Many people who move to Dhaka, the capital of Bangladesh, end up living in slums where the availability of healthcare is often very limited. In April 2010, Médecins Sans Frontières opened a health centre and a therapeutic feeding centre in the Kamrangirchar slum, which is home to nearly 400,000 people.

Médecins Sans Frontières aim is to improve access to free care and treatment for children, focusing on severe acute malnutrition. Pregnant and breastfeeding women also receive treatment for malnutrition, and antenatal and postnatal care are provided.

Two-thirds of all deaths of children under five in Bangladesh are attributed to malnutrition. Our team is taking a community-based approach in Kamrangirchar. Teams go out into the community to screen children, and those who are found to be severely malnourished are admitted to a feeding programme and given ready-to-use food to eat at home until they regain normal body weight. During treatment, teams of health promoters regularly visit the children and provide support to ensure that the ready-to-use food is being given in the correct way. In 2010, staff admitted 378 children and 440 pregnant or breastfeeding women to its nutrition programme and conducted over 10,000 consultations at its health centre.

Kala azar in Fulbaria

Kala azar (visceral leishmaniasis) is a deadly parasitic disease caused by the bite of infected sand flies, and is the second biggest parasitic killer worldwide after malaria. Medication to treat kala azar is expensive and hard to obtain. Few Bangladeshis are aware of the disease, its symptoms or its cause, so they do not know they need to protect themselves from the flies around them.

In collaboration with the Ministry of Health and Family Welfare, our team opened a clinic providing free treatment of the disease in the subdistrict of Fulbaria, in the east of Mymensingh district. Fulbaria and neighbouring Trishal account for about 60 per cent of kala azar cases in Bangladesh. The clinic is the main provider of kala azar treatment in the subdistrict and the only such clinic in Bangladesh.

Outreach teams work with local communities to educate people about the disease and to identify suspected cases. Patients diagnosed with kala azar are treated with a new drug called liposomal amphotericin B, which is more effective, cuts the duration of treatment, and has fewer side effects than the drugs that were previously used. Médecins Sans Frontières also treats post kala azar dermal leishmaniasis (PKDL), a related skin infection that can appear long after a patient has seemingly been cured. By the end of 2010, more than 400 patients had received treatment for kala azar at the Médecins Sans Frontières clinic and more than 400 people were treated for PKDL.

Chittagong Hill Tracts

In the Chittagong Hill Tracts region in the south, our staff provided general and reproductive healthcare in Dighinala and Baghaichhari subdistricts. Teams operated eight health centres, and carried out almost 25,000 outpatient consultations and more than 1,000 antenatal consultations. More than 1,450 people were treated for malaria.

Kutupalong, Cox’s Bazaar

Kutupalong is in Cox’s Bazaar, a coastal area bordering Myanmar. In 2010, Médecins Sans Frontières continued to provide medical care to people living in Kutupalong, including an estimated 30,000 unregistered Rohingya refugees living in a makeshift camp on the outskirts of the UNHCR-supported camp. Our staff, many of whom are from the local area, treat common yet potentially deadly illnesses such as respiratory tract infections and diarrhoea.

In February 2010, Médecins Sans Frontières spoke out publicly to condemn a surge in violence against the unregistered Rohingya refugees. Since then the level of violence has dropped, but people remain highly vulnerable due to their lack of official status and the limited provision of assistance that this allows.

Médecins Sans Frontières has worked in Bangladesh since 1985.