髒水與排泄物橫流,50 萬羅興亞難民面臨傳染病危機/無國界醫生孟加拉現場

乾淨的飲用水供應是難民目前迫切需要之一/©Antonio Faccilongo

文/無國界醫生

國際醫療人道組織國界醫生指出,孟加拉正需要增加大規模的人道援助,以避免隨著數以十萬計湧入孟加拉的羅興亞難民所導致的大型公共衛生災難爆發。

國界醫生自 1985 年起於孟加拉工作,目前在科克斯巴扎爾區(Cox’s Bazar)的庫圖巴朗臨時營地附近,運作一間醫療設施和一間診所,向羅興亞難民和當地社群提供綜合的基本及緊急醫療照護,以及住院和化驗服務。因應大量難民湧入,國界醫生向難民大幅增加飲用水、衛生設施的供應和醫療護理。

營地居住環境惡劣,並缺少飲用水和糧食供應,無國界醫生在營地附件設立診所,每天都接收大批病人/©Antonio Faccilongo

在針對羅興亞人的暴力行動展開以來,3 週內已有超過 42 萬 2 千人由緬甸若開邦逃至孟加拉。這批最近湧入的羅興亞難民浪潮,讓過去數年間為逃離暴力事件而跨越邊境到孟加拉的數十萬人再度擴增。

大部分剛抵達的難民落腳於臨時營地,沒有適當的棲身之所、糧食、乾淨的飲用水與廁所。其中的庫圖巴朗(Kutupalong)和巴魯哈利(Balukhali)這 2 個既有的聚落,也已因此融合為一個將近 50 萬名難民聚集、人口稠密的大型聚居地,使其成為世界上最大的難民集中地之一。

國界醫生緊急醫療項目統籌懷特(Kate White)說:「這些聚居地就在貫穿該區的一條二線道馬路兩旁,事實上是鄉郊貧民窟。」她接著說︰「聚居營地基本上沒有道路可進出,讓分送救援物資變得非常困難。這裡的地形多丘陵,容易發生土石流;而且完全沒有廁所可用。當你在營地裡走動,你得穿過橫流的髒水和人們的排泄物。

營地環境惡劣,但每天仍有大批難民湧至。/©Antonio Faccilongo

在幾乎沒有飲用水的情況下,人們從稻田、水坑或在雙手被排泄物汙染的情況下挖掘淺井取水飲用。自 9 月 6 日至 17 日間,國界醫生在其位於庫圖巴朗的醫療設施內便治療了 487 名腹瀉病人。懷特說:「我們每天都在收治險些死於脫水的成年人。這在成年人中實屬罕見,也是一場緊急公共衛生危機即將爆發的信號。」

在聚居地及其周邊地區,糧食安全非常脆弱。新到的難民完全依賴人道援助,糧食的市場價格暴漲,道路不通也加劇了援助最脆弱人群的難度。懷特說:「由於沒有錢,以及糧食分發的混亂、擁擠和匱乏,很多羅興亞人每天只吃一頓白飯。有些難民告訴我們,在幾天沒有進食之後,他們一家 6 口人吃的所有東西,就是從一間孟加拉餐廳老闆那裡得到的一碗飯。」

包括國界醫生診所在內的所有醫療設施,都完全不堪重負。8 月 25 日至 9 月 17 日間,國界醫生的診所醫治了共 9602 名門診病人、3344 件急症個案、427 名住院病人、225 名因暴力而受傷的傷患,以及 23 個性暴力受害個案。

每天在無國界醫生診所外等待門診的病人/©Antonio Faccilongo

鑒於巨大及快速增長的人數,以及緬甸羅興亞社群眾所周知的低疫苗接種率,傳染病爆發的風險非常高。針對麻疹和霍亂的綜合疫苗接種需要立即展開,以減少疾病爆發的風險,並保護羅興亞人和孟加拉人。有見及此,國界醫生已在庫圖巴朗的醫療設施內準備了一個隔離區,以便一旦有任何疑似或確診的霍亂和麻疹個案,都可以迅速遏止疫情。國界醫生緊急救援行動統籌奧納斯(Robert Onus)說:「營地的狀況極度惡劣,特別是棲身之所、食物、飲用水和衛生等方面。一件小事就足可導致一場疾病爆發,而疫情將可能是讓危機演變成災難的引爆點。」

奧納斯說︰「數以十萬計的難民目前正處於極度危困的處境,當地已累積了爆發公共衛生災難的所有條件。」他續說︰「我們很可能仍未見到這場危機在醫療方面造成的全面影響。當地正急切需要大規模的人道援助介入,針對糧食、乾淨的飲用水、棲身之所和衛生設施的需求,同時還需要有效縮減這些擁擠營地規模。」

大批難民湧至,臨時營地佈滿山頭/©Antonio Faccilongo

延伸閱讀:

【羅興亞危機】「即刻停止種族清洗」 孟加拉總理 UN 大會提 5 點建議

羅興亞人的逃亡、假新聞的黑洞與翁山蘇姬的沉默

翁山蘇姬 9 月 19 日針對羅興亞難民事件全國演說全文(英文版)

Bangladesh:Immediate action needed to avert massive public health disaster

A massive scale-up of humanitarian aid in Bangladesh is needed to avoid a massive public health disaster following the arrival of hundreds of thousands of Rohingya refugees, says the international medical humanitarian organization Médecins Sans Frontières/Doctors Without Borders (MSF).

Following a wave of targeted violence against Rohingyas more than 422,000 people have fled to Bangladesh from Rakhine State in Myanmar within a three week period. The most recent influx of Rohingya refugees has added to the hundreds of thousands of Rohingyas who fled across the border during episodes of violence in previous years.

Most of the newly arrived refugees have moved into makeshift settlements without adequate access to shelter, food, clean water, or latrines. Two of the main pre-existing settlements in Kutupalong and Balukhali have effectively merged into one densely populated mega-settlement of nearly 500,000 refugees, making it one of the largest refugee concentrations in the world.

難民身無長物,僅能以塑膠帆布和樹枝搭建臨時帳篷,飽受風吹雨打/©Antonio Faccilongo

“These settlements are essentially rural slums that have been built on the side of the only two-lane road that runs through this part of the district,” says Kate White, MSF’s emergency medical coordinator. “There are no roads in or out of the settlement, making aid delivery very difficult. The terrain is hilly and prone to landslides, and there is a complete absence of latrines. When you walk through the settlement, you have to wade through streams of dirty water and human faeces.”

With little potable water available, people are drinking water collected from paddy fields, puddles, or hand-dug shallow wells which are often contaminated with excreta. At MSF’s medical facility in Kutupalong, 487 patients were treated for diarrhoeal diseases between 6 and 17 September. “We are receiving adults every day on the cusp of dying from dehydration,” says White. “That’s very rare among adults, and signals that a public health emergency could be just around the corner.”

Food security in and around the settlements is incredibly fragile: newly arrived refugees are completely reliant on humanitarian aid, prices in the market are skyrocketing and the lack of roads is compromising access to the most vulnerable populations. “With very little money and chaotic, congested and insufficient food distributions, many Rohingya are only eating one meal of plain rice per day,” says White. “Some refugees told us that after days without food all they had eaten was one bowl of rice they received from a Bangladeshi restaurant owner, shared among a family of six.”

營地環境惡劣,但每天仍有大批難民湧至/©Antonio Faccilongo

Meanwhile, medical facilities, including MSF’s own clinics, are completely overwhelmed. Between 25 August and 17 September, MSF clinics received a total of 9,602 outpatients, 3,344 emergency room patients, 427 inpatients, 225 patients with violence-related injuries, and 23 cases of sexual violence.

There is a very high risk of an infectious disease outbreak in the area given the huge and rapid increase in the population, as well as the known low vaccination coverage among the Rohingya community in Myanmar. Comprehensive vaccination campaigns for measles and cholera need to be launched immediately to reduce the outbreak risk and protect the Rohingya and Bangladeshi populations. In anticipation, MSF has prepared an isolation unit in the Kutupalong medical facility to rapidly contain any suspected or identified cholera or measles cases. “The situation in the camps is so incredibly fragile, especially with regard to shelter, food and water and sanitation, that one small event could lead to an outbreak that may be the tipping point between a crisis and a catastrophe,” says Robert Onus, MSF Emergency Coordinator.

“Hundreds of thousands of refugees are living in an extremely precarious situation, and all the preconditions for a public health disaster are there,” adds Onus. “We most likely still haven’t seen the full impact of this crisis in terms of health. There is an acute need for a massive humanitarian intervention focusing on food, clean water, shelter, and sanitation, and a solution is needed to reduce the size of these massive, congested camps.”

營地居住環境惡劣,缺乏飲用水和糧食供應,無國界醫生在營地附近設立診所,每天接收大批病人/©Antonio Faccilongo

MSF in Bangladesh

MSF first worked in Bangladesh in 1985. Close to the Kutupalong makeshift settlement in Cox’s Bazar district, MSF runs a medical facility and a clinic offering comprehensive basic and emergency healthcare, as well as inpatient and laboratory services to Rohingya refugees and the local community. In response to the influx of refugees MSF has significantly increased water, sanitation and medical activities for the refugee population.

Elsewhere in Bangladesh, MSF works in Kamrangirchar slum, in the capital, Dhaka, providing mental health, reproductive healthcare, family planning and antenatal consultations, as well as an occupational health programme for factory workers.

 


史上唯一!全球最大 NGO 執行長首次來臺,錯過再也見不到的重量級貴賓!

● 全世界最大的國際非政府組織 BRAC 創辦人兼主席
● 2017 年《財富雜誌》全球前 50 大領袖
● 曾獲世界糧食獎、世界企業家獎等無數榮譽獎項
● 旗下擁有頂尖大學、社會企業、商業銀行、行動支付平臺
● 在全球 11 個國家影響 1.38 億人,工作者規模 11 萬人

除此之外,今年年會邀請到包括資訊透明、兒少安置、社工工會、無家者、身障者街賣原住民長照等各領域的深耕工作者;以及 NPO/NGO 執行長們機會難得的圓桌對談(每個人都可以匿名發問!),還將今年最熱門卻又最陌生的趨勢如 SDGs、中國公益觀察等統統奉上,讓忙碌的你一天追完所有進度!

 現在就報名,三人同行團體票優惠中(快按下去)

 

按讚,追蹤更多好文章:


▼ 這篇不能只有我看到!分享給朋友一起讀 ↓ ▼

作者介紹

NPOst 編輯室

NPOst 公益交流站,隸屬社團法人臺灣數位文化協會,為一非營利數位媒體,專責報導臺灣公益社福動態,重視產業交流、公益發展,促進捐款人、政府、社群、企業、弱勢與社福組織之溝通,強化公益組織橫向連結,矢志成為臺灣最大公益交流平臺。另引進國際發展援助與國外組織動向,舉辦每月實體講座與年會,深入探究議題,激發討論與對話。其姐妹站為「泛傳媒」旗下之泛科學、泛科技、娛樂重擊等專業媒體。NPOst 臉書:https://www.facebook.com/npost.tw

FACEBOOK讀者迴響