Nursing in the world's largest refugee camp

900,000 refugees are currently living in Cox's Bazar, Bangladesh. Medical needs are running high. Hanne joins the Médecins Sans Frontières / Doctors Without Borders (MSF) team trying to meet them.

MSF nurse Hanne and a colleague in Bangladesh

I watched the cow with interest, as it wandered through the busy market eating rubbish, seemingly oblivious to the lungi-clad men and women in burkas that made way for it. Not so strange a sight as the elephant randomly walking along traffic that I’d seen earlier in the capital, but still worlds apart from the cobbled streets of Ghent, my hometown. 

We continued on along a road that led from my new home, surrounded by rice fields, to the diphtheria clinic, watching as the world’s largest refugee camp rose up around me and stretched away over the hills. 


This was Ukhia, Cox's Bazar district, Bangladesh, the once-small district now home to over 900,000 Rohingya refugees who have fled the targeted violence in Rakhine State, Myanmar, and I was here on my first assignment with Doctors Without Borders / Médecins Sans Frontières (MSF). 

So, with excitement and trepidation I entered the clinic for the first time. 

My first day in the clinic I was made to feel welcome by the warm reception the local staff and international team provided. 

My role for the coming three months was to be a nursing team supervisor and I was excited to work with recently graduated nurses who seemed eager to learn. 

Learning fast

However, in Belgium my experience was working as an intensive care unit (ICU) bed-side nurse, with direct patient interaction, a very different job. This meant I needed to learn an entirely new role on the job and find my own place within the project. 

I was assigned several wards to supervise, including an intensive care ward as well as 34 nurses and nurses' aides to manage. So, walking into the wards for the first time, it was understandable that I felt a little insecure, with no clue if I would be able to make the role my own. 

Through time and guidance, I learned to appreciate managing a team and providing structure and knowledge for others. 

As time went on I ended up growing close to the Bangladeshi staff and was devoted to my own way of connecting people. I discovered that engaging on a personal level with the local staff and showing genuine interest in both their professional and personal lives opened a gateway to mutual acceptance. 

The world's largest refugee camp

I learned that in many cases the Bangladeshi open their eyes where others might avert them, and their acceptance and hard work for the Rohingya people made me question how many more “developed” countries might handle a similar situation. 

Wandering through the camp it was hard not to be charmed by the groups of children, semi- and fully naked, who would run along behind shouting “bye bye” thinking it meant "hello". 

But what truly stood out on these wanders was the vastness and oppressive density of the camp, and I haven't the words to describe the emotion one feels witnessing the living conditions the Rohingya are forced to endure.

It is essential to find your own coping strategy to deal with frustrations. 

These refugees, who fled their homes seeking safety, now live in shelters wracked by landslides and floods. My walks, and visiting the homes of our patients, reinforced for me why MSF is there. Within the team we made it our mission to treat these people in the kindest ways we could, and provide them with quality health care.

Challenges and joys

Frankly, there were times where we struggled. On assignment you are confronted with yourself, with others, with decisions made for you. It is essential to find your own coping strategy to deal with frustrations. 

Personally, I will never forget auscultating the chest of a child, who we had tried to save for hours and not hearing a heartbeat. But there are also many, many cases where we were able to cure our patients and seeing them recover after treatment is incredible motivation. 

Watching the nurses I worked with develop into a capable team was a highlight of mine and I saw each and every one grow throughout my time there. I leave so proud of them all and I hope that they can use what they learned in the future. 
Returning home, I leave behind so much and many beautiful memories, but I will return a stronger person. 

My life has changed entirely. 

The ups exceed the downs and it’s natural to feel sad, but mostly I feel grateful for the opportunity to connect with so many people and to provide help where the needs are so overwhelming. 

I have never experienced anything this intense, but feel grateful to be leaving bits of myself in this beautiful country and all the countries I journey to in the future. 

If you live in the UK, please donate to MSF UK’s winter 2018 appeal to support our work with Rohingya refugees in Bangladesh.

If you live elsewhere in the world, please click here to make a donation.