Respiratory palliative care amongst the Rohingya in Cox's Bazar

Background

Since August 2017, over 700,000 of Myanmar’s minority Rohingya community have been forced across the border into southern Bangladesh.

The situation in Cox’s Bazar, Bangladesh, is now shifting from an emergency response to dealing with a prolonged crisis. It is essential to address everyday illnesses and health care needs, including the large numbers of adults and children with long-term and life-threatening illnesses who are currently not receiving the care they need.

In 2014, chronic pulmonary diseases made up over 10% of the global total of adults in need of palliative care at the end of life.

Improving palliative care is a vital step to improve quality of life for refugees and achieving universal health coverage.

Aim and impact

Preliminary research was undertaken to map respiratory illnesses and care amongst the refugee community in Cox’s Bazar – the first assessment of palliative care during an unfolding humanitarian crisis.

Following this initial mapping, a more comprehensive mapping process and training programme was implemented. This has led to the training of up to 80 Community Health Workers (CHWs) in palliative care early identification and management, recognition of non-communicable diseases, as well as specific palliative needs of children, and palliative care service delivery.

Not only is this training increasing knowledge and understanding of palliative care needs, it is building capacity and upskilling the local CHWs, which in turn improves palliative care service provision amongst the Rohingya in Cox’s Bazar.

Key developments

• Training programs are ongoing.
• The FKRF has been providing respiratory palliative care in 10 primary health centres in Rohingya refugee camps, including two Upazilla health centres – Ukhia and Teknaf.
• In Cox’s Bazar General Hospital, the FKRF has been given a place, next to the Intensive Care Unit and Cardiac Care Unit, to start a Pulmonary Rehabilitation Centre for patients with Chronic Respiratory Diseases. This is the 250-bedded secondary level government health facility at district level, where all critical patients are being referred from eight Upazilla health centres and refugee camps of Cox’s Bazar, Bangladesh.
• Dr Khan led a formal meeting on 11 July 2019 in Cox’s Bazar with the Health Sector Coordinator Dr Balwinder Singh Chawla.
• Dr Khan attended a Royal Institute of International Affairs meeting “Closing the Global Access Gap in Palliative Care and Pain Relief: A Top Priority in Achieving Universal Health Coverage” on 17 July 2019 at Chatham House, London. This meeting brought together leading experts, palliative care service users and advocates with key figures from the Universal Health Coverage (UHC) movement and global health.