Inside the sprawling Kutupalong Rohingya refugee camp, more than 700,000 men, women and children have found sanctuary from a brutal regime.
The Rohingya people, a Muslim minority in their home country of Myanmar, have come to the camp in overwhelming numbers fleeing violence. Makeshift shelters, made of bamboo poles, tarps and any other materials they can find, spread out across the valley in northern Bangladesh, stretching as far as you can see.
Finding clean water and handling sanitation for the city-sized camp remain constant concerns. Disease and other medical problems are persistent, but even occasional medical care is a luxury, and most don’t even get that.
"These are among the most vulnerable people and traumatized people on earth," said Dr. Adam Paarlberg, associate program director for Franciscan Health’s Family Medicine Residency program. "If we can provide compassionate care, that’s a good thing."
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In an effort to provide care for these refugees, a team of physicians from Franciscan Health Indianapolis have traveled to Bangladesh to work in the camp. The six doctors will see 30 to 40 patients each day over the course of two weeks, treating everything from common maladies such as respiratory illnesses to diseases such as dengue fever or cholera to providing ultrasounds for women in the camp.
"It’s like the last vestige of real medicine. There’s none of the documentation or all of the different things, all of the testing, that we have here. So you go and have to use your physical exam and your clinical skills to diagnose and treat people," said Dr. Gregory Specht, a third-year family medicine resident. "Here in Western medicine, we can think something is going on, and we can order imaging or tests to confirm that. In this situation, we have to use what we have and figure out what we’re going to do."
They left for the trip on Friday, and will be back in central Indiana Nov. 14.
The experience is centered on doing anything they can for the Rohingya people, the doctors said. At the same time, it is an opportunity to get at the heart of why they wanted to practice medicine in the first place.
"That’s the cool part about medicine — putting all of the pieces together. That’s what we get to do," said Dr. Hira Naqvi, a second-year family medicine resident.
The humanitarian emergency surrounding the Rohingya people has become one of the largest and fastest-growing refugee crises in the world, according to the United Nations Refugee Agency. Rohingya refugees started fleeing government-led violence and genocide in Myanmar in the 1990s, but renewed aggression and oppression starting in 2017 drove a new wave of people out of their homeland.
They walked for days through the thick jungle to Bangladesh, where the camp at Kutupalong was built in only five months. Overcrowding, disease outbreaks and landslides are a daily threat to the people in the camp.
Since October 2017, OBAT Helpers has been been working inside the camp to help improve access to health care, education and economic empowerment to the Rohingya population. OBAT Helpers is an Indianapolis-based nonprofit founded to care for refugees in Bangladesh.
The organization’s Humanitarian Assistance Program for the Rohingya united OBAT Helpers with volunteers, donors and organizations to help the refugees in a variety of ways. They’ve built learning centers for children, constructed bridges and pathways, operated a community kitchen feeding hundreds of people daily, and built shelters for people.
Their two medical centers treat up to 400 patients each day. That is where the Franciscan Health group will spend much of their time.
"It’s mostly going to be primary care. They have a primary care clinic, so no one is going to be asked to step outside their comfort zone too much," Paarlberg said. "’We all bring something to the table with adult and family medicine."
The medical mission trip came about through Paarlberg, whose wife works for OBAT Helpers. As he learned more about the plight of the Rohingya refugees, he felt compelled to find a way to help. Indianapolis’ southside has a large population of Chin refugees, also from Myanmar, and though the groups aren’t the same, they faced the same kind of violence that forced them out of their homes.
"They’re different ethnic groups, but the same persecutor — the Burmese military government," Paarlberg said.
The idea percolated among the other doctors at Franciscan Health’s Family Medicine Residency program. Regularly scheduled medical mission trips to South and Central America are a regular part of the residency program, but this was something that no one at Franciscan Health had ever done, Specht said.
He has experience on medical missions in eastern Africa, and really enjoyed his time there.
"To be part of something that is newer for the residency was a really exciting thing to be a part of," Specht said. "The idea of going somewhere new and doing something unique was exciting."
Slowly, interested physicians stepped forward to volunteer, and by earlier this year, a team of six had been confirmed.
In addition to Paarlberg, Naqvi and Specht, the team will consist of Dr. Jeffrey Jones, a family physician for Franciscan Health’s TravelWell Medicine clinic in Greenwood; Dr. Kami Smith, a family physician practicing in Greenwood, and Dr. Kevin McNulty, a third-year family medicine resident.
Medical mission work is unique, Paarlberg said. You are immersed in an entirely new culture, working in new health care systems and medical education systems, as well as sometimes working in areas that are underdeveloped.
"Sometimes it’s a culture shock. But you just learn — we’re all people. These are all things that unite us," Specht said.
For Naqvi, the opportunity to provide care in Bangladesh has personal meaning. She grew up in India, where a free medical clinic and school was built into her home. Her uncles, one a retired physician, the other a retired teacher, helped people in need.
Witnessing that was one of the main reasons she became a doctor.
"I always wanted to do medical mission work, but unfortunately couldn’t do that in undergrad or medical school," Naqvi said. "When Dr. Paarlberg approached me, I was very excited."
In preparation for the trip, the Franciscan Health team worked with OBAT Helpers to coordinate flights, hotels and transportation within Bangladesh. They helped arrange for cellular connection while they’re on the trip, and also put together the vaccination regimen to protect against the variety of tropical infectious diseases they might encounter.
The group is also prepared to help treat some of the emotional and mental trauma that the refugees have faced over the past two years.
"Most of these refugees have experienced pretty awful things that none of us want to even consider still happens in this world, in terms of brutality and sexual assault and murder," Paarlberg said. "So we’ll be administering some level of trauma-informed care there."
In addition to providing care, they would also be engaging in some sharing and education of staff at the medical clinics, exchanging ideas that will benefit both groups.
Prior to leaving, there was much excitement for the trip, not only about the work they’ll do in the next few weeks, but about the potential for even greater assistance in the future.
"In these areas of great need of the world for medical care, establishing some regular contact with physicians or whatever medical care it is, it’s a huge deal," Specht said. "Hopefully, we can have the opportunity to keep doing that as a residency."
