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Helping displaced Rohingya children in a refugee camp

Children’s nurse Becky Platt spent three weeks working as part of an emergency medical team in the Kutupalong refugee camp on the Bangladesh-Myanmar border

Children’s nurse Becky Platt spent three weeks working as part of an emergency medical team in the Kutupalong refugee camp on the Bangladesh-Myanmar border


More than 500,000 Muslims have fled Myanmar
Picture: Russell Watkins/Department for International Development
 

It is the world’s fastest-growing refugee crisis. Since an outbreak of violence in Myanmar’s Rakhine state in August last year more than half a million minority Rohingya Muslims have been displaced. 

The majority have fled to refugee camps in the south of neighbouring Bangladesh. Conditions are challenging, with a lack of basic sanitation, food and clean water.

Matron for children’s services at Watford General Hospital, Becky Platt worked for three weeks with a medical team to manage a diphtheria outbreak in the Kutupalong refugee camp in Cox’s Bazar, south-eastern Bangladesh.

Ms Platt, who has more than 20 years’ experience as a children’s nurse, joined the rota for the UK Emergency Medical Team (UKEMT) in May last year. A colleague told her children’s nurses were in demand and suggested she would have the necessary skills.

Last minute notice of deployment

3

The number of weeks Becky Platt and the team spent in the Kutupalong refugee camp.
At the end there was a two-day crossover with the incoming team to ensure a good handover

She had been interested in doing humanitarian work for a while, but knew that many projects required a time commitment of several months, which was not feasible. In the UKEMT, short-term deployments of about three weeks to respond to humanitarian crises are the norm.

Ms Platt explains: ‘Once I joined the rota I was expected to deploy with 12-24 hours’ notice, so I had a bag packed and ready in the spare room. For the first few weeks I jumped every time the phone rang.’

In the months before she flew out to work in the refugee camp, Ms Platt completed a training programme with UK-Med, one of the partners delivering the UKEMT. This prepared participants to deal with high-stress situations, cope with a lack of resources, gel quickly as a team and build personal resilience. There was also training on infection prevention and control and managing a walk-in blood bank.


A patient with suspected diphtheria
Picture: Russell Watkins/Department for International Development

Ms Platt travelled to Bangladesh on 28 December. The team on the ground had already launched a major diphtheria vaccination programme, and needed help with administering diphtheria antitoxin (DAT) and providing advanced airway support to patients.

Ms Platt describes being shocked initially by the inadequacy of the shelters in the camp and ‘overwhelmed by the scale of it’.

‘Even having seen it on the news, nothing compares to feeling it, hearing it, smelling it. There are people everywhere – especially children.’

On a typical day she would wake up early to travel to the camp, the driver dodging rickshaws, chickens and cows along the roads. In the diphtheria treatment centre, she and the team would work predominantly with children, triaging for signs of diphtheria.

Having never encountered the disease before, they had to familiarise themselves quickly with its symptoms: the diphtheria pseudomembrane (a leathery coating at the back of the throat); gross lymphadenopathy (a large swelling of the glands under the jawbone); and bull neck (a soft tissue swelling in the neck and throat).

5-12

The ages of most of the children cared for in the diphtheria treatment centre 

If they identified someone as infected, they would administer the DAT. People can have a severe anaphylactic reaction to the drug so sensitivity testing was vital. Each infusion took several hours, and they would have to use drop-counting methods due to a lack of modern equipment.

Ms Platt remembers: ‘The lack of resources and modern equipment was a bit of a shock. At one point I was handed a mercury thermometer to check someone’s temperature.’

The power of touch

Another challenge was communicating with children between five and 12 years old. Apart from the language barrier, the necessity of wearing masks to prevent infection was a further hindrance.

She explains: ‘We had to use a lot of exaggerated eye movements and hand gestures. Despite wearing gloves, the power of touch is incredibly important. Usually gestures like putting a hand on someone’s arm are subconscious, but we found ourselves thinking about them a lot more.’

Background to the Rohingya crisis

The Rohingya are a minority Muslim ethnic group in Myanmar. Living predominantly in Rakhine state in the west of Myanmar, they have been persecuted for years in the majority Buddhist country.

In August Rohingya militants in Rakhine state attacked police posts, which led quickly to an escalation of violence. Large numbers of Rohingya civilians, the majority being women and children, began fleeing over the border into Bangladesh, reporting brutal violence by Myanmar security forces. The UN Refugee Agency says more than half a million Rohingya refugees have fled to Bangladesh since 25 August 2017 (UNHCR 2018) The majority are sheltering in refugee camps in Cox’s Bazar, in southern Bangladesh.

 


Picture: Russell Watkins/Department for International Development

Despite the difficulties, Ms Platt emphasises that finding solutions to problems and thinking outside the box can be satisfying.

She describes an occasion when she and a colleague had to resuscitate a newborn baby. The baby was freezing cold and needed a hat, so they improvised and used two surgical face masks with cotton wool stuffed underneath. She adds that it was ‘not glamorous, but effective’.

40

The number of people who made up the emergency medical team

Her aim now is to apply this kind of flexible thinking to her job in the UK. ‘It makes you realise how much you can achieve with very little. We couldn’t rely on any tests like X-rays, so we had to go on what we knew of the patient’s history and the symptoms in front of us. That can be very satisfying.’

Ms Platt acknowledges that the team’s work was ‘only scratching the surface’ of the problems facing Rohingya refugees, which could be frustrating’.

However, she would not hesitate to recommend the experience to others. One of the main benefits, she feels, has been to test her personal resilience: ‘Knowing that I can go into that situation and be okay is immensely reassuring.’

Becky Platt’s ‘top tips’ for nurses interested in humanitarian work

  • Do it. There is always a need for paediatric nurses to join the UKEMT and you will not regret your decision.
  • Develop your clinical skills as much as you can before you sign up. You will not be able to rely on the usual tests you have access to at home.
  • Think about how you will cope with seeing distressing sights and how you might help other members of your team to cope with this.

You can join the UKEMT programme here

 


 Joanna Bacon is a freelance writer

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