[Bangladesh]Covid-19 Awareness-Raising Activities: Challenges to be addressed
Around 860,000 Rohingya displaced from Myanmar have been living in 34 refugee camps in Teknaf and Ukhiya in Cox’s Bazar, Bangladesh. In the Rohingya refugee camp, with about 40,000 people per square kilometer, a family of eight to ten lives together in a single 10-square-meter shelter, with one toilet shared by multiple families. There is also a lack of knowledge and personal hygiene items to protect themselves from COVID-19.
The first COVID-19 case was detected in the camp on May 14. The access to the Rohingya refugee camp has been strictly regulated since the end of March but even then, the spread of novel coronavirus could not be prevented in the camp. Peace Winds Japan (PWJ) and its local partner Dhaka Community Hospital Trust (DCHT) have started awareness messaging about COVID-19 since March. Since June, the Health Sector partner organizations have taken part in the enhanced Community Based Surveillance (CBS) supervised by WHO to detect, isolate, and test suspected cases. The data collected in CBS is used to analyze the spread of infection in the community, as well as tendency by age and gender, which gives the index of the infection prevalence in the refugee camps. As an active partner of the Health Sector of the Rohingya crisis response, PWJ and its local partner DCHT have conducted CBS in Camp 14.
Community Health Worker (CHW) is doing CBS by home visit.
5 CHWs of PWJ/DCHT have been working on the CBS, while spreading the awareness messages among the community every day. Messages include general information on COVID-19; risks and vulnerabilities, safe and dignified burials, home-based care, quarantine, isolation and treatment centers, use of masks, frequent hand wash, etc. Additionally, the CHWs have continued awareness messaging on Maternal and Child Health such as antenatal care, postnatal care, facility delivery, immunization, and personal hygiene, which used to be their primary task prior to COVID-19 outbreak. One of the serious consequences of the COVID-19 pandemic is that immunization coverage has come down drastically. Therefore, CHWs have to put more emphasis on creating awareness in this regard.
After 7 months of awareness activities, it is still often seen that people are chatting without wearing masks or respecting physical distancing in the camp. One of the reasons for this challenging situation is that many refugees believe that COVID-19 is a disease affecting only the rich or Bengali people. Some even think that the disease does not exist anymore. In this circumstance, CHWs are trying to make refugees understand that the pandemic is ongoing by informing the number of positive cases in the camp and appropriate information on COVID-19.
Rohingya people in camp’s morning market without mask.
CHW is demonstrating physical distancing.
To effectively mitigate the negative impact of those rumors, CHWs give greater effort to getting community and religious leaders involved. CHWs place special emphasis on building good relationships with influential individuals in communities such as Majhi (recognized as a leader in the camp), teachers, imams (religious scholars), and requesting them to spread messages to the community. Community members have frequent contact with these leaders on various occasions such as relief item distribution, class in school, home tutoring, and daily prayer. Given this fact, frequent messaging from community leaders should help create more awareness among their own community.
Majhi is learning proper hand washing from a CHW.
CHWs are carrying out awareness activities on wearing masks and ensuring physical distancing when they find a gathering in shops or markets. Although educational facilities have been closed due to the pandemic, it is seen that children are gathering in the school premises. They play sports and have a chat without any infection prevention measures. Awareness activities are being carried out by CHWs targeting those children as well.
A gathering of children and teenagers in front of a learning center
PWJ is hopeful that the awareness messaging and subsequent improvement in health-related knowledge and behavioral change brings a long-term benefit on the community.