Dr Janet Hall is an Australian emergency physician who has just returned from Bangladesh after a stint with the Red Cross …
ON the eastern edge of the Bay of Bengal, between the winding course of the bottom reaches of the Bakkhali River and the sea, is a town called Cox’s Bazar. It is considered a tourist spot, one of the best-known destinations in Bangladesh. Today it is also the location of the Kutupalong refugee “mega-camp”.
In August of 2017 Rohingya Muslims were driven from neighbouring Myanmar in huge numbers – 300 000 in 2 weeks, according to some estimates. Currently, according to Dr Janet Hall, an Australian emergency physician who has just returned from a stint with Red Cross, there are over 700 000 Rohingyas living in the camp.
“These people are living in a very small area, in a really precarious position,” Dr Hall tells the MJA.
“The problem with the camps is that they’re sitting on these deforested hillocks of dirt. The monsoon season is about to hit in April and May, and if there’s a cyclone it will be catastrophic.
“They have said that anything on a 45-degree slope, with extensive rain, will slide. And what it’s going to slide into is the rice paddies and the water systems of the local inhabitants. So, it’s perhaps going to have significant impact, and not just for the refugees.”
Dr Hall is an emergency physician based at Lake MacQuarie on the NSW Central Coast. Working overseas in disaster zones has always been one of her ambitions.
“But partners, children – life happens,” she says. “A few years ago I made the decision that this was what I wanted to do. But I wanted to do it appropriately and make sure that what I was doing was right and with the appropriate people.”
She completed her Masters degree in International Health through Monash University – “it gave me a great grounding in emergency response” – and has also enrolled for a second Masters degree, in Tropical Medicine and Public Health, through James Cook University.
Dr Hall joined up with Red Cross and after extensive training was sent to Cox’s Bazar in Bangladesh to work and manage public health programs in the organisation’s five clinics and one field hospital in the camps. She was in the fourth rotation of Red Cross staff going through the camp.
“By the fourth rotation, people should be transitioning from acute care to public health programs and education programs,” Dr Hall says.
“When I got there, people were starting to think about transitioning but in many ways, they were still in acute crisis mode. We were still seeing 100-150 patients a day at the clinics – children with acute respiratory infections and diarrhoeas. Musculoskeletal injuries presented, very much so in the women, particularly in the early phases of the camp.
“There was a diphtheria outbreak and underlying everything was significant malnutrition.”
Acute watery diarrhoeas are a major concern coming into the monsoon season, she says. The numbers in the camp are so great that fears of an epidemic are real.
“Absolutely. Everyone’s aware that there are water pumps in place, and people are working hard to keep them clean, but it’s not as good as it could be. There are massive contingency plans being prepared, and a lot of mapping going on, that hopefully will tell people where to go to get medical help.”
Significant numbers of pregnant women in distress present to the hospital and require specialist care, particularly for pre-eclampsia and beriberi. Additionally, the clinics provide important reproductive health care, a vital element of emergency health response.
“I found the camps to be an absolute testament to human dignity and human resilience,” Dr Hall says. “The people that I engaged with were nothing but gracious and dignified and I just thought, the human spirit is alive and well.
“You’ve got to maintain hope. You can’t say ‘oh, this is too much, it can’t be done’. It has to be done.”
During her time in the camp Dr Hall became famous for one saying: “Small wins are really very big ones.”
Dr Hall would absolutely recommend overseas aid work to medical students and junior doctors.
“It’s incredibly rewarding. “You will experience medicine in a different, interesting way. You will meet amazing people, have fantastic discussions about medicine and about solving things. You will make friends for life, because you’re all in this together.
“It’s intellectually stimulating. It’s almost old-fashioned medicine.
“These are very vulnerable people, who really need help. It gives you a slightly different view of medicine and what you can do for them.”
But, she stresses, don’t go it alone. Join up with an organisation like Red Cross.
“I can’t speak highly enough of Red Cross. I was given extensive safety and security training before I went, as well as public health training, emergency response unit training – so I could be the senior medical officer of a hospital if needed.
“I went in feeling well trained, I felt incredibly safe and well supported by a big, positive organisation.”
Will she go back?
“Yes, certainly,” she says. “I’ve promised the Red Cross one mission a year, and I’ll go wherever they need me to go.
“I will definitely do it again.”
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