WHO completed its fourth annual operational review of health dimensions for the Rohingya emergency response in Cox’s Bazar, Bangladesh, on 2nd March 2022. The event brought together WHO members from all levels of the organization— WHO Emergency Sub-Office, Bangladesh Country Office, Regional Office and the Headquarters—to evaluate the performance of the WHO Emergency Sub-Office operations and the health sector thus far.
As 2023 marks five years of the Rohingya emergency in Cox’s Bazar, the operational review will form a critical part of planning for improved health services for both the Rohingya and the host population. WHO has been undertaking this exercise each year to review operations and improve interventions in the evolving health landscape in Cox’s Bazar.
In 2017, over 700,000 displaced Rohingya risked their lives crossing the border from Myanmar into Bangladesh. In partnership with the international humanitarian community, the Government of Bangladesh launched a united response, providing for the imminent health needs of a fatigued and vulnerable community.
An operational review in 2021 provided evidence that WHO has successfully carried out public health interventions and coordinated comprehensive primary and secondary healthcare services for the Rohingya in Cox’s Bazar. Today, however, the Rohingya emergency is listed by WHO as a ‘Grade II Protracted Health Emergency’. The health needs of the Rohingya have evolved.
With quality health services now a staple of life in the camps, the sector is looking to upscale responses to long-term health challenges and chronic epidemiological threats. This year’s operational review forms a critical part of that plan, allowing health leaders to understand how much progress has been made and how the health situation on the ground is evolving.
“As an ongoing crisis,” says Dr Jorge Martinez, head of the Cox’s Bazar Sub-Office, “there are further, critical areas to tackle. We have to respond also to non-communicable diseases, such as hypertension and diabetes, as persistent threats. So that’s the next step—linking our urgent humanitarian needs with services geared around more chronic, so-called ‘developed-world’ diseases.”
Beyond COVID-19, persistent threats in Cox’s Bazar include diseases such as dengue, diphtheria, and cholera, as well as environmental health challenges like cyclones, floods, and landslides. As part of the operational review, WHO leadership identified lessons from the COVID-19 pandemic that can apply to broader epidemiological threats. It was also a chance to identify future challenges and opportunities in the operating environment for health. The team explored avenues for strengthening health systems to determine the strategic direction of the health response over the next year. WHO wants to build on the COVID-19 response pillars to enhance risk reduction measures in Cox’s Bazar.
Mr. Peter Graaff, Dr Sourabh Sinha, and Dr Egmond Evers, WHO Operational Review Team members in discussion with the health care workers on WHO’s support on different pertinent public health issues at Primary Health Care facility in Camp 10, Ukhiya (Photo: WHO/Dr Raisul Islam)
Another focus for this year’s review was sustainability. The review panel looked for opportunities to align the health emergency response with strengthening initiatives driven by the WHO Country Office across WHO’s Triple Billion targets. Resources at the country-office level may dovetail with health-sector responses and interventions envisioned at the national level by government counterparts, ensuring long-term sustainability.
The 2023 operational review team consisted of leadership personnel from the four WHO service levels, and key partners from across the sector. Dr Martinez was joined by Md. Mahbubur Rahman, Civil Surgeon in Cox’s Bazar, and heads of UN partner offices Ezatullah Majeed (UNICEF) and Roseliadah Raphael (UNFPA). The team also met with members from UNHCR, IOM, the International Rescue Committee (IRC), the Inter-Sector Coordination Group (ISCG), the IEDCR Field Laboratory, and the Health & Family Planning Offices of Upazila Health Complexes.
The methodology of the review included strategic interviews, focus group discussions, and a desk review of relevant data and documentation developed at sub-national and national levels. The interviews provided stakeholders an opportunity to feedback to the health sector on operational challenges and opportunities in the field. The entire process was documented by an external expert consultant to capture observations and inputs received during stakeholder consultations.
The review explored a range of specific technical areas crucial to the operation of the health sector. Such as:
- Coordination, Leadership and Financing
- Administration, Grant Management and Logistics
- Health Sector Response Epidemiology and Information Management
- Communicable and Non-Communicable Diseases
- Laboratory Services
- Immunization and Vaccine Development
- Water, Sanitation and Hygiene (WASH) and Healthcare Waste Management
- Infection Prevention and Control
- Reproductive, Maternal, Neonatal, Child and Adolescent Health
- Emergency Preparedness & Response
- Prevention of Sexual Exploitation and Abuse
A report documenting the observations and conclusions will be shared by review team with the senior management at the country and regional offices. WHO look forward to an improved health response in Cox’s Bazar as we adapt programming to provide the best possible services to the Rohingya
The operational review team members from HQ/RO/CO of WHO
Dr Bardan Jung Rana, WHO Representative to Bangladesh, reiterated the importance of the process for improvement of health services. “The operational review is our chance to reflect on everything the health sector has achieved since 2017. It marks our operational achievements in building a resilient health system in a fragile and vulnerable emergency. Many challenges lie ahead. But the sector will continue to drive better health outcomes until the Rohingya can return safely to their homes.”