Interview with Dr. Sadia Afroz – Rohingya in Bangladesh

“Ill health is an important factor that forces the poor to remain poor.
If they make a little bit of money, one episode of illness can wipe them out.”
(Zafrullah Chowdhury)

Dr. Sadia. Cox's Bazar – 27 February 2020

More than a million Muslim-majority Rohingyas live in camps in Bangladesh, most of them arriving in August 2017 after fleeing genocide by Buddhist fundamentalists in Myanmar.

Three years have passed since genocide sent hundreds of thousands of Rohingyas in Myanmar fleeing for their lives, the majority into neighbouring Bangladesh.

Bangladesh is hosting around 1.1 million Rohingya refugees with about three quarters of those fleeing to the country in or after August 2017.

When I was in Bangladesh during February 2020, I couldn't miss the opportunity to visit this camp, so I took three days to go to Cox's Bazar, and be able to enter the camp for half a day.

When we were going there, my friend Alberto who worked for the Health Post told me: “Get ready to see hell on earth.”

In fact, what I saw I will never be able to forget.

Just as it's impossible to forget the Clinic Manager of the Health Post, Dr. Sadia.

I believe a lot in the little heroes who fight every day, in the shadows. She is one of them, always with a smile on her lips, small in stature but with the strength of a lioness.

I have a deep respect for people like her, which has grown even more after this interview, which I managed to obtain after a year – but she herself struggles to find the time to breathe. On the other hand, she also just got married in August.

I hope that I can meet her again one day.

This interview of mine is obviously dedicated to the Rohingya, hoping that the spotlight will never go out on their tragedy; and also because I hope that Sadia's life be an inspiration for those who read these lines.

We are the architects of our lives.

 

Dr. Sadia

Thanks for the allowed time Dr. Sadia, first of all tell me a little about yourself and your passion for medicine.

My name is Sadia Afroz and I was born in 1995 in the city of Savar, an Upazila (sub-district) of the Dhaka district of Bangladesh, which is located at a distance of about 24 kilometers northwest of the city of Dhaka.

I graduated in medicine in 2018 from Gonoshasthaya Samaj Vittik Medical Hospital and College. For the same industry, Gonoshasthaya Antibiotic Ltd. my mother worked, in the production of antibiotics and medicines, and from her I took not only the passion for medicine, but also her way of thinking: that it is important to go to places where it's more difficult to have the cure and find medicines, as she did when she went to the rural areas of the villages.

We are two sisters, and my mother always dreamed that one of us becoming a doctor one day. I wanted to make her wish come true.

 

You can describe, for those who are not aware of it, the condition of the Rohingya, their humanitarian tragedy, and how they were received in Cox's Bazar Camp. How the camp is structured and how long you have been working in this hospital?

The rural area of Ukhiya has been hosting the camp for almost four years now. I have been working as Clinic Manager for Cox's Bazar Gonoshasthaya Kendra Health Post, in Camp 1 East of Lambasia, for Malteser International-Germany, since September 2019, after a year of practice in Cox's Bazar Gonoshasthaya Baharchara Hospital. 

The Rohingya arrived in Cox's Bazar in 2017 fleeing the ongoing genocide in their country. At first the Bangladeshi people welcomed them with pity and empathy. I myself felt the same emotions when I learned of their tragedy. 

The biggest problem of this coexistence has two souls: the first is linked to the frustration of the inhabitants of the hill area that hosts the camp, a very poor and rural area. Day after day they saw many international NGOs arrive (the camp hosts almost 80), to take care of the Rohingya but not care about their problems. 

With the costs of the little land that remained rising significantly, while more than half of the land in those hills was taken by the government to house the camp. Imagine over 500 foreign people who now live in the proximity of the camp, with the costs of everything that adapt to the lifestyle of foreigners, certainly not of the local population, who however must adapt. With the dirt roads accustomed to local means of transport now beaten by SUVs and heavy vehicles in NGOs. 

The other aspect is linked to the style of life of the local inhabitants, deeply religious, who have seen their teenage daughters move from the Islamic veil and the burqa – in many cases – to the fascination for the t-shirts and tight pants of foreigners women whom meet continuously. 

My landowner himself told me with despair of his two young daughters aged 18 and 19 fascinated by the Western way of dressing, and how gossip was undermining their serenity. 

In the long run this state of affairs has exasperated the local inhabitants and made their level of tolerance overflow. 

I am a doctor, I can understand their anger, but for me the compassion for this people in suffering remains. 

It's not the Rohingya's fault what is happening, they are just the victims. 

Now the conditions of the camp are improving, especially in terms of health, in the last year. 

After one of the most serious events, which occurred in October 2020, when two groups of Rohingya fighted each other with guns and machetes, causing the death of 7 people, police checks have also intensified. Now, in addition to the normal military checkpoints, those of the police have also been added to each entrance to the camp, as well as their presence inside the camp itself. 

Also guaranteeing safety to the staff of nurses and doctors of the PHC – Primary Health Care who are the only ones who are allowed to stay overnight in the camp, while for all the others – including NGOs and doctors – it's mandatory to leave the camp after sunset. 

The government has worked hard in this last period to ensure extra security for all 34 camps that make up the large refugee camp.

 

Activites at the hospital

The situation is now getting complicated: when I was there in February I could see for myself the overcrowding of the Rohingya, and when the tragedy of Covid-19 broke out and also arrived in Bangladesh, my thoughts went to your camp. Can you describe the current conditions?

In fact, when the first case of Covid-19 appeared in the camp, and it was in my camp on May 14, we all thought that there would be a massacre, with thousands of infected and dead, due to overcrowding. But the astonishing thing is that, to date, the confirmed cases of Covid-19 are 371, with ten victims since its appearance. 

It is no coincidence that tests are being carried out on about 6000 Rohingya at the level of antibodies and their immune capacity to understand how this was possible. 

However, the camp has about 200 areas called SARI – Sever Acute Respiratory Infection, in which to isolate Rohingya cases found in serious condition after quarantine. 

The procedure in our Health Post remains to wear a mask and gloves, only in cases of infection the doctors have to wear specialized coveralls, but ours is a primary medicine hospital, with general patients. 

What are the biggest challenges for you, as doctors, in this humanitarian catastrophe and what do you need most in your daily struggle in the field? Is there a way for those who want to help all of you, from far?

The biggest challenge remains to be distant from my family.

You know, my mother is sick, she has to do dialysis every day.

I can't be close to her, but I know a doctor takes care of her. Just as I take care of mothers of other children.

It's like a scale: my mother's lack and concern for her health push me to do my best to help other mothers.

It's stress and energy at the same time.

Anyone can donate to my NGO, just go to the sites and that money is then used to fund the activities of Malteser International-Germany, including my Health Post. 

Photo: Dr. Sadia Afroz. December 2020

Before concluding, and thanking you again, I would like if you can repeat here the reason for your choice in working in this hospital rather than in Dhaka, as you told me face to face.

During the five years of my degree there was a rule: at least three times we students had to go to rural areas and villages to meet people, to heal in the place. 

My myth, as for all Bangladeshi doctors, is Zafrullah Chowdhury, our national hero who founded the Gonoshasthaya Kendra, where I studied and of which this hospital is also a part. The name itself means in Bengali the center for people's health. 

He pursued the policy of medicines for the people, for those who could not afford treatment. 

As my mother also dreamed. 

So I have always thought: if I want to give my best as a doctor I have to go where people really need treatment, where the situation is more difficult. In Dhaka there are many hospitals, it is easy to access drugs and treatment, so after my degree, after a few months I decided that I had to go to Cox's Bazar, where the Rohingya were coming. 

It wasn't easy at first, I had to learn their language in a month and a half. 

But being able to take care of their children, seeing their smiles gives me the strength to smile every day. 

One last question. By now the news is on all sites that since last December a relocation of part of the Rohingya population to the island of Bhashan Char has begun. To date, it seems they are already 1600. The Foreign Minister AK Abdul Momen called it a “beautiful resort” Bhashan Char which is an island in the Bay of Bengal, 34 kilometers away from the earth, subject to floods that emerged from the sea 20 years does. But in the eyes of the international community, this seemed worrying because the Rohingya were removed militarily and without giving permission to international NGOs to control their living conditions. Now that almost two months have passed, how is the situation?

It is true that international NGOs still not go in the island but there are our national NGOs, and now it's the Rohingya themselves who are calling their families from the island to join them.

The camp has a capacity of 100,000 people with better sanitation and brick houses. I believe it is a better way of life than the overcrowding of our camps.

Thanks again and good luck

P.S. Thanks to lot Sadia, for the use of photographs taken by her in the Health Post during Covid-19.

 

Cox's Bazar – 27 February 2020

 

To be fair, I quote an excerpt from an AP News article on the relocation of the Rohingya:

“Saleh Noman, a Bangladeshi journalist who traveled with the refugees, said by phone from the island that the refugees were given rice, eggs and chickens for lunch after their body temperatures were measured by health workers as a coronavirus precaution.

Before they boarded the ships they were also given face masks to protect against COVID-19.

The island’s facilities are built to accommodate 100,000 people, just a fraction of the million Rohingya Muslims who have fled waves of violent persecution in their native Myanmar and are currently living in crowded, squalid refugee camps in Cox’s Bazar district.”

The sites related to the organizations of the  Health Post of Dr. Sadia: 

- Gonoshasthaya Kendra

- Malteser International

To be updated on the situation of the Rohingya: TRTWORLD

About Zafrullah Chowdhury (from Wikipedia):

Zafrullah Chowdhury (born 27 December 1941) is a Bangladeshi public health activist. He is the founder of Gonoshasthaya Kendra (meaning the People's Health Center in Bengali), a rural healthcare organisation. Dr. Chowdhury is known more for his work in formulating the Bangladesh National Drug Policy in 1982. In 1992, he was awarded the Right Livelihood Award for “..outstanding record of promotion of health and human development.”
He spent his early childhood in Kolkata and later his family settled in Bangladesh. He was one of ten children born to his parents. After attending Nabakumar School at Bakshibazar, he studied at Dhaka College. He studied medicine at Dhaka Medical College, where he got involved with leftist political ideologies. As the general secretary of the Dhaka Medical College students' union, he held a press conference to expose the corruption at the hospital. After a turbulent student life, he finished his MBBS degree in 1964 and left for the UK for post-graduate studies in general and vascular surgery. In 1971, he fought for independence during Bangladesh Liberation War.
He was involved in setting up the 480-bed Bangladesh Hospital for freedom fighters and the refugees. The hospital was run by a team of Bangladeshi doctors, medical students and volunteers. Women with no previous training in healthcare were trained within days to help out the patients. This experience in the field hospital led him to believe that an effective healthcare delivery system can be developed in rural Bangladesh by training women as a primary healthcare delivery platform. This achieved worldwide credibility when it was eventually published in The Lancet.
In 1972 Dr. Chowdhury set up the Gonoshasthaya Kendra. Actually the idea was introduced in a concept paper titled, “Basic Health Care in Rural Bangladesh” in Dhaka. The centre focuses on providing basic healthcare to the rural areas. The centre also runs a university, vocational training centre, agricultural cooperatives, hospital, a printing press, community schools and a generic drug manufacturing plant. Gonoshasthaya Kendra has been very successful in providing family planning services, lowering maternal, infant mortality rates. Though limited in its reach, it pioneered the introduction of cheaper generic drugs. In 1973, Gonoshasthaya Kendra introduced a Rural Healthcare Insurance System, the first of its kind in Bangladesh.
Critiques have pointed out that rather than being national, the centre's reach has been confined to specific areas. However, Zafrullah Chowdhury believes that public health is a state matter, it can never be left to the private sector.

• Beauty is Mystery
• Rohingya Girl 

 

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