Forcibly Displaced Myanmar Nationals Research Articles

Health service providers' views on barriers and drivers to childhood vaccination of FDMN/Rohingya refugees: a qualitative study in Cox's Bazar, Bangladesh.

Despite established vaccination programs, vaccine-preventable diseases persist among about 900,000 Forcibly Displaced Myanmar Nationals (FDMN)/Rohingya refugees in the world's largest refugee settlement in Bangladesh. Health service providers (HSPs) play a key role in the delivery of childhood vaccination programs. This study explored their views on individual and context barriers and drivers to childhood vaccination in this setting. Informed by the theoretical framework of the Capability-Opportunity-Motivation-Behavior (COM-B) model for behavior change, this qualitative study collected data through eight focus group discussions (FGDs) with community health workers (CHWs) and vaccinators in selected camps with high or low vaccination coverage rates, and through 11 in-depth interviews (IDIs) with key informants working in strategic, management, and administrative roles. Barriers and drivers were evident across all COM factors for HSPs and caregivers. Among HSPs, knowledge around vaccination acted both as a barrier and driver, while communication skills and confidence in vaccination served as drivers. Caregivers' lack of awareness of vaccination, concerns and mistrust were described as main barriers. Context barriers included information system deficiencies, family dynamics, HSPs' working conditions, and vaccination site accessibility. Context drivers included effective communication, mobilization, and incentives. Differences between high and low coverage camps in Cox's Bazar included variations in HSPs' knowledge, communication strategies, incentive use, and stakeholder collaboration. For better vaccination coverage in the camps, context-related changes regarding collaboration, health workforce and the use of incentives seem necessary. Caregivers' mistrust toward vaccination needs to be considered under the social and historical background of the Rohingya community, and further addressed with targeted communication and campaigning.

Comprehensive strategies for effective fecal sludge management in Humanitarian Settings: A case study of Cox’s Bazar Rohingya Response

The influx of Forcibly Displaced Myanmar Nationals (FDMN) into Bangladesh has necessitated the development of robust Fecal Sludge Management (FSM) strategies in Cox’s Bazar to ensure safe and sustainable sanitation solutions. Effective fecal sludge management (FSM) is crucial in humanitarian settings for public health, environmental protection, and dignity. This study investigates comprehensive FSM strategies in Cox’s Bazar Rohingya refugee camps, one of the largest and most complex humanitarian crises. Using a mixed-methods approach, it combines quantitative data from surveys and field observations with qualitative insights from interviews and document analysis to examine the FSM value chain, including sludge production, containment, collection/emptying, transport, treatment, and disposal/reuse. Findings show high sludge production rates require frequent desludging, with challenges in containment due to structural weaknesses and privacy concerns. Collection and emptying face logistical and health issues, while transport is hindered by difficult terrain and limited vehicle availability. Treatment facilities are often inadequate, leading to operational challenges and environmental risks. Despite these issues, disposal and reuse practices in agriculture show promise but need safety and community acceptance improvements. The study recommends increasing desludging capacity, enhancing containment designs, improving transport infrastructure, expanding treatment facilities, and promoting safe disposal and reuse practices. Emphasizing community engagement, technological innovations, and coordinated efforts among stakeholders is crucial for sustainable FSM systems. Future research should focus on innovative technologies, long-term sustainability, and scalability of FSM strategies across contexts. This research provides valuable insights and practical recommendations for improving sanitation in similar emergency contexts worldwide.

Health State and Barriers to the Provision of Health Services among Forcibly Displaced Myanmar Nationals in Bangladesh

Background: Forcibly displaced Myanmar nationals (FDMNs) are one of the most persecuted minorities groups, suffering from an abundance of health issues. They are exposed to a wide range of stressful events that are associated with adverse health consequences, which leads to decreased life expectancy due to increased morbidity and mortality. Methodology: A descriptive cross-sectional survey among conveniently selected 203 healthcare workers (HCWs) to assess the health state and barriers to the provision of health services to FDMNs in the Kutupalong and Balukhali camps at Ukhiya Upazilla, Cox's Bazar. Data were collected by face-to-face interviews by using a semi-structured questionnaire. Results: The mean age of the HCW was 29.2±3.6 years and mean service duration was 5.8±4.1 months. Most of the health facilities provided treatment for CDs (62.5%) and NCDs (80.0%). About one-third of the facilities had no laboratory facilities for diagnosing CDs (32.2%) and NCDs (40.0%). More than half of HCCs (55.0%) were maintain sterilization processes, such as boiling (90.9%), chemical components (45.5%) and an autoclave machine (13.6%). One-fourth of the HCWs (25.6%) get training during their joining times and above two-thirds of the HCWs (69.5%) received training after joining their service. The most frequently cited challenges faced during the provision of health services were transportation barriers (96.4%), language barriers (87.2%), scarcity of drugs (67.5%), vague disease histories (60.9%), unfavorable weather (59.4%) and electricity problems (44.7%). Conclusion: This study suggests that an organized primary healthcare service, specially designed for communicable and non-communicable disease prevention and management is necessary to improve health condition of FDMNs. Eastern Med Coll J. July 2023; 8 (2): 33-39

Community perception and utilization of services for the severe wasted children aged 6-59 months in the Forcibly Displaced Myanmar Nationals and their nearest host communities in Bangladesh: a qualitative exploration.

There is a paucity of data on community perception and utilization of services for wasted children in Forcibly Displaced Myanmar Nationals (FDMN) and their nearest host communities. We conducted a qualitative study to explore community perceptions and understand the utilization of services for severely wasted children among the FDMN and their nearest host communities in Teknaf, Cox's Bazar. We carried out 13 focus group discussions and 17 in-depth interviews with the caregivers of the children of 6-59 months, and 8 key informant interviews. Caregivers' perceived causes of severe wasting of their children included caregivers' inattention, unhygienic practices, and inappropriate feeding practices. However, the context and settings of the FDMN camps shaped perceptions of the FDMN communities. Caregivers in both the FDMN and host communities sought care from healthcare providers for their children with severe acute malnutrition (SAM) when they were noticed and encouraged by their neighbors or community outreach workers, and when their SAM children suffered from diseases such as diarrhea and fever. Some caregivers perceived ready-to-use therapeutic food (RUTF) as a food to be shared and so they fed it to their non-SAM children. Caregivers of the children having SAM with complications, in the FDMN and host communities, were reluctant to stay in stabilization centers or complex respectively, due to their households' chores and husbands' unwillingness to grant them to stay. The findings of this study are expected to be used to design interventions using locally produced RUTF for the management of SAM children in the FDMN, as well as to inform the health sector working on SAM child management in the host communities.

Institutional capacity assessment in the lens of implementation research: Capacity of the local institutions in delivering WASH services at Cox's Bazar district, Bangladesh.

The influx of Forcibly Displaced Myanmar Nationals (FDMNs) has left the Southwest coastal district of Cox's Bazar with one of the greatest contemporary humanitarian crises, stressing the existing water, sanitation, and hygiene (WASH) resources and services. This study aimed to assess the existing capacity of local institutions involved in delivering WASH services and identify relevant recommendations for intervention strategies. We used a qualitative approach, including interviews and capacity assessment workshops with institutions engaged in WASH service delivery. We conducted five key informant interviews (KII) with sub-district level officials of the Department of Public Health Engineering (DPHE), Directorate General of Health Services (DGHS), Directorate of Primary Education (DPE) and Bangladesh Rural Advancement Committee (BRAC) to have a general idea of WASH service mechanisms. Seven capacity assessment workshops were organized with the relevant district and sub-district level stakeholders from August 2019 to September 2019. These workshops followed three key areas: i) knowledge of policy, organizational strategy, guidelines, and framework; ii) institutional arrangements for service delivery such as planning, implementation, coordination, monitoring, and reporting; and iii) availability and management of human, financial and infrastructural resources. Data were categorized using thematic content analysis. The majority of stakeholders lacked awareness of national WASH policies. Furthermore, the top-down planning approaches resulted in activities that were not context-specific, and lack of coordination between multiple institutions compromised the optimal WASH service delivery at the local level. Shortage of human resources in delivering sustainable WASH services, inadequate supervision, and inadequate evaluation of activities also required further improvement, as identified by WASH stakeholders. Research evidence suggests that decision-makers, donors, and development partners should consider learning from the WASH implementers and stakeholders about their existing capacity, gaps, and opportunities before planning for any WASH intervention in any particular area.

Factors influencing food preferences and eating behaviour among the Forcibly Displaced Myanmar Nationals (FDMN) adolescents in Cox’s Bazar, Bangladesh: a cross-sectional survey

BackgroundAdolescence is a pivotal period for physical, mental, social and behavioural development, so it is crucial to understand the factors influencing adolescent food preferences and eating behaviour. This study aimed...

Prevalence of scabies and its associated environmental risk factors among the Forcibly Displaced Myanmar Nationals living in the Cox's Bazar district of Bangladesh

IntroductionThe Forcibly Displaced Myanmar Nationals (FDMNs) residing in refugee camps face various health challenges, including a rising prevalence of scabies, exacerbated by overcrowded conditions and limited healthcare access. This study aims to assess scabies prevalence, clinical features, and environmental factors among FDMNs, aiding interventions and recommendations for better health outcomes. MethodologyA cross-sectional study was conducted from April to May 2023 in six camps of Teknaf/Ukhia Cox's Bazar. Using a multistage sampling technique, 12 blocks were identified, and FDMNs seeking healthcare services from Primary Health Care posts were invited to participate in the study. Participants were adults, and children who volunteered to participate in this study. Scabies diagnosis was based on clinical examinations of exposed body areas by trained health professionals. Data on sociodemographic factors, environmental risk factors, and scabies symptoms were obtained through a semi-structured questionnaire administered by trained interviewers. Statistical analysis included descriptive statistics, Chi-square tests, and binary logistic regression models to explore associations between scabies infection and other explanatory factors. ResultA total of 679 FDMNs participated in the study, with a mean age of 29.13 years. Overall, 66.42 % of participants were diagnosed with scabies. Age, marital status, history of scabies infection, previous skin infection, family history of scabies and skin infection, floor type, pet animal, dust exposure, and seasonal exposure were significantly associated with the scabies infection. Binary logistic regression suggested that having history of scabies infection (OR 3.98, 95 % CI: 1.86 to 8.49, p < 0.001), skin infection (OR 2.46, 95 % CI: 1.32 to 4.58, p = 0.004), having family history of scabies infection (OR 3.06, 95 % CI: 1.29 to 7.23, p = 0.011), family history of skin infection (OR 27.41, 95% CI: 14.46 to 51.97, P < 0.001), having contact with street animal (OR 2.16, 95% CI: 1.27 to 3.66, P = 0.004), and winter season (OR 3.33, 95 % CI: 1.89 to 5.87, p < 0.001) were significantly associated with scabies infection. ConclusionTailored public health measures targeting hygiene, living conditions, and animal contact can mitigate the spread of scabies, particularly among vulnerable groups like Rohingya refugees, necessitating collaboration between stakeholders.

Caregivers’ socio-cultural influences on health-seeking behavior for their wasted children among forcibly displaced Myanmar Nationals and their nearest host communities

IntroductionA total of 19% of forcibly displaced Myanmar Nationals (FDMNs) Bangladesh fall within the age range of under five years old, while an average of 1% exhibit severe malnutrition. Cox’s Bazar is the closest host community for FDMNs, with similar traditional culture and religion and shared linguistic, ethnic, and cultural ties.MethodsA qualitative study was conducted to investigate the impact of socio-cultural factors on the healthcare-seeking behavior of caregivers of critically malnourished children in FDMN camps and neighboring host communities.ResultsThe utilization of informal healthcare by caregivers in both populations can be attributed to cultural attitudes, taboos, and peer pressure. The healthcare by practices in the FDMN camps and host towns were primarily affected by household responsibilities, familial assistance in accessing medical services, decisions made by husbands or mothers-in-law, and the availability and accessibility of healthcare facilities. Certain features were identified that prompt caregivers to seek formal treatment in both groups. The efficacy of the treatment was a primary consideration. In instances where conventional remedies and informal treatments proved ineffective in restoring the health of children, others who were invested in their well-being, such as family members and neighbors, advised caretakers to pursue professional medical care.DiscussionEnhanced caregiver awareness of severe wasting, enhanced healthcare accessibility, and increased community volunteer engagement have the potential to facilitate early identification of severely wasted children and mitigate delays in treatment.

Prevalence of Soil-Transmitted Helminths at Baseline and after Albendazole Treatment in the School-Age Children of Forcibly Displaced Myanmar Nationals in Bangladesh.

The forcibly displaced Myanmar nationals (FDMNs) known as Rohingya refugees are the largest group of stateless individuals globally. According to the emergencies humanitarian actors at the United Nations Office for the Coordination of Humanitarian Affairs, the worldwide refugee crisis involving FDMNs is intensifying at the fastest rate in history. Growing public health demands are being exacerbated by current difficulties in addressing poor access to health services, severe food shortages, and a lack of adequate housing. Infectious diseases constitute a major public health emergency in this vulnerable population. A study was carried out in FDMN children to investigate common soil-transmitted helminth (STH) infection at the time of enrollment and prospectively followed-up to 12 months after 2 doses albendazole treatment. At baseline, the prevalence of STH infection with at least one species was found to be 91.7% and 87.3% for Kato-Katz (KK) and quantitative polymerase chain reaction (qPCR) methods, respectively. Similarly, for follow-up children, the overall infection rate was 95.3% and 91.5%, respectively. Trichuris trichiura was the most predominant STH infection by both KK (baseline 87%, follow-up 89.1%) and qPCR (baseline 77.5%, follow-up 82.9%). The overall prevalence of stunting in the children was 37.8% at baseline and rose to 51.3% at 12 months. Alpha-1 antitrypsin (r = 0.13, P = 0.01) and myeloperoxidase (r = 0.12, P = 0.01) levels showed a positive correlation with Aascaris lumbricoides egg count per gram at baseline. An in-depth investigation is urgently needed to identify the underlying protective measures and the root cause of STH infections to improve the health of FDMN children.

The assessment of geriatric malnutrition, geriatric depression and associated co-morbidities among forcibly displaced Myanmar nationals in Bangladesh.

To assess the nutritional status and depression of the elderly forcibly displaced Myanmar nationals (FDMN) in Bangladesh and determine the associated factors of geriatric depression (GD). This was a community-based, cross-sectional study among elderly FDMN. The Mini Nutritional Assessment Short-Form (MNA@-SF) and Geriatric Depression Scale Short-Form (GDS-15 SF) were used to determine malnutrition and GD, respectively. The study was conducted between November 2021 and March 2022 in Kutupalong Refugee Camp, Cox's Bazar, Bangladesh. The study participants were elderly FDMN aged ≥ 60 years (n 430). The mean age and BMI were 71·7(±7·8) years and 21·94(±2·6) kg/m2, respectively. There was a high prevalence of self-reported diabetes mellitus (32·1 %), hypertension (26·7 %), hypotension (20 %), skin diseases (28·4 %) and chronic obstructive pulmonary disease (16·5 %). The prevalence of malnutrition was 25·3 %, and another 29·1 % were at risk. The prevalence of GD was 57·9 %, and co-occurrences of GD and malnutrition were seen in 17·5 % of participants. GD was significantly higher among elderly people with malnutrition (adjusted OR, AOR = 1·71, 95 % CI: 1·01, 2·89). FDMN aged ≥ 80 years were at higher risk of GD (AOR = 1·84, 95 % CI: 1·01, 3·37), and having fewer than five members in the household was an independent predictor of GD. Diabetes mellitus (AOR = 1·95, 95 % CI: 1·24, 3·08) and hypotension (AOR = 2·17, 95 % CI: 1·25, 2·78) were also significantly associated with an increased risk of GD. A high prevalence of GD and malnutrition was observed among elderly FDMN in Bangladesh. The agencies working in Cox's Bazar should focus on geriatric malnutrition and GD for the improvement of the health situation of FDMN in Bangladesh.

Oral cholera vaccine coverage evaluation survey: Forcibly Displaced Myanmar Nationals and host community in Cox's Bazar, Bangladesh.

Cholera remains a significant public health concern in many parts of the world, particularly in areas with poor sanitation and hygiene. Bangladesh and other impoverished nations have been severely affected by cholera outbreaks, especially in areas with a high population density. In order to mitigate the spread of cholera, oral cholera vaccines (OCVs) are recommended as a prophylactic measure. In May 2018, 775,666 of the Forcibly Displaced Myanmar Nationals (FDMN) in the registered and makeshift camps and 103,605 of the residents in the host community received two doses of OCV ShancholTM in Cox's Bazar, Bangladesh, because the conditions in the area favored the transmission of cholera and other waterborne diseases. This study aimed to assess the coverage of OCV among the FDMN and the host community in Cox's Bazar. In August 2018, we enrolled 4,240 respondents for this study following the "World Health Organization (WHO) Vaccination Coverage Cluster Surveys: Reference Manual (2018)." The coverage survey was conducted with three strata of the population: the host community from the Teknaf Upazila, the registered camp, and the makeshift camp from the Ukhia Upazila. We collected information regarding OCV coverage, demographic characteristics, and knowledge and behaviors of people toward the vaccine. The data were analyzed using descriptive statistics. According to our study, the overall OCV coverage was 85%, with 68% in the host community, 91% in the registered camp, and 98% in the makeshift camp. The lower coverage in the host community was due to residents unaware of the vaccination campaign, the unavailability of vaccines, and unaware where to go for vaccination. Our findings demonstrate that the OCV campaign in the FDMN camps was successful, reaching over 90% coverage, while coverage in the host community was much lower. In order to make sure that OCV vaccination efforts are reaching the target population and having the desired impact, our study emphasizes the need to inform the target population of when and where to get vaccinated.

Genomic epidemiology of Vibrio cholerae during a mass vaccination campaign of displaced communities in Bangladesh

Ongoing diarrheal disease surveillance throughout Bangladesh over the last decade has revealed seasonal localised cholera outbreaks in Cox’s Bazar, where both Bangladeshi Nationals and Forcibly Displaced Myanmar Nationals (FDMNs) reside in densely populated settlements. FDMNs were recently targeted for the largest cholera vaccination campaign in decades. We aimed to infer the epidemic risk of circulating Vibrio cholerae strains by determining if isolates linked to the ongoing global cholera pandemic (“7PET” lineage) were responsible for outbreaks in Cox’s Bazar. We found two sublineages of 7PET in this setting during the study period; one with global distribution, and a second lineage restricted to Asia and the Middle East. These subclades were associated with different disease patterns that could be partially explained by genomic differences. Here we show that as the pandemic V. cholerae lineage circulates in this vulnerable population, without a vaccine intervention, the risk of an epidemic was very high.

Forcibly Displaced Myanmar Nationals (FDMN) in Bangladesh: The Need for Repatriation to Myanmar

Forcibly Displaced Myanmar Nationals (FDMN) have been created by the Myanmar army to leave their motherland. Due to inhuman torture by the Myanmar army, the FDMN had no other way but to leave their land. These FDMN took shelter in the neighboring countries, especially in Bangladesh. Bangladesh government established an extraordinary example of humanity providing shelter to the FDMN. But the temporary shelter should not be a permanent solution for the FDMN. Bangladesh is not their motherland, rather it is Myanmar and they are eager to go back to their motherland with honor and dignity. Bangladesh is trying its best to provide safety and security to the FDMN. But how long? Global actors had witnessed the brutality of the Myanmar army with the FDMN. This is high time for all stakeholders to come forward and find sustainable solutions for dignified repatriation of the FDMN to their motherland, Myanmar.

Understanding fertility behavior of the Forcibly Displaced Myanmar Nationals in Bangladesh: A qualitative study.

Rohingya- the Forcibly Displaced Myanmar Nationals (FDMN)- are largely characterized by a high total fertility rate (TFR) and a low contraceptive prevalence rate. This study aimed to explore the reasons behind their high fertility behavior by utilizing the Theory of Planned Behavior. We adopted a cross-sectional qualitative research approach. Fifteen semi-structured, face-to-face in-depth interviews were conducted with the Rohingya husbands, wives, and community leaders (Majhi and Imam/Khatib) living in Camps 1 and 2 of Ukhiya Refugee Camp, Cox's Bazar, Bangladesh. We analyzed the qualitative data using the thematic analysis approach. The Muslim-majority FDMN predominantly constructed the fertility outcome as the will and order of Allah. On the one hand, the Rohingya parents highlighted various religious, political, economic, and social advantages of having more children, especially sons. On the other hand, beliefs about religious restriction, fear of side effects, and community pressure against contraception sustained the reality of the low contraceptive prevalence rate in the community. Alarmingly, the Rohingya religious leaders and mass people were found highly politically motivated to continue the practice of high fertility with a view to 'expanding the Rohingya community' or 'to increase Muslim soldiers', so that they may fight back and take control of their ancestors' place in Myanmar in the future. Furthermore, these pronatalist attitudes and beliefs translated into high TFR through various high-fertility-supportive social norms and practices widely prevalent in the Rohingya community. These include child marriage, gendered division of labor, women's subordinate nature, the Purdah system, and joint-family members' support during childbirth and rearing. Religion, ethnic identity, and the unique political context and experiences of the Rohingya people jointly explain their high fertility behavior. This study warrants the urgency of initiating social and behavior change communication programs to change the religiopolitically-motivated high-fertility notions that prevailed in the Rohingya community.

Bacterial and viral etiology of acute respiratory infection among the Forcibly Displaced Myanmar Nationals (FDMNs) in fragile settings in Cox's Bazar- a prospective case-control study.

The leading infectious cause of death in children worldwide is lower acute respiratory infection (LARI), particularly pneumonia. We enrolled a total of 538 acute respiratory infection (ARI) cases according to WHO criteria and age-sex matched 514 controls in the Forcibly Displaced Myanmar National (FDMN) refugee camps in Cox's Bazar, Bangladesh, between June 2018 and March 2020 to investigate the role of bacteria, viruses, and their co-infection patterns and observe Streptococcus pneumoniae (S. pneumoniae) serotype distribution. According to the etiological findings, children ≤5 years of age have a higher bacterial positivity (90%) and viral positivity (34%) in nasopharyngeal samples (NPS) compared to those >5 years of age, in both ARI cases as well as for the control group. Among the bacteria, S. pneumoniae was predominant in both cases and controls (85% and 88%). Adenovirus (ADV)(34), influenza virus A and B (IFV-A, B)(32,23), and respiratory syncytial virus (RSV)(26) were detected as the highest number among the viruses tested for the ARI cases. The total number of viruses was also found higher in ≤5 years of age group. Within this group, positive correlation was observed between bacteria and viruses but negative correlation was observed between bacteria. Both single and co-infection for viruses were found higher in the case group than the control group. However, co-infection was significantly high for Streptococcus aureus (S. aureus) and Haemophilus influenzae b (H. influenza b) (p<0.05). Additionally, semi-quantitative bacterial and viral load was found higher for the ARI cases over control considering Cycle threshold (Ct)≤30. Pathogen identification from blood specimens was higher by qRT-PCR than blood culture (16% vs 5%, p<0.05). In the S. pneumoniae serotype distribution, the predominant serotypes in ARI cases were 23F, 19A, 16F, 35B, 15A, 20 and 10F, while 11A, 10A, 34, 35A and 13 serotypes were predominant in the control group. Pathogen correlation analysis showed RSV positively correlated with human metapneumovirus (HMPV), S. aureus and H. influenza b while S. pneumoniae was negatively correlated with other pathogens in ≤5 years age group of ARI cases. However, in >5 years age group, S. aureus and H. influenza b were positively correlated with IFVs, and S. pneumoniae was positively correlated with HMPV and ADV. Logistic regression data for viruses suggested among the respondents in cases were about 4 times more likely to be RSV positive than the control. Serotype distribution showed 30% for PCV10 serotypes, 41% for PCV13 and 59% for other serotypes. Also, among the 40 serotypes of S. pneumoniae tested, the serotypes 22F, Sg24, 9V, 38, 8, and 1 showed strong positive correlation with viruses in the case group whereas in the control group, it was predominant for serotypes 14, 38, 17F and 39 ARI cases were prevalent mostly in monsoon, post-monsoon, and winter periods, and peaked in September and October. Overall these region-specific etiological data and findings, particularly for crisis settings representing the FDMNs in Cox's Bazar, Bangladesh, is crucial for disease management and disease prevention control as well as immunization strategies more generally in humanitarian crisis settings.

Nutritional and dietary diversity status of under-5 children and adolescent girls among forcibly displaced Myanmar nationals living in Bhasan Char relocation camp, Bangladesh: a cross-sectional survey

ObjectiveTo generate baseline evidence regarding the nutritional and dietary diversity status of under-5 children and adolescent girls among forcibly displaced Myanmar nationals (FDMN) relocated to Bhasan Char relocation camp of...

Seroprevalence of SARS-CoV-2 antibodies among Forcibly Displaced Myanmar Nationals in Cox’s Bazar, Bangladesh 2020: a population-based cross-sectional study

ObjectivesThe study aimed to determine the seroprevalence, the fraction of asymptomatic infections, and risk factors of SARS-CoV-2 infections among the Forcibly Displaced Myanmar Nationals (FDMNs).DesignIt was a population-based two-stage cross-sectional...

Quantitative soil erosion risk assessment due to rapid urbanization in the Cox’s Bazar district and Rohingya refugee camps in Bangladesh

Soil erosion due to anthropogenic interventions is an emerging threat to the south-eastern coastal districts of Bangladesh. In the recent decade, land degradation intensified this process in this region due to the settlement of the Forcibly Displaced Myanmar Nationals popularly known as ‘Rohingya’, who fled from Myanmar in 2017. To control soil erosion, it is necessary to identify the soil erosion locations and their intensity. The present study has attempted to quantify the regional soil loss (from 2015 to 2020) using the Revised Universal Soil Loss Equation model. In this method, soil erosion risk assessments are carried out by integration of different physiographic parameters in the spatial dimension. Results showed that the year 2015 and 2020 witnessed mean soil erosion at a rate of around 58.2 and 59 t ha− 1 yr− 1, respectively in the Cox’s Bazar district in which 20–21% of the study area was highly subjected to soil erosion. But in the Rohingya camps mean soil erosion for these periods is 59 and 78 t ha− 1 yr− 1, respectively with a cumulative increase of 32%. The sub-districts adjacent to the Rohingya refugee camps (Ramu, Ukhia, and Teknaf) have experienced intense erosion compared to the others. From 2015 to 2020, a large increase of about 4.54 (6%) t ha− 1 yr− 1 is observed in the Palongkhali union whereas a maximum decrease of about − 8.08 (23%) t ha− 1 yr− 1 is observed in the Pokkhali union. In Rohingya camps, the worst soil erosion-affected areas are the camps 8E, 10, 14, 15, 16, and 17 having more than 100 t ha− 1 yr− 1 mean soil loss. The geographic detector method is used to identify the influence of different factors on soil erosion. Land use change is found to be the major contributing factor to soil erosion increase from 2015 to 2020. The spatial variations are significantly controlled by slope and elevation factors. This work can help to understand the dynamics of soil erosion and the knowledge can be used for conservation planning in the Cox’s Bazar and Rohingya camp areas.

The Stability and Suitability of the Bhasan Char Island as an Accommodation for the Forcibly Displaced Myanmar Nationals (FDMN)

Assessing the dynamics of Bhasan Char is very crucial, as the Government of Bangladesh (GoB) has recently selected the island as the accommodation of the FDMN. This article critically evaluates the spatiotemporal morphological variations due to erosion, accretion, and subsurface deformation of the island through multi-temporal geospatial and geophysical data analysis, groundwater quality-quantity, and also determines the nature and rate of changes from 2003 to 2020. This is the first study in this island on which multi-temporal Landsat Satellite Imagery and seismic data have been used with geospatial techniques with Digital Shoreline Analysis System (DSAS) and petrel platform, respectively. The analysis of satellite images suggests that the island first appeared in 2003 in the Bay of Bengal, then progressively evolved to the present stable condition. Significant changes have taken place in the morphological and geographical conditions of the island since its inception. Since 2012, the island has been constantly accreted by insignificant erosion. It receives tidally influenced fluvial sediments from the Ganges-Brahmaputra-Meghna (GBM) river system and the sedimentary accretion, in this case, is higher than the erosion due to relatively weaker wave action and longshore currents. It has gained approximately 68 km2 area, mostly in the northern part and because of erosion in the south. Although the migration of the Bhasan Char was ubiquitous during 2003–2012, it has been concentrated in a small area to the east since 2018. The net shoreline movements (NSM) suggest that the length of the shoreline enlarged significantly by around 39 km in 2020 from its first appearance. Seismic and GPS data clearly indicate that the island is located on the crest of a slowly uplifting low-amplitude anticline, which may result in a stable landform around the island. Based on the analysis of historical data, it has been assessed that the current configuration of Bhasan Char would not be severely affected by 10–15-foot-high cyclone. Therefore, FDMN rehabilitation here might be safer that would be a good example for future geo-environmental assessment for any areas around the world for rehabilitation of human in remote and vulnerable island. The findings of this research will facilitate the government’s decision to rehabilitate FDMN refugees to the island and also contribute to future research in this area.

Health problems among Forcibly Displaced Myanmar Nationals (FDMNs) admitted to the Medicine ward of Cox's Bazar Medical College Hospital

BackgroundForcibly Displaced Myanmar Nationals (FDMNs) or Rohingya refugees are one of the vulnerable groups suffering from different kinds of health problems but have been less reported yet. Therefore, the study was designed to delineate the health problems among FDMNs admitted to Cox's Bazar Medical College Hospital. MethodsThis hospital-based cross-sectional study was conducted at the Medicine ward, Cox's Bazar Medical College Hospital, for a six-month period following approval. Rohingya refugees who were admitted during the study period were approached for inclusion. Informed written consent was ensured prior to participation. A structured questionnaire was used during data collection. Collected information was recorded in case record form. A total of 290 subjects were interviewed. Analysis was performed using the statistical package for social science (SPSS) version 20. ResultsThe mean age of the participants was 48.76 ± 18.67 years (range: 16–91), with a clear male predominance (60.7%). Family size ranged 6–8. All of the participants reported at least one of the illnesses. Of all, 29.66% patients had disease of the respiratory system, and 26.9% had disease of the gastrointestinal and hepatobiliary system. Accidental injury or injury due to electrocution or thin falls or snake bites was present in 10.4% of the cases. Among the single most common diseases, COPD (20%) was the most frequently observed, and the rest of them were chronic liver disease (13.1%), pulmonary TB (5.5%), ischemic stroke (5.5%), CAP (4.1%), acute coronary syndrome (3.4%), thalassaemia (3.4%) and hepatocellular carcinoma (3.4%). Among the top 6 diagnosed diseases, PTB was more common in elderly individuals (p = 0.29). The disease pattern was similar across the sexes among the refugees except community acquisition pneumonia (CAP), which was commonly observed among males (p = .004). Considering different age groups, genitourinary problems were more common in males aged >60 years, and rheumatology and musculoskeletal problems were equally affected in females aged between 40 and 60 years. ConclusionCOPD, CLD and CAP were the most prevalent diseases in FDMN patients who attended the Medicine ward of Cox's Bazar Medical College Hospital. Further exploration is warranted before any policy making and comprehensive plan.