by Nat Crewe; DRG Team Leader
Cox’s Bazaar, Bangladesh
We’re super-happy to report that we managed to get all team members into the field today; it seems that all lingering stomach bugs have been squashed!
Simon, Lily and I headed to Burma Para to run the clinic. It was busy from the get-go as the locals have to come to know, accept and welcome us there. They are always patient and understanding, always forming an orderly queue and accepting when someone with a more serious complaint is pulled in front. The team worked without a break until 4pm- Simon and Lily manning the clinic with Dr Ayub, whilst I went completed house calls.
I was fortunate enough to meet a little newborn- just hours old. As Simon had experienced yesterday, bub wasn’t feeding well, and the family had a smoking fire inside the shelter. A little education and some formula for backup put everyone at ease. Back at the clinic there was plenty of the usual diarrhoea, coughs, fevers and skin conditions, some worse than others.
One elderly gentleman was carried into the clinic with a very low blood pressure, possible pneumonia and wasn’t passing urine. As well as oral ABs, Simon ran two bags of IV fluids and our guy walked away by himself a couple of hours later, desperate for a pee!
I was presented with a 10 year-old boy that had an infection on the end of his penis. Further questioning revealed that he had actually been shot there by Myanmar soldiers. Fortunately he and his family had survived, and we were able to transport him to hospital for further treatment. In total, the clinic treated well over 60 patients for the day!
Alex and Shane continued their fantastic work transporting patients from Leda Camp to the two clinics. Unfortunately they came across a terminally ill cancer patient that was suffering in agony. They transported her to the MSF clinic and were heartened that, despite being overwhelmed with patients, the MSF clinic took her in and administered pain relief in order to relieve her suffering.
Amy, Kate and Mel were asked by our interpreter, Mr Moslem, to visit a Rohingya refugee who is living with extended family outside the camp. She indicated that she had been hit in the back of the head by the Myanmar Army. Since arriving in Bangladesh, the patient had begun to lose feeling in her arms and legs. She had recently attended Chittagong Hospital, and presented a patient report of a full work-up, including x-rays and ECG. The diagnosis suggested spinal cord damage, and resulted in brief surgery, however since then, the feeling in her limbs has continued to diminish. From a psychological standpoint, it was evident that she was significantly distressed and exhibiting pure fear about her condition. Amy and Mel conducted a medical assessment, and explained to the patient and her family (through Moslem) that it was a permanent injury. They also explained the cause and physiology; then subsequently fashioned a ‘theraband’ (flexible training band) and taught the patient and her family some exercises to strengthen her legs. Kate then provided psychological first aid in the form of comfort, connection, touch and compassion.
After leaving this patient and then arriving in camp, the team continued a roving clinic through Kutapalong-1 and Kutapalong-2. Of particular note, the roving team came across a 65 year old woman who was literally skin and bones. She hadn’t eaten in over 2 months, which coincided with her arrival in the camp. She demonstrated low mood, psychological distress and severe lack of energy. After a medical assessment by Amy which showed all observations to be normal, Dr Kate provided more psychological support: comfort, compassion and connection. Given her weakened state, the team will return tomorrow to transport her to Red Cross Clinic to address her nutrition as a priority, then provide psychosocial support.
Aside from all these cases, the team was continually bombarded by an overwhelming number of families who brought out their children experiencing diarrhoea, low grade fever or respiratory problems. It would often take the team over 90 mins to walk 50m due to the number of people who sought assistance for their babies or children.
Whilst this highlighted a strong need for nutrition and hygiene support, it also raised the question of how best to utilise our resources, and focus on the fundamental role of DRG – acute trauma and severe cases. It was a question that the team would discuss in detail throughout the remainder of the afternoon and evening.
After dinner and when the team was resting, Kate, Amy and I had a very fruitful meeting with a Myanmar NGO that are operating in the area. They are responsible for training young refugees in community engagement and creating local employment. They have put us in touch with some of their team leaders who, with their unparalleled access to the camp community, are going to help us reach the more serious patients that have been overlooked. This is a huge help to us, as well as providing them with a little employment.
If you would like to help our mission, you can donate to the Backpacker Medics cause here: https://chuffed.org/project/bpmdrg-bangladesh#/supporters