Volunteer Doctor for Rohingya Medical Mission Trip, MHPA Team 1B (14-21 Oct 2017)

  • Written by Dr Mohamad Fahamy Koenitz Bin Iskandar
  • Medical Officer, KTPH

Look through any dictionary, one can find similar definitions to the term refugee, ‘a person who has been forced to leave their country in order to escape war, persecution, or natural disaster’. Partnering with Global Ehsan Relief, MHPA sent out a team of volunteer doctors, nurses and a pharmacist to Bangladesh with the aim of providing free primary healthcare to the Rohingya refugees recently in October.

The day arrived when the team had to scoot to Bangladesh leaving loved ones behind. It was a 4 hour trip. Arriving in Dhaka airport was an experience in itself. It was night time. The airport was cold and it looked very used. Some dim lights mushroomed along the ceilings and a few were flickering. We had to walk to our first check point. The Visa station. Visas had to be bought on arrival and it was not without a lot of scrutiny. Custom officers would ask questions after questions, wanting to know more about the trip, one’s background and other details. Once the Visa was granted, a team of Bangladeshi policemen escorted the team and we breezed through immigration. First destination was our hotel. We were driven through roads that had baracades, police and army check points. Along these roads were uniformed personnel, armed with weapons. Going thru these roads however reduced our transport time to our accommodation by at least 50 minutes. The normal civilian route would have taken at least an hour based on maps. There, in our accommodation, we rested and departed the very next morning to Cox Bazar via a small domestic plane.

Cox Bazar. Some say it’s the world’s longest beach. Whilst others deemed it to be the second longest beach. We landed during the steaming hot afternoon weather. We were greeted by a small domestic airport no bigger than 2 or 3 basketball courts. The building reminisced of short buildings built in Singapore in the 50s. Though infrastructure maybe ageing, hospitality was refreshing. Outside the airport as we waited for our transport to our permanent accommodation, groups of Bangladeshi onlookers came to greet us and welcoming us. Some were taxi drivers whilst a few just wanted to start friendly chatter. Interestingly, a few spoke Malay as some of them had previously worked in Malaysia before. As we left in our transport, they bid us farewell and thanked us for wanting to help the Rohingya Refugees.

One of the many other NGO transports at the camp.

Cox Bazar. Our permanent abode in Bangladesh. It was from here that we would commute daily to the refugee camp. With our fellow NGO partners, the free field clinic was set up in Balukhali Camp which was about 1 hour away by land transport. However, with the traffic conditions in Cox Bazar, our journey time would transverse to about 1.5 hours. We were only allowed to work when there was day light. By 5 pm daily, the team had to leave back to our accommodation in Cox Bazar. Driving in Cox Bazar was a niche only the locals could provide. There was only a narrow 2 way road meandering through most of Cox Bazar. Horning was a norm and bumpy rides were the runner up.

A view of the shelters of the refugees made off bamboo and canvas within the campsite

A brief look at the entrance of the camp near our clinic.

Setting foot onto the refugee camp was so surreal. Disembarking from our vans, we saw ambulances from MSF and UN parked beside us. There were no foot paths from the carpark to lead us into the camp. Just wet pools of sand and mud kissed our shoes. As we walked down the muddy walkway, the refugees were busy walking up and down them as well. Some walked bare footed. Some were carry sacks of rice. Some were carry bamboos the very foundation to make their shelter. As we walked deeper into the camp. We began seeing make shift shelters of bamboos and black canvas as walls. Naked children were running around. While some of the elders just sat out side these shelters looking beyond the far horizon, seeming to be deep in thought. These people once led normal lives, had proper homes. Now, all they have are these temporary shelters and many had no other worldly belogings other than they clothes they came into Bangladeshi with. As we walked deeper into camp, many of us too were deep in thought, contemplating about the things we took for granted back home. A home. Yes, that’s what we all have back in Singapore. Looking around at the surroundings,

A dirty stream meanders through the refugee camp. Though dirty, it is still a source of water used by the refugees.

Anyone’s heart would be scarred to think that people are actually living here. No human being should live in such conditions.

Even before the team arrive, the line of patients have started to form. Many brave the heat for to seek treatment.

After a 10 minute walk into the camp under the blazing heat, we arrived at our Field Clinic. 4 tents pitched up. Each tent having a different role to play. One was registration, the other triage, the third was a consultation tent where the refugees would be seen by the doctors while the final tent was the dispensary. Each tent had something in common though, it all felt like a huge microwave. With no electricity, the temperatures were easily reaching the high 40s. Though we just arrived at about 10am, lines of patients had started forming. God knows for how long they have been patiently waiting in the heat. They did not complain. Many had the faces of weary, fear and weakness masked on their faces. Each face had a story to tell. Stories which we would soon hear and soon feel. 

As the sun climbs higher, the Q gets longer.

Within our field medical team, we had 5 enthusiatic and hardworking Rohingya Volunteers who were our interpreters. They were able to speak 4 languages, Rohingya, Bengali, Burmese and yup, Malay. Despite having faced hardships, these volunteers were eager and genuine to help.

Team Leader, Dr Fadzil with a local Bangladeshi doctor seeing a pediatric case together.

Slowly, our patients starting coming in. Some were frail, while some were weak children. Many came in with pneumonia. With exposure to the soil, one would have to think of pathogens such as Burkholderia pseudomallei to be a highly possible cause of infection. Poor sanitation, it was no surprise gastroenteritis was also rampant. Toilets were just a hole in ground which was enclosed in a zinc walls. There was no water to flush. Human waste would just collect.

The Nani. She is our 100 year old patient. She traversed into Bangladesh in a basket carried by younger men.

 Everytime, a patient walked in, a sense of sympathy would always accompany. One would be thinking about what has this refugee gone through. How could he survive in a place like this. Yet, they not only survive, they try to live. Majority of them were under the BMI scale. Cheek bones prominent, shoulder joints well defined and ebony skin. These were the common physical features. Many wore shredded clothes and some wore dirty and sandy clothes. Each patient one sees, makes one reflect on the blessings one already has back home. For we could very well be in their position as well.

Our 2IC, Dr Iqbal and a Rohingya refugee volunteer helping him interpret the consultation.

Emergencies. The team had a fare share of emergencies. With a suspected ectopic pregnancy, a possible meningitis and a possible hip fracture, these were only some of the emergency cases that presented to us. Emergencies that were beyond the field clinic’s capabilities were immediately sent off via ambulances to the local hospital. There were also field hospitals set up by the Norwegian and Finnish whilst the Japanese had free mobile clinics. Malaysian and Indonesian teams were there as well providing field clinics too.

Patients qeueing outside the pharmacy awaiting for their meds.
 
The pharmacy

Our medicines would usually run low by the end of the day. Antibiotics and iron supplements were the usual endangered pharmacological species. Every night, after dinner, the team would procure more medicines from a local pharmacy distributor and this was all possible from the donations received.

Within a short span of 4 days, we saw close 900 patients. Many would leave memories in us while a few would be daily remembered. There was this patient whom I saw, a young mother of four. She walked slowly into the tent. Small framed and very bony. One would not expect her to be a mother of 4. Her 6 year old walked behind her as if he were her bodyguard while the other 3 younglings gripped on tightly to her. She sat down. As she began giving history, her children looked us scared and suspiciously and their gripped grew tighter and tighter.  That caught my eye, and I apologised to her for making her children scared. She replied softly that there was no need to apologise, these kids saw their father being shot down and killed in front of their very eyes. Now, they are scared of almost everyone. That was about 10 days ago...Many refugees had similar stories. Even our volunteer sadly shared how he saw his mother being burnt alive in their home as the army torched their houses. He and his remaining family ran and left for Bangladesh. That was one month ago. One month ago he saw his own mother being burnt alive and here he was wanting to help the sick volunteering as an interpreter.

Myself posing with 2 of our Rohingya Volunteers. Genuinely hardworking.

These volunteers were welcoming too. They invited us to their homes. As we walked amongst the tiny makeshift houses, a stream of dirty water would flow along the pathway. Some could be seen dipping their fingers into the dirty water and with the very same finger scrubbed their teeth. There were water points where refugees could pump water from wells. The better materials such as bricks and small amounts of cements were reserved to be used to build mosques. Their shelters were no bigger than half a badminton court with the raw soil as their floor. Sleeping areas usually had a thin canvas covering while their kitchen was a shallow hole in the ground with fire wood. Many would eat just rice and onions. These refugees though are very resourceful. Many were farmers back in Myanmar, so they started to cultivate the land in their refugee camp. Some padi fields were seen to be blossoming while some caught wild chickens and started rearing them for eggs. Others would fish at a nearby river. With these produce, some would trade and walked outside of the camp to a nearby Bangladeshi village to sell.

The field clinic was continued by 2 local Bangladeshi doctors and 2 nurses. In the coming months, we hope to send more teams to aid the refugees. Leaving the mission for good, one would reflect about life and be at awe at their resilience. Despite being faced with atrocities, they try to rebuild back their own ‘cities’. Sometimes we wonder, is it us helping the refugees or the refugees helping us t to remain human.

 

A child and her mom pumping water from an underground well. Beyond them, fragile homes provide shelter to countless of families.

 

A Rohingya refugee child playing and making do with whatever he has to play with.

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