Assessment of palliative care needs amongst the Rohingya refugees in Cox’s Bazar, Bangladesh
Working with PalCHASE, Dr Farzana Khan (Fasiuddin Khan Research Foundation, Bangladesh) and Dr Megan Doherty (World Child Cancer) have recently completed (Nov 2017) a Palliative Care Rapid Situational Analysis in Rohingya Refugees in Cox’s Bazar, Bangladesh.
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.
You can find out more in:
- final report
- real-life stories from the camp and Dr Khan’s personal experiences and reflections.
This data-gathering activity will inform a new research project. It will aim to develop robust tools for the assessment of the palliative care needs of refugees and people in humanitarian emergencies more generally. If you are interested in joining the project, please contact Tony Powell, richard2powell [with the address at] yahoo.co.uk.
You can see the detailed ACAPS analysis of the Rohingya crisis here. Briefly, an estimated 622,000 Rohingya refugees fled Myanmar to Bangladesh between August and November 17. The trigger were security operations of the Myanmar Army in northern Rakhine state. No large-scale humanitarian response is yet in place. Key challenges include:
- congestion in settlements;
- water, sanitation and hygiene – e.g. high faecal contamination of drinking water;
- high malnutrition rates;
- an ongoing measles outbreak;
- psychosocial support needs, as many refugees have experienced trauma and rape.
There is also limited time to scale up humanitarian responses before the cyclone season (April – June).
PalCHASE is currently raising funds to send its own team in the field.
PalCHASE survey – hearing from you and creating a global community of practice
We’ve launched a survey for people interested in the work of PalCHASE. We want to identify key priorities, challenges and drivers to palliative care in humanitarian contexts as well as to create a community of practice. You can access the survey here.