The vaccine preventable disease is no longer common in the western world. There have recently been cases in Yemen, Indonesia and now in the camps for over 628,000 Rohingya people forced to flee human rights atrocities in northern Rakhine state in Myanmar.
Save the Children's leading health specialist working on the Rohingya crisis is Maria Tsolka from the agency's Emergency Health Unit. Based in the southern Bangladeshi district of Cox's Bazar she said, “It will be a challenging December for the humanitarian community here that is rallying to control the diphtheria outbreak.
“The entire humanitarian community is alert to the crisis here. We are coordinating closely together and working alongside the Bangladesh Ministry of Health to ensure we reach everyone who needs treatment and to contain the spread of the disease,” said Ms Tsolka.
In the Rohingya camps, Save the Children runs a network of seven, soon to be nine, community health posts. Staffed by experienced doctors and nurses, they see between 50 and 100 people a day who present with a range of conditions such as skin disease and measles. They also treat children for severe acute malnutrition and provide sexual and reproductive health services to women and girls.
Now they are screening for diphtheria as well. “Diphtheria is transmitted from person to person respiratory droplets, like coughing and sneezing. Poor hand hygiene contributes to transmission too. It can be fatal in more than 10 percent of cases but this can increase in overcrowded camps with limited access to health services,” said Ms Tsolka.
In response to the health emergency, the aid agency has commenced the roll out of a home visit program to check on the families and close contacts of diphtheria patients that had recently presented at its health posts and MSF facilities. The aim is to provide them with a seven-day course of oral antibiotics as prophylaxis and to contain the transmission of diphtheria. Health staff will immediately refer any suspected cases of diphtheria for hospital care and treatment to an MSF dedicated facility.
Currently MSF is the only organisation in Cox’s Bazar that can administer treatment for these patients, while others including Save the Children are gearing up to support swift identification of suspected cases and diagnoses to attempt to contain the spread of the disease.
Also this week, Save the Children will commence the roll out of planned child vaccination programs through its health posts in the camps. This includes vaccination against diphtheria among other diseases. Save the Children will also vaccinate almost 1,400 aid workers and volunteers currently working in different programs. The vaccine will be provided by the Bangladesh Ministry of Health with support from the World Health Organization and UNICEF.
"While we hoped there would not be an outbreak of diphtheria, we quickly mobilised our Emergency Health Unit on the ground here and trained our health staff to detect clinical signs of the disease and to be familiar with the referrals process set by the World Health Organisation and agreed with the Ministry of Health of Bangladesh. We also trained staff from other parts of our response like shelter and child protection to detect signs of the disease. This includes our partner’s networks of teachers at Temporary Learning Spaces and Child Friendly Spaces. In total, we have orientated more than 400 staff in the past two days ,” Ms Tsolka said.
"Our health teams are on high alert looking out for suspected diphtheria cases. It is curable with anti-toxins and antibiotics if detected early and referred to appropriate health services."
In the Rohingya camps the vaccination of children 0-6 years of age started on December 12th. The mass vaccination campaign for 7 to 15 years old on December 17th. This will be done at dedicated vaccinations points throughout the camps.
Save the Children Bangladesh Country Director Mark Pierce said issues around water and sanitation must be urgently addressed, and that mass vaccination campaigns as well as routine immunisation programs must be carried out among the camp population.
“The response to this outbreak requires an urgent lift of funding to ensure we can contain it, and save lives,” he said.
For interviews, call Ian Woolverton in Bangladesh on +880 1701 212 605 or Lily Partland in Australia on 0416 355 851.