background knowledge of the local community, cervical cancer etiology and benefit of early diagnosis for better VIA Counseling and Community Mobilization.
  • The training was attended by the Project Coordinator and other team members of the HAEFA project team in CXB.

Mental Health & Resiliency Support for the Healthcare Workers of Bangladesh

 
  • HAEFA has been planning to provide mental health support to the frontline healthworkers including physicians, nurses and midwives of Bangladesh in collaboration with the Project HOPE and HERO-NY from October 2021 through April 2022. 
  •  This Training of the Trainers (ToT) Mental Health and Resiliency Training will have three modules that have been contextualized to the perspetive of Bangladesh under the guidance of Prof. Dr. Mekhala Sarker and mental health postgraduate trainees.
  • Master trainers will conduct two to four monthly training sessions beginning in October 2021 through March 2022 to train and help cascading secondary training to 3,000 healthcare workers by April 2022.
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Joint Response Plan, Cox’s Bazar: Protection Mainstreaming Training

  • In line with the 2021 JRP and the objective of ensuring age, gender and diversity approaches, WHO/Health Sector and Protection Working group jointly took the initiative and conducted Protection Mainstreaming training targeting HS partners for ensuring integration of protection principles and standards within the scope of sectoral response plans.
  • The management team of HAEFA and Operations Department took the training and attended the two-day summit which started from 26th September, 2021 at Hotel Seagull, Cox’s Bazar along with more than twenty national as well as international NGO’s Program Manager, Technical Manager, Project Coordinator, Project Heads and Program Heads.

Supporting 20-Bed Hospital in Bashan Char

  • Since Noivember 2020, HAEFA has continued to provide medical treatment, including free medicine to the FDMN patients from 9:00 am to 2:30 pm at the HAEFA Medical Center located at shelter 66 in Bhasan Char. In September 2021, HAEFA provided medical treatment and free medication to 1596 FDMN patients.
  • In addition to that, from March 19, 2021, HAEFA has started providing medical support via its physicians, paramedics and pharmacists in the Only 20-bed hospital in Bhashan Char
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RMG Inclusive Business Program in Sept. 2021

  • HAEFA team attended the Sharing and Learning session of Ready Made Garments (RMG) Inclusive Business Program, hosted by SNV Netherlands Development Organization on September 28th, at Le Meridian Hotel.

Online “Advanced COVID-19 Clinical Management Certification Course”:

  • This 3-hour online interactive clinical course is becoming popular among the physicians of Bangaldesh who serve at the forefront of the COVID-19 pandemic
  • Since June 2021, 1,995 physicians have registered for the online course 821 physicians completed the MCQ test, and 416 doctors passed and achieved the certificate (jointly issued by the DGHS, Brown University’s CHRHS, Project HOPE, HAEFA, USAID and SCiB) as of September 29, 2021.
  • Two promotional videos, one around 2-min and the other around 5-min in length, are being prepared for publicity of the course.
  • Another version of the improved and revised web design (UI/UX) of this online course will be completed in October 2021.

New HAEFA Diagnostic Path Lab in Balukhali

  • 7-day Onsite training of HAEFA’s two Clinical Laboratory Technologists was completed by the Technical Assistance and Support of LABAID Diagnostics (Main Branch) Laboratory in Dhaka this month.
  • This Diganostic LAB, with a major focus on Non-Communicable Disease (NCD) patietns, will serve the FDMN (Rohingya)  and nearby host communities in Ukhiya.
  • This LAB will perform Lipid profile including cholesterol and triglycerides, HbA1c, Liver function tests including Bilirubin and Alk. Phosphatase, and Renal function tests including Creatinine, Serum Electrolytes, Serum Albumin (for SAM and MAM), Hb% for preganant women, Pregnancy tests, etc .
  • The pathological lab will start functioning and serving the FDMN and host communities in October 2021.

COVID-19 Vaccinations

  • Number of COVID tested in the Rohingya camp: 64018
  • Number of positive cases: 3095
  • The 2nd dose of COVID-19 vaccine was provided in Teknaf and Ukhia UHCs from September 18- 23, 2021. 
  • Among 36,943 people of 50+ years of age, 90% coverage was achieved with the 2nd dose of COVID-19 vaccination of 33,386 people.

Rohingya FDMN Camp Updates, Sept. 2021:

HAEFA healthcare professionals have been giving medical care to the Rohingya Refugees since its establishment in 2017. In September, a total of 6,430 refugees received medical care from HAEFA. A summary of the medical conditions of the patients treated by the three camps of HAEFA is provided below. 

  • Kutupalong (Camp 1w): 
    • Total patients seen: 3219
    • Among them are DM, HTN, Asthma, COPD, Anemia, Presumptive COVID-19, Musculoskeletal Disease, Dermatitis & scabies, Diarrhoea, Malnutrition, Fever, Cough, Dyspepsia, and Helminthiasis were the most prevalent cases.
  • Balukhali (Camp 09):
    • Total patients seen:1615
    • Among them  DM, HTN, Asthma, COPD,  Malnutrition, Anemia, Presumptive COVID-19, Musculoskeletal Disease, Dermatitis & scabies, Diarrhoea, Dyspepsia, Helminthiasis were the most prevalent cases.
    Bhashan Char FDMN:
    • Total patients seen: 1596
    • Among them, DM, HTN, Asthma, Pregnancy,  Presumptive TB, Skin Disease, Fever, and Cough were the most prevalent cases.

HAEFA Newsletter – September 2021

 HAEFA COVID-19 Response

  • As part of HAEFA’s “Emergency Covid-19 response”, HAEFA Bangladesh has provided 7 Oxygen cylinders on an emergency basis to help Covid patients in Sirajdikhan Upazila Health complex, Munshiganj on September 3, 2021. 
  • Honorable DG of NGOAB of Bangladesh, the country director of HAEFA, and the UHFPO of Sirajdhikan Upazila Health Complex were present at the occasion.

Advanced COVID-19 Clinical Management Certification Course 

  • In collaboration with Brown University CHRHS, Project HOPE, DGHS Bangladesh, Bangladesh National COVID-19 Guideline Committee, SCIB, and USAID, HAEFA has developed and launched a new, web-based, interactive Advanced COVID-19 Clinical Management Certification Course on the DGHS website. 
  • This course is contextualized for Bangladesh with a major goal to help physicians acquire a standardized COVID-19 management and treatment protocol in a convenient, self-paced manner. 
  • The course consists of 3 interactive modules, each of which contains pre-recorded videos about the clinical management of Covid-19 patients and an exam based on interactive case scenarios.

Cumulative number of Doctors registered for the online training course as of 7th September: 1961
Completed Certification MCQ Test as of 7th September: 810
Passed and Achieved Certificate as of  7th September: 407

Residential Training on VIA for Service Providers

  • Prof. Dr. Sabera Khatun, Gynecological Oncologist, Professor & Head, Dept. of Gynae Oncology (BSMMU), was the focal point of the training. 
  • The goal of the training was to create awareness on cervical and breast cancer as these are the prevalent types of cancer among women in Bangladesh. 
  • The training included steps for the prevention of cervical screening and breast cancer,  use and interpretation of diagnostic tools for example VIA, CBE, SBE. 
  • Two doctors from Cox’s Bazar and one midwife from Kurigram participated in the training on behalf of HAEFA. Other participating midwives and SSNs were from Cox’s Bazar, Narayanganj and Kurigram.
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Project HOPE’s Mental Health and Resiliency Training:

  • HAEFA is implementing a 5- module online TOT on Mental Health and Resiliency Training for the frontline healthcare workers including physicians, nurses, paramedics of Bangladesh collaborating with Project HOPE and Brown University  
  • The HERO-NY module will be updated based on the contexts of Bangladesh
  • Master trainers will conduct two monthly training sessions beginning in October 2021 through February 2022 aiming to train 3,000 healthcare workers by April 2022. 

Updates: 

  • The HAEFA Mental Health team had meetings with Dr. Mekhala Sarkar (Associate professor of psychiatry, National Institute of Mental Health) regarding the review of modules. 
  • The team is working on the identification of the implementation team and review and compilation of edits to modules. 
  • The team will have meetings with the Project HOPE and New York City Health & Hospitals and other master trainers from other countries in Southeast Asia in the 3rd week of September.

Pathology Laboratory Updates:

  • HAEFA has completed building the infrastructure for a diagnostic pathological laboratory at Balukhali camp in collaboration with the PwC Charitable Foundation to achieve the highest level of quality for diagnosing medical conditions, monitoring diseases, and evaluating patient treatment.
  • The laboratory setup and procurement of equipment is underway, with technical assistance, personnel training and expertise from LABAID.
  • Free lab facilities will be available for the Rohingya and the host community when the lab opens on October 1, 2021.
  • The lab services include Lipid profile, HbA1c, Serum albumin /creatinine/electrolyte/urea test, LFT (SGPT, SGOT), Pregnancy test, (RBS),  urine creatinine test, ASO (Anti-streptolysin O), Bilirubin test, Widal test – TO, TH, AH, BH.
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Cervical Cancer (See-and-Trat) Screening:

Total number of patients screened from October 2019 till August 31, 2021 with a table for (A) total positive cases, (B) total received treatment: (i) Thermocoagulation, (ii) LEEP/biopsy/Surgery

  • In August, a total of 4544 women were screened in 9 subdistricts (UHCs) in Kurigram. Fifty-five cases were positive. Positive cases are receiving treatment now.
  • In August,  474 women were screened in 5 VIA centers in 5 upazilas in Cox’s Bazar. Twenty-two cases were positive. Positive cases are receiving treatment now.

Awareness Campaign

Community Facilitators of HAEFA have started the door-to-door awareness sessions at the community level and are motivating the targeted group for VIA screening. As a result, VIA (visual inspection by acetic acid) screening number significantly increased after starting the campaign at the Upazila/union level. The team is working hard to build awareness among the community to increase the VIA screening numbers.

rohynga camp

COVID-19 in Rohingya Camps:

  • Rohingya refugees usually suffer from malnourishment and multiple comorbid conditions, such as Hypertension, Diabetes Mellitus, etc., which put them at high risk for severe Covid-19 illness, hospitalization, and mortality.
  • HAEFA is providing free medical services in the Rohingya refugee camp in Cox’s Bazar. 
  • HAEFA identified 154 presumptive Covid-19 cases in the Rohingya camp in August 2021 and provided medical care to the suspected cases. The patients were provided health education to maintain quarantine and health hygiene in preventing the outbreak.
  • HAEFA is trying its best to prevent the outbreak of Covid-19 by raising awareness among people, and by providing protective equipment to healthcare professionals.

Rohingya Camp Vaccinations:

  • As of the 23rd of August, a total of 36,943 people have received their first dose of the vaccine out of the targeted 43,093 population of 55+ years of age. This helped HAEFA to achieve 86% coverage. 

Rohingya Camp Updates:

HAEFA healthcare professionals have been giving medical care to the Rohingya Refugees since its establishment. In the month of August a total of 6050 refugees have received medical care from HAEFA. A summary of the medical conditions of the patients treated by the three camps of HAEFA is provided below. 

  • Kutupalong (Camp 1w): 
    • Total patients seen: 3054.
    • 644 DM, 814 HTN, 31 Asthma, and COPD, 29 Anemia, 78 COVID-19, 267 Musculoskeletal Disease, 262 Dermatitis & scabies, 98 Diarrhoea, 90 Fever, 65 Cough, 227 Dyspepsia, Helminthiasis 67. 
  • Balukhali (Camp 09):
    • Tota patients seen: 1631.
    • 171 DM, 241 HTN, 13 Asthma, and COPD, 29 Anemia, 71 COVID-19, 208 Musculoskeletal Disease, 211 Dermatitis & scabies, 59 Diarrhoea, 75 Fever, 47 Cough, 203 Dyspepsia, Helminthiasis 46.
  • Bhashan Char FDMN:
    • Total patients seen: 1365.
    • Among them 93 DM, 91 HTN, 5 Asthma, 24 Pregnancy, 8 Presumptive TB, 145 Skin Disease, 260 Fever, 183 Cough.

HAEFA NEWSLETTER – August 2021

Flash Flooding and Landslide Devastates Rohingya Refugees!

Heavy rain caused by monsoons have caused flash flooding and huge landslides in the Rohingya refugee camps which have killed at least 11 and left thousands of Rohingya families homeless yet again. These flash floods and landslides are the next tragic event to happen to the suffering Rohingya refugees and are likely to continue as local weather officials predict the heavy rain will persist over the next few days.
 

The Rohingya people live on steep hills in makeshift housing made from bamboo, plastic tarps, and mud. As the monsoon rain continues, these houses are easily swept away as the ground beneath is eroded and falling or drifting debris becomes a major concern to all people in the area. Filthy rain water mixed with silt has accumulated and is quickly rising to submerge all in its path.
 

At least 3 children have been confirmed dead as they were crushed in their homes by a large chunk of a falling hill. Other casualties include children drowning in the flooded streams near Palong Khali refugee camp. More bodies will inevitably be found when the water levels decrease and the rubble is lifted. The elderly and sick are also at high risk, as they also lack the means to relocate to safety.
 

Many Rohingya have been injured from these catastrophic events and require immediate medical attention. Moreover, HAEFA’s medical center 1W Kutupalong remains in imminent danger of submerging due to poor drainage systems and surrounding dense forests. While several Rohingya Refugees died, some are currently hospitalized and thousands were relocated in the South-east camps in Bangladesh.
 

We urge you to support the Rohingya people in their time of need. By donating to HAEFA, you will be helping supply our emergency medical and rescue teams with the supplies and PPE they need to save lives as the flash flooding continues. Your donations will also be used to provide medical treatment to the many Rohingya who have been injured and infected by various water-borne illnesses. Once the water levels lower, there will be an increase in water-borne and other infectious diseases that will require increased resources to be managed by HAEFA. 
 

Please extend your support for these suffering people and spread awareness of this catastrophe by sharing with your friends and family!

Rohingya Camp Activity:

Prior to the flash flood and landslide, the HAEFA medical team in the camps were able to provide healthcare to the refugees, with a total of 173,000 patients seen between October 2017 and July 2021.
Number of Patients Seen:
Kutapalong           Balukhali
June: 1,904           June: 905
July: 2,118             July: 867

HAEFA has also treated 88 patients exhibiting COVID-19 symptoms (but not tested) in the Rohingya camps in July 2021, and 37 patients as of August 5th, 2021. 

Cervical Cancer Screening Program

Kurigram

The camp in Kurigram has been re-opened after being closed for a few weeks due to COVID-19 related lockdown. Since October 2019, HAEFA cervical cancer (CC) screetiing team has been working in 3 subdistricts/Upazilas: Ulipur, Chilmari and Negashwari. Recently, HAEFA CC team has expanded to working in all 9 subdistricts where women aged between 30 and 60 years of age are being informed of HAEFA’s activities and CC Screening by the community mobilizers, who counsel people for screening.

Cox’s Bazar

HAEFA has appointed a Project Coordinator, two medical officers, one IT manager alongside two assistants, one project assistant and two office assistants for the Cox’s Bazar site office in June 2021. The Inception Workshop on the “See & Treat” approach to screening and treating precancerous lesions of cervical cancer was held on June 10th 2021. After the workshop, the Cervical Cancer (CC) Team visited their respective UHCs, DH and MCWC to be introduced to their UHFPOs, Superintendent, DDFP, MO clinic, RMO, and other key stakeholders and see the existing VIA screening facilities in the respective centers.

The CC team is in the process of procuring VIA beds, examination screens, consumable items and other necessary arrangements to send to all the centers /UHCs in Cox’s Bazar.

Pathology Laboratory in Balukhali

When patients in the refugee camp visit our facilities with non communicable diseases (NCD) such as diabetes and hypertension, they undergo a few point of care tests at the HAEFA clinics. A need for HbA1c, lipid profiles, serum electrolytes and albumin, liver and renal function  tests, Hb%, Pregnancy tests, etc was felt. Due to lack of diagnostic facilities in the camps, HAEFA has partnered with PwC Foundation and is currently setting up a Diagnostic Laboratory for the above tests to help determine prognosis and manage secondary compilcations of NCDs. The laboratory construction is expected to be completed in September 2021. LABAID is providing technical assistance to set up the Lab. Once the Lab is completed, HAEFA will be able to provide advanced care to the Rohingya refugees.

Update: Renovation of Health Centers

In collaboration with PwC Foundation, annual renovation of the HAEFA health centers in camp 1W (Kutupalong) and camp 9 (Balukhali) is being completed soon. Roof work has been completed, and toilet renovation is 80% complete.

Advanced COVID-19 Clinical Management Certification Course 
In collaboration with Brown University CHRHS, Project HOPE, DGHS Bangladesh, Bangladesh National COVID-19 Guideline Committee, SCIB and USAID, HAEFA has developed and launched a new, web-based, interactive Advanced COVID-19 Clinical Management Certification Course  on the DGHS website. This course is contextualized for Bangaldesh with a major goal to help the physicians of Bangladesh acquire a standardized COVID-19 management and treatment protocol in a convenient, self-paced manner through a series of 3 hour prerecorded videos and interactive case scenarios .

  • More than 1800 doctors are currently registered for the course.
  • 694 physicians completed the training course.
  • 336 have obtained online, printable certificates issued by Brown University CHRHS, Project HOPE, HAEFA and DGHS, Bangladesh.

Program Updates

  • An audio-visual promotional video for the COVID-19 certification course was produced with the goal of raising awareness of the course among doctors across the country.
  • A letter from the DGHS was sent to all BMDC-registered physicians to promote and recognize the need for the course nationally to help train Bangladesh physicians with a standardized evidence-based treatment protocol for COVID-19 management.
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