Innovative measures slash sexually-transmitted infections in Bangladeshi camps

News Stories, 14 January 2009

© UNHCR/I.M.Bayzid
Stocking Up: In Nayapara camp, a refugee visits community health worker Zafor Ullah (right) in his home for a fresh supply of condoms.

NAYAPARA REFUGEE CAMP, Bangladesh, January 14 (UNHCR) Zafor Ullah has been a community health worker for his fellow Rohingya refugees for eight years. When his duties expanded nearly two years ago to include condom distribution, he became an immensely popular man.

"The people in my community like to come to my house to get condoms as they can catch me [there] all the time," the 22-year-old refugee from Myanmar explains. "They might have to wait at the clinic and explain the purpose of their visit. So, to avoid all the hassle, they prefer to visit my house."

Using community health workers to distribute condoms out of their houses to both male and female refugees in the two camps in Bangladesh was the breakthrough move in a series of measures taken by UNHCR that have dramatically reduced the incidence of sexually-transmitted infections (STI) among the refugees, says Zahid Jamal Khattak, UNHCR's medical coordinator in Cox's Bazar.

Since the end of 2005, the average STI incidence per month has dropped 67 percent in the Nayapara and Kutupalong Camps, near Cox's Bazar, together home to 28,000 Muslim Rohingya refugees from Myanmar's northern Rakhine state. The actual drop among registered refugees has been greater, Dr. Jamal explains, but the numbers are kept higher by unregistered Rohingya living on the outskirts of Kutupalong who are treated in the camp on a humanitarian basis.

The success comes from a three-year UNHCR programme that started by training staff in the camps' out-patient clinics to recognize and properly diagnose STIs, coupled with increased availability of the correct drugs. However, problems arose in tracing partners to treat all affected patients.

Many male refugees who work outside the camp are having extramarital sex and bringing infections back to their wives, but "culturally, giving condoms to women [in the clinic to prevent future infections] was not very well appreciated," Dr. Jamal explains.

The breakthrough came with the distribution of condoms through the 39 community health workers (14 of them women) in the two camps out of their own homes, rather than the clinics. Religious leaders were included in the health workers' training to avoid any problems.

Condom distribution has skyrocketed from a paltry 780 in 2005 to 62,580 last year, and Mahamuda Khatun, a 32-year-old community health worker, says she gets requests from women refugees as well as men. "Unmarried male and female refugees visit my house in order to get condoms," she says. "They say it will help them to prevent disease."

She says one refugee woman told her she gets her husband to use a condom because "he goes out to work frequently and I don't want to catch any disease from him."

Condom use was also spurred by training on HIV prevention and education on family planning for a population that traditionally has many children. It's the kind of knowledge that Mahamuda wishes she had had earlier. "I have four children. If I had had a chance to know the consequences of having more children, I certainly would have limited my family," she says.

Both Zafor and Mahamuda feel they are helping their community. "The remuneration that I get is very little," says Zafor, "but the contribution that I provide to my fellow refugees is very big."

He's even had some pleasant surprises. One refugee man Zafor thought he had failed to persuade, later came back asking for condoms for birth control. "He said if his family becomes bigger, he will not be able to give them proper education and food," Zafor reports. "This gives me a lot of confidence and satisfaction."

And if UNHCR is able to supply more condoms, Zafor wants to be even more active. "Currently I do not go to refugees' houses to motivate them to take condoms," he explains. "When I have more supply, then I will visit refugees' houses and I'll try to motivate them and make more people aware."

By Ikterrudin Mohammed Bayzid in Nayapara Refugee Camp
and Kitty McKinsey in Cox's Bazar, Bangladesh




UNHCR country pages

Myanmar Cyclone Victims Still Need Aid

With eight relief flights and an earlier truck convoy from nearby Thailand, UNHCR had by June 6, 2008 moved 430 tonnes of shelter and basic household supplies into Myanmar to help as many as 130,000 victims of Cyclone Nargis. The aid includes plastic sheeting, plastic rolls, mosquito nets, blankets and kitchen sets. Once the aid arrives in the country it is quickly distributed.

On the outskirts of the city of Yangon – which was also hit by the cyclone – and in the Irrawady delta, some families have been erecting temporary shelters made out of palm leaf thatching. But they desperately need plastic sheeting to keep out the monsoon rains.

Posted on 12 June 2008

Myanmar Cyclone Victims Still Need Aid

Returnees in Myanmar

During the early 1990s, more than 250,000 Rohingya Muslims fled across the border into Bangladesh, citing human rights abuses by Myanmar's military government. In exile, refugees received shelter and assistance in 20 camps in the Cox's Bazaar region of Bangladesh. More than 230,000 of the Rohingya Muslims have returned since 1992, but about 22,000 still live in camps in Bangladesh. To promote stability in returnee communities in Myanmar and to help this group of re-integrate into their country, UNHCR and its partner agencies provide monitors to insure the protection and safety of the returnees as well as vocational training, income generation schemes, adult literacy programs and primary education.

Returnees in Myanmar

Refugees from Myanmar: Ethnic Karens Seek Shelter

Over 2,000 refugees from Myanmar have crossed the border into Thailand in recent months. Most claim to be fleeing renewed conflict and human rights abuses in Kayin state, Myanmar. The mainly ethnic Karen refugees say their houses and villages have been burned and civilians killed. Many were weak upon arrival, suffering from illnesses such as malaria, after a long, dangerous journey to the camps through heavily mined areas. The refugees have been arriving at government-run camps, mainly in the Mae Hong Son area in northern Thailand.

UNHCR is working with the Thai government and non-governmental organisations to ensure the new arrivals are admitted to the camps and provided with adequate shelter and protection. Shelter has been a major issue as the capacity in many refugee camps has been overwhelmed. In a breakthrough in mid-May, Thai authorities agreed to build proper houses for the new arrivals.

There are currently 140,000 refugees from Myanmar living in nine border camps in Thailand, many of them have been there for up to 20 years.

Refugees from Myanmar: Ethnic Karens Seek Shelter

Displaced women sew up a future in Kachin campPlay video

Displaced women sew up a future in Kachin camp

Conflict in Myanmar's Kachin state has displaced tens of thousands. In the town of Laiza, UNHCR is helping women in Hpun Lum Yang camp to learn tailoring skills as part of a pilot project to foster cohesion among IDP women in the camp and help them find solutions for the practical problems they and their community face.
Myanmar: Olympic Spirit AlivePlay video

Myanmar: Olympic Spirit Alive

The International Olympic Committee and Samsung recently presented sports kits to 20 schools in south-east Myanmar. The lucky children were happy to show off their skills.
Bangladesh: Rohingya Refugees Play video

Bangladesh: Rohingya Refugees

Living in limbo for years has pushed some Rohingyas to risk everything in search of a better life.