Six months ago, on 14 May 2020, Nur Alam - a 35-year-old and father of five children - became the first Rohingya patient testing positive for COVID-19 at the Cox’s Bazar Refugee camps. Just like 6 months back, staff from the World Health Organization (WHO) went to his shelter to learn how he and his family are doing and in which way(s) has COVID-19 impacted their lives.
A Rohingya refugee, Nur Alam was the first person testing positive for COVID-19 at the refugee camps in Cox’s Bazar. WHO Bangladesh/Tatiana Almeida
“I had been experiencing fever for a few days and went to the IOM Primary Health Care Facility (PHC) in Camp 1W, near my shelter, to ask for medicines. The doctor advised me to get tested for COVID-19 but I hadn’t heard about the disease before”, recalls Nur Alam.
Nur Alam and his family of six reached Cox’s Bazar, Bangladesh, at the end of August 2017 in very poor health conditions: he had a bullet wound on his left arm, his wife and children were sick and the youngest, 5 months old, had died on the way. He says that he will never forget the humanity with which his family was taken care of by the doctors in Cox’s Bazar.
“I trust the doctors here. So, when WHO told me that I had tested positive for COVID-19 and needed to go to an isolation and treatment center, and my family to a quarantine facility for 14 days, I accepted. But I was worried, of course”, he adds.
One day later, after every member of the family made the COVID-19 test, positive results came for Nur’s 9-year-old son. Both mild cases of COVID-19, father and son received treatment and care at the MSF Kutupalong Severe Acute Respiratory Infection Isolation and Treatment Centre (SARI ITC) where Nur stayed for 28 days. During that period, his family was able to see him separated by a window shield.
After Nur Alam’s 9-year-old son tested positive for COVID-19, they were together at the MSF SARI ITC in Kutupalong where they received treatment for mild symptoms. WHO Bangladesh/Tatiana Almeida
Before Nur Alam, 236 Rohingya refugees had been suspected COVID-19 cases. While he and his family were the first Rohingya being affected by the coronavirus, at the time the host community counted already 132 confirmed cases and 3700 suspected cases in the district of Cox’s Bazar. The district’s first case was reported on 23 March bringing Cox’s Bazar to a lockdown. By then, Bangladesh registered over 22 000 COVID-19 cases and more than 300 deaths.
“In Cox’s Bazar, the preparations for COVID-19 pandemic began months before the first confirmed case in the country. WHO, together with the Ministry of Health and Family Welfare (MoHFW) and Refugee Relief and Repatriation Commissioner office (RRRC), provided leadership, coordination, supportive supervision, and collaborative support to all health partners and sectors to prepare for COVID-19. While the impact of the pandemic was unknown to us, of one thing we were sure: we had to be ready. And we were: on 14 May all partners were ready to receive Nur and his family. The health sector’s response was remarkable”, says Dr Kai von Harbou, Head of WHO Emergency Sub-Office.
“To be effective, public health decisions must be guided by evidence. At first, the strategy in Cox’s Bazar focused on reducing the chances of transmission as much as possible to contain first infections both in the host and refugee communities. That rapid initial intervention allowed us precious time to prepare our teams, coordinate with health partners and provide capacity building to all health care workers in Cox’s Bazar”, explains Dr Egmond Evers, WHO Public Health Officer.
Six months ago, 14 (out of 25) sentinel sites in the refugee camps were active for COVID-19 testing; active surveillance systems and teams, including EWARS and GoData platforms, were fully operational; 120 health care workers (out of 488 to date) had been trained on clinical case management by WHO; 2 SARI ITCs (out of 16) were active and counting 270 beds (to date, there are 1106 beds for COVID-19 patients); 300 health care workers (out of 3600 to date) had received training on Infection Prevention and Control; WHO was developing a plan to effectively communicate with the public through engaging with communities, local partners and other stakeholders to help prepare and protect individuals and their families from COVID-19.
WHO Community Health Disease Surveillance Officers (CHDSOs), Dr Mahmud Al Razi and Dr Chowdhury Nehal talking with COVID-19 recovered patient Nur Alam at Camp 1W, Ukhiya, Cox’s Bazar. WHO Bangladesh/Tatiana Almeida
As of 11 November 2020, 348 confirmed cases and 10 deaths were reported in the Rohingya refugee camps. In the host community, to date 5000 COVID-19 positive cases were identified and 72 have died.
As for patient number one, Nur Alam, he and his family are healthy. They have a small stall where they sell facial masks to help other refugees reduce the risk of COVID-19 infections.
Considered patient number one in the Rohingya refugee camps, the 35-year-old has successfully recovered from COVID-19. WHO Bangladesh/Tatiana Almeida
Confirmed cases of COVID-19 in the refugee camps remains lower than initial estimates. To understand more about COVID-19 transmission in the camps, the Bangladesh Institute of Epidemiology and Disease Control Research (IEDCR) with support from WHO, UNHCR, BDRCS and MSF, will undertake a seroprevalence study in all 34 camps to identify antibodies to SARS-CoV-2, the causative agent of COVID-19.