..GK Cox’s Bazar : Preparedness & response for COVID-19

19 April 2020 On January 30, 2020, the WHO declared the COVID-19 outbreak a global health emergency. On March 11, 2020, the WHO declared COVID-19 a global pandemic, its first such designation since declaring H1N1 influenza a pandemic in 2009.
Until today, this coronavirus attack more than Two hundred ten (210) countries and areas and 2,386,478 peoples are identified as confirmed cases and among them, 164,049 died. In Bangladesh 2,456 confirmed cases and 91 people died. (Ref: Johns Hopkins Corona Virus Resource Center, IEDCR, Bangladesh.) [as of 19th April 2020] In Cox’s Bazar, one case is identified on 24th March 2020 as a positive case and the patient is taken care of in Isolation unit by Cox’s Bazar Sadar Hospital.

GK’s Response on COVID – 19

Health Facility Level -

GK team is also working 24/7 in the camps to mitigate the risk of virus spread and possible response in case of an outbreak in the refugee camps. Out of eleven (11) health facilities (except Shamlapur Physiotherapy Center), five (05) health facilities are served as PHCs 24/7 including Kutupalong and Nayapara Registered camps. Moreover, the rest of the health facilities are operational as Health posts (HPs) including Kutupalong and Nayapara Registered camps.

Outreach Actvities -

Gonoshasthaya Kendra working in the Refugee Camps and surrounding host community took some preventive measures for COVID-19 through its outreach program. GK has 163 Community Health Workers in 11 camps. Currently, they are working with FDMNs to prevent COVID-19 in the camp. Our current activities are –

Disseminating IEC Material:

GK developed/reprinted IEC material on COVID-19. For the FDMNs GK reprinted it in Burmese language. Bangla leaflets were printed for the host community. The posters are posted inside the camp. It helps to raise awareness in the community. So far – five hundred (500) posters, four thousand five hundred (4500) leaflets (in Burmese language), three thousand five hundred (3500) leaflets (in Bangla for host community) are distributed in the catchment areas of Ukhiya and Teknaf.

Hygiene Practical Demonstration:

As per WHO recommendation our outreach workers carry out practical hygiene demonstrations during household visits and make them aware of its benefit. They are following WHO recommended hand washing practices. Since the start of the COVID-19 crisis period until now, GK Outreach Team conducted a total of 31,790 hygiene demonstration sessions where 90,602 community people participated.

Capacity building

GK has done Community Health Workers (CHWs) training regarding the prevention of COVID-19 among 163 CHWs and 11 CHW supervisors to sensitize community people. Moreover, we have arranged a focus group discussion (FGD) at the community level as an additional health support regarding community consultation for the pilot shielding program. Besides, online training on “Mortality Surveillance and Risk messaging” for CHW Supervisors as part of COVID-19 response in the camps has successfully been attended and already being circulated to CHWs. CHWs are conducting sessions in the community as well as raising awareness for preventing COVID-19 by household visits along with regular activities. CHWs have already been provided with IEC materials such as FAQs, Flashcards, leaflets, posters and audio messages concerning COVID-19. Outreach Supervisors conducted training on COVID-19 for the Community Health Workers (CHWs). They also trained community leaders (Imam, Maji`s, Block leaders) and community youth volunteers. They raising awareness in their community. 93 other Organizations‘ Volunteers and 31 Community Leaders (Imam, Majhis) received the awareness training by GKs community outreach supervisors.

What happens if someone is tested positive?

There have been no reported cases of infection in the camps yet, but officials remain concerned. If any suspicious cases identified then the patient and persons in contact with him/her are taken under quarantine with the help of IOM and MSF. In response to COVID-19, MSF and IOM are now implementing IPC measures in medical facilities it runs or supports. GK has a defined patient-referral pathway including their focal person’s contact number. And following it if any such cases identified and manage it properly.

Isolation Capacity-CXB

Key preparedness & response activities carried out by GK: In Cox’s Bazar

1. Installed adequate handwashing setup in all health facilities in the camps and volunteers were trained to ensure handwashing of all patients and visitor coming to the health center and Cox’s Bazar Office
2. Triage and identification of patients with respiratory illness are being done in all facilities with adequate social distance
3. Separate treatment corner established for respiratory illness patients with a temporary separation room to keep highly suspected patients till referral
4. List of isolation center and ambulance hotline number are available in each facility for quick referral
5. Distribution of PPEs (Personal Protection Equipment’s) to the staffing who has direct contact with the patients and/or outsiders.
6. CHWs were given adequate mask for caring out one to one sessions and home visit
7. Necessary protection commodities (including masks, gloves, hand sanitizer, shoe cover, head cover etc) are distributed to all staff for their personal protection.
8. Circulate the awareness messages endorsed by WHO & IEDCR, Bangladesh (Institute of Epidemiology Disease Control And Research) to all the health facilities and Cox's Bazar office staffing in printed & online version.
9. Following IPC (Infection Prevention and Control) Procedure in a timely manner at all, the health facilities as well as Cox's Bazar Office as par national and WHO protocol.
10. Supporting Refugee Health Unit in the registered camps for IPC (Infection Prevention & Control)
11. Three times cleaning and swapping daily at health facility with disinfectant continued
12. Ambulance disinfectant before and after caring patients ensured
13. Following CORONA virus-related instructions by GoB & health sector accordingly.
14. Maintain office hours in a reduced way and advised the Cox's Bazar office staff to follow 'work from home' and/or via online as per need basis.
15. Regular skype meeting with director and coordinators for getting guidance and advice
16. Only few office staffs at a time in the office and strongly advised to keep maintain social distancing.
17. Storing related necessary devices (including; oxygen cylinder, nebulizer, blood pressure measurement device, Infrared Digital thermometer etc) for facing emergency.
18. Took part in the training on IPC organized by WHO
19. Eight CHW supervisors took ToT organized by UNHCR and subsequently GK team completed training and awareness sessions for all CHWs in the camps. Total of 150 volunteers got the orientation sessions.
20. Key messages (approved by CHW working group & civil surgeon) are distributed
21. Technical team continue visiting camps as require for moral and operational support to field staff
22. Regular contact with CIC and other stakeholders as needed