Call for Palliative Care Colleagues from Kenya and other East African countries – Short Term Training Visits to Cox’ Bazar, Bangladesh responding to the Rohingya Crisis.

A recent call has been put out for all palliative care colleagues to help in the response to care for palliative care patients in the Rohingya refugee camps in Cox’s Bazar, Bangladesh.

Dr. Farzana Khan and her team have been working for the last several months to set up a Palliative Care service to serve the suffering patients in this area. Due to the immense need and complex situation, there is a call for other colleagues to come on short term visits to help with facilitating training of the community health workers in the camps.

Dr. Farzana Khan alongside Dr. Megan Doherty on behalf of PalCHASE (the Palliative Care in Humanitarian Aid Situations and Emergencies) network have been approached to train more local health care providers in palliative care (doctors, nurses and community health workers). They are looking for palliative care colleagues who could travel to Bangladesh in the next 6 months, for 1-2 weeks to help to facilitate training with Dr. Farzana. (Training materials have already been developed)

If you are interested to volunteer or to hear more please inquire directly with Erin Das (Canadian Palliative Care Nurse based in Kenya) or with Dr. Megan Doherty (MDoherty@cheo.on.ca).

In order to fund the ongoing essential work of delivering palliative care in Cox’s Bazaar a crowd-funding campaign has been launched. For more details please see the following link: https://www.gofundme.com/rohingya-refugees-palliative-care

Stories from the Field:

Taslim was a 4-year old girl in Cox’s Bazar refugee camp, Bangladesh, suffering from eye cancer. When her cancer first appeared, Taslim had surgery to remove her tumour. But just two months later, the cancer had returned and spread.

When our team met Taslim, she was in severe pain. She desperately needed palliative care, including medicine to relieve her pain. But there was no morphine – the best treatment for her pain – available at the local health facility. In desperation, Taslim’s father took her to a distant government hospital, but the hospital staff did not know how to provide adequate pain relief. Taslim died at this hospital only days later without the right care and support that she and her family so urgently needed.

Over in another part of the refugee camp, we met Mojibor, a 10-year old Rohingya boy with bone cancer. When he was diagnosed at the camp field hospital, Mojibor and his mother cried all night fearing he would soon die. When we first met Mojibor in a tent lying on a mat, he was unable to move or walk because of his pain. In the past, Mojibor was a typical football-loving boy. His nickname was ‘bhuissya’, meaning ‘buffalo’. We started pain treatment, and now Mojibor can walk and even smiles a little. Palliative care has improved the quality of Mojibor’s life and given much needed comfort to his family.

These stories are not unique. There are many other Rohingya refugees, living in makeshift camps in Bangladesh, who are suffering because of a lack of medicine or supplies, or the absence of health workers who know what care to provide. Families who watch their loved ones in severe distress unaware of how they can help.

Since 2017, we have been providing palliative care services to Rohingya refugees with chronic or terminal illnesses who are living in refugee camps in Bangladesh after fleeing violent attacks in Myanmar. Our palliative care team includes a passionate physician, Dr Farzana Khan and two dedicated community health workers. The team visits patients in their homes, ensuring they get the medications and equipment that they need to live with greater quality of life, easing their burden of avoidable pain and suffering.

But, we need your support to continue providing palliative care to Rohingya refugees living in refugee camps in Bangladesh. We need financial support to continue to provide essential medications, supplies and supports for patients facing chronic or terminal conditions. Our goal is to expand our services to reach many more individuals living with chronic or terminal conditions. It costs only $10/month to provide these supports for one patient.

Who We Are and Where We’re From:

Our project is led by Drs. Farzana Khan  and Megan Doherty , two passionate palliative care physicians with extensive experience providing in Bangladesh. We are partnered with Palliative Care in Humanitarian Aid Situations and Emergencies , a global network of clinicians and researchers who want to raises awareness about the need for palliative care in humanitarian emergencies.

In 2017 a Rapid Response Assessment was done and the following shows a picture of the results. (https://www.phpc.cam.ac.uk/pcu/palchase/led-initiatives/)

The Rapid Situational Analysis aimed to assess the burden of pain, suffering, and severe distress for refugees living with life-threatening illnesses. It used four pilot needs assessment tools (for patients, current carers, bereaved carers and healthcare facilities). Ten Rohingya translators/surveyors collected the data, after being trained by Dr Khan and Dr Doherty.

304 refugees took part: 147 individuals with life-limiting illnesses and 157 caregivers.

Respondents saw as their “greatest needs”:

  • 97% Medication
  • 94% Money
  • 76% Food
  • 45% Pain relief
  • 44% Someone to help me (provide care for me)
  • 24% Help with sadness or depression.

73% of respondents reported significant pain. 46% of them had not received any treatment for it. No one reported receiving opioid pain medications (which the WHO recommends as first line treatment for moderate or severe pain).

Most health facilities reported that they did not have morphine or other strong opioids.

There have been limitations to the study due to the complexity of the situation and the use of non-medical youth to gather the data. There is, however, no doubt that the need for palliative care provision is high and practically unmet.

Author: Erin Das

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