Healthcare in a Humanitarian Crisis

An EVMS Global Health team learns and serves in the world's largest refugee camp

A team of EVMS students, faculty and staff led by Alexandra Leader, MD, MPH, Director of Global Health at EVMS, recently traveled to Cox’s Bazar, Bangladesh, to learn and serve in the world’s largest refugee camp. The team’s medical mission trip was coordinated through MedGlobal, a non-governmental organization, or NGO, founded in 2017 to provide sustainable healthcare services to refugees around the world. For the last two-plus years, MedGlobal, in conjunction with the Bangladesh nonprofit OBAT Helpers, has deployed short-term medical missions to the Camp 4 clinic in the Kutupalong camp, treating about 2,000 Rohingya adults and children every week.

Hope, health and humanity

In 2017, thousands more Rohingya people began to flee religious and ethnic persecution in Myanmar, a country adjacent to Bangladesh, after their communities were destroyed. The crisis intensified, and today officials estimate that nearly 1 million Rohingya refugees are living in the Kutupalong camp. Camp 4, the one whose healthcare needs are served by MedGlobal, houses 30,000 refugees — about 60% of them children.

The rut-filled roads in Cox’s Bazar, Bangladesh, were always congested and often chaotic. Each morning, the 15 volunteers on the EVMS medical team piled into two vans to begin a raucous and arduous two-hour drive to the Kutupalong Refugee Camp.


But when the team arrived, they quickly forgot the trek and turned their attention to the full waiting room. Over their six clinic days, they treated an average of 230 patients a day in the Camp 4 Medical Clinic, located within the largest refugee camp in the world.

Camp
4

Dr. Leader says the team’s work crossed the entire spectrum of human connection and human resilience.


“We’re taking on healthcare in the midst of an enormous humanitarian crisis,” she says. “At the same time, we’re also face to face with these Rohingya men and women and so many children in the intimate spaces of an eight-room bamboo clinic.”


While there, the six EVMS trainees on the team — one resident physician and five students — performed the same duties they would in their normal rotations. “It’s a wonderful opportunity to work with doctors who do this day in and day out, all day, every day,” says Ellen Dowling, MD Class of 2020. “It’s humbling to witness such beautiful dedication to this work.”

“I’ve been to many places in the world, but I’ve never seen anything like this.”

Samir Abu-Hamid, MD Class of 2020

Samir Abu-Hamad, MD Class of 2020
Samir Abu-Hamad, MD Class of 2020, works with one of the visiting doctors in the clinic.
Nicole Hawkins, MD Class of 2021
Nicole Hawkins, MD Class of 2021, took a selfie with one of OBAT Helpers’ interpreters on the team’s last day.

“Something that’s been unique is the intentionality we’ve approached this with.”

Nicole Hawkins, MD Class of 2021

“Being with people when they’re vulnerable like this is not a sacrifice. It’s a privilege.”

Jessica Quirk, MD (Family and Community Medicine Residency ‘19)

Jessica Quirk, MD (Family and Community Medicine Residency ’19)
Jessica Quirk, MD (Family and Community Medicine Residency ’19), taught a Rohingya woman who had back problems how to stretch.

Clinic Snapshot

The small eight-room clinic in Camp 4 was made of bamboo and included a pharmacy. At least half of the refugees who lined up each day to be seen at the clinic had to be turned away due to a lack of healthcare volunteers.

Dr. Leader explains that the work in the refugee camp taught the team members to be more self-sufficient, more thoughtful and more skilled clinicians. “It is a challenge for the experienced attending physicians,” she says, “and it is a tremendous learning experience for the trainees as well. You find yourself facing disease processes that you either haven’t seen or haven’t seen with regularity, and then you have to go about managing them without the diagnostic tools and therapeutic measures that are usually available.”
But the experience was much more than a series of clinical encounters.

“Being here in this clinic,” Dr. Leader says, “and getting to watch the men, women and children who wake up every day in this camp — which is itself an expression of hope — teaches us that it is truly in the shelter of one another that we will live. We must learn from them, share in these moments of connection and then commit to and act upon that same hope. Let it be what wakes us up in the morning and determines what kind of physicians we will be, what kind of health professionals we will be, what kind of people we will be.”
EVMS Medical Team

EVMS Physicians

  • Alexandra Leader, MD, MPH, Director of Global Health and Assistant Professor of Pediatrics
  • Robert Bradshaw, MD, MPH, Associate Professor of Family and Community Medicine
  • Peter Paik, MD, Assistant Professor of Family and Community Medicine
  • Jessica Quirk, MD (Family & Community Medicine Residency '19)

EVMS Staff

  • Lydia Cleveland, MPH, Program Coordinator for Global Health
  • Cory Hooper, Media Manager, Marketing and Communications

EVMS Students

  • Samir Abu-Hamad, MD Class of 2020
  • Ellen Downing, MD Class of 2020
  • Nicole Hawkins, MD Class of 2021
  • Nour Mhaimeed, Medical Master's Class of 2020
  • Amanda Severn, MD Class of 2021

Community Partners

  • Bernardo Canga, MMT, Music Therapist
  • Karen Ireland, RN, LCC, Sentara Lactation Specialist
  • Hyasinter Ruguro, MA, Human Security and Peacebuilding Commonwealth Catholic Charities
  • Sara Ahmed, MD, Medical Director of Education, Chair of Pediatric Medical Services at Mary Bridge Children's Hospital Emergency Department

EVMS Global Health fosters collaboration with local and international NGOs that support education, quality improvement, clincal service and collaborative research to strenghten systems of care and uphold the health of communities worldwide.

Journey to Panama
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In Bangladesh, monsoon season lasts from June to October, and landslides can easily destroy the camp shelters.
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A young Rohingya refugee sits on her mother’s lap outside one of the clinic rooms.
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Dr. Alexandra Leader, Director of Global Health at EVMS, listens to the breathing of a Rohingya refugee baby with a fever and a severe cough.
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A Rohingya refugee man poses for a picture as he waits at the camp clinic.
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Robert Dana Bradshaw, MD, Associate Professor of EVMS Family and Community Medicine, listens to the patient with his stethoscope.
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The team frequently treated dehydration in children. Nour Mhaimeed, Medical Masters’ Class of 2020, taught this Rohingya mother how to administer a saline solution to her infant.
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About 1 million Rohingyas fled Myanmar and are now in the refugee camp in Bangladesh.
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The clinic pharmacy is stocked with a myriad of medications including antihistamines, antibiotics and asthma inhalers.
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More than 60% of Rohingya refugees are children.
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Most of the Rohingya refugees can see their homeland of Myanmar from the camp’s shelters
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The Rohingya refugees represent a Muslim minority group in Myanmar.
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Shelters in the Rohingya refugee camp are simple
in construction and sit closely to one another.
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Before being treated by the EVMS team, patients stopped at a “vitals table” staffed by volunteers with the nonprofit OBAT Helpers.
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Some of the Rohingya women in camp gave Amanda Severn, MD Class of 2021, a henna tattoo.
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A Rohingya child waits to be seen by one of the visiting pediatricians.
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Family members carry sick or injured loved ones unable to walk to the camp clinic in makeshift stretchers of bamboo and blankets.
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Amanda Severn, MD Class of 2021, worked with an interpreter as she helped see patients.
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A Rohingya boy waits outside the clinic on a rainy day.
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A Rohingya woman waits in the clinic with her family to see a doctor.
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Every day, the EVMS students and doctors hiked to the
clinic after getting dropped off outside of the camp.
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Alexandra Leader, MD, MPH, Director of Global Health at EVMS, works by cellphone flashlight while examining a young refugee child.