Vaccinating refugees in Kutupalong – You need a strong team

After working for Médecins Sans Frontières / Doctors Without Borders (MSF) in South Sudan and the Mediterranean, German nurse Heidi Anguria is now in Bangladesh. From inside Kutupalong refugee camp, home to hundreds of thousands of Rohingya, she shares her second blog on meeting new people, unique experiences and great challenges…

Rain, elephants and more rain

Welcome to the new year! At least if you live in Bangladesh.

Recently, Bengali New Year was celebrated here (on 14 April), welcoming in the year 1425 in the Bengali calendar.

With up to 38 degrees heat, the first days of the new year are very hot and humid. It also rained twice. But these are only the warning signs of the incoming monsoon season that will bring flooding and cyclones with it.

We, along with all the other organisations here, are worried about how it will impact the people in the refugee camp.

Great efforts are being made to make the camp safer. For example, some of the residents have been relocated to another area. However, the supply of latrines and clean water in the new location is very bad.

Flooding and landslides could occur in the coming monsoon season. Photo: Heidi Anguria/MSF

Flooding and landslides could occur in the coming monsoon season. Photo: Heidi Anguria/MSF

There are other problems as well.

Where the huge Kutupalong camp is now, there used to be a forest where elephants lived that unfortunately had to be cleared. Sometimes the elephants still come though, causing damage or injuring people. And of course, the locals are not happy about the loss of the forest area either.

For them, the incoming refugees have an impact on local life. For example, the price of many goods here has now increased enormously.

However, every day I am amazed at what there is to buy in the local markets - fruits, vegetables and especially the mountains of watermelons!

Many people here also chew betel nuts. They are wrapped in small green leaves and often mixed with spices because of their bitter taste. They have a stimulating effect but stain people's lips and saliva red.

However, the offer of the markets does not benefit the Rohingya refugees at first. They have little money and are not allowed to work. Although they are supplied with food (for example, from the World Food Organisation). To buy something else, they either sell some of this food or even their spare possessions.

Out and about in the market where betel nuts are available. Photo: Heidi Anguria/MSF

Out and about in the market where betel nuts are available. Photo: Heidi Anguria/MSF

Community outreach workers

The traffic here is incredible! Everyone drives as if there is no tomorrow, overtaking continuously with a minimum distance between the lanes. Sometimes I hold my breath, but I trust our drivers. Never have I used my MSF cell phone as often as here, either. For example, if I want to go anywhere I must check in via SMS, and again when I return so that our team always know where our cars and staff are.

Every morning, I collect the vaccines for the day from the Ministry of Health with a colleague. Then I meet my 25 co-workers for a brief meeting before the teams make their way to each of the vaccination stations.

At the moment, we are mainly vaccinating people who have had contact with diphtheria.

Each patient needs three vaccinations. However, in order to find each individual, our community outreach workers must help us. They know every inhabitant, every stone and every hut in the camp. Overall, we work with nearly 400 such community outreach workers.

Although I'm in touch with my teams by phone, I often like to go to them myself. I enjoy being in the camp even when it’s exhausting. Still, cannot imagine how it will be during the rainy season in the mud!

My job also includes attending meetings. This week I had a meeting with the head of the local health department to discuss the start of a cholera vaccination campaign.

Good cooperation. A photo of one of the vaccine teams and me. Photo: Heidi Anguria/MSF

Good cooperation. A photo of one of the vaccination teams and me. Photo: Heidi Anguria/MSF

Unimaginable experiences

In addition to the vaccination campaign, we also take care of the mental health of our patients.

The Rohingya have seen the unimaginable in the Rakhine region of Myanmar: trafficking, mistreatment, rape and murder.

Now they have to deal with the extremely difficult conditions in the refugee camps of Bangladesh, too, which can have an additional impact on their mental health.

Well, I think that's enough for now. I'll use the rest of my day off to relax. Tomorrow morning, the local call the prayer will wake me again... then the work will go on!