Baran-Unland: Are you limited by location, culture or supplies to provide care?
Qureshi: We work with our local partners, CSPD, who set up clinics in these camps in different locations based on a predetermined rotational order. We try to go a little bit further and deeper into the camps outside the periphery where other medical care providers may not necessarily venture.
As far as our supplies, there are certain things we are allowed to do and not allowed to do based on the government regulations that apply to these camps. So we are limited to providing primary care services and we don’t do any surgical procedures that are required by the local rules to be referred to an approved field hospital.
But what we’ve done is establish very good relationships with a few of those hospitals, so if we need to have patients transferred, IMANA has purchased an ambulance that can send these patients directly to the relevant facilities and get the appropriate care for them as quickly as possible.
As far as culture, we are working with the Rohingya, who speak a different language. Each physician has a dedicated translator; these translators have been working with us for a long time now, some of them up to a year, others up to six months or so. They tend to be 18-to 20-year-old people who may have just started to develop their English or had some pre-existing English skills.
What we’ve noticed over the six to 12 months is that these translators are not only picking up a lot of the medical lingo, but also understanding certain symptoms and even treatment protocols to the point where they can respectfully make suggestions.
These people have been invaluable to us in communicating with the patients and helping the patients feel more comfortable; they’ve provided a great deal of efficiency in treating patients from a different culture and a different language.
Baran-Unland: Describe your accommodations.
Qureshi: The IMANA teams all stay at Cox’s Bazar, which is a town approximately 90-100 minutes away from the Rohingya camps directly southeast of us. It’s actually a pretty grueling and intense drive through broken dirt roads with potholes that we go through every day to get to our camps. This is the closest place where team members can stay and still get to the camps, since there are really no facilities or hotels near the camps themselves.
As far as accommodations of where we work, we go into a camp each day without electricity, but we do have battery-powered medical devices as needed, such as nebulizers and blood pressure medicines, and the use of a portable android-powered ultrasound.
We usually go into a small space of about 30x30 feet, often used as a school when we’re not there. We take it over and have a team of people that bring all the supplies in and set up the tables, an examination table, a makeshift pharmacy, and areas for the physicians to work.
We see our patients in this open space and have a few sheets set up should we need to do a private examination or an ultrasound; we can take them to that corner. We also use that private space for the clinical psychologist to have more in-depth and private conversations for the therapy she undertakes with our patients with PTSD or other mental health issues that need to be addressed.