COVID-19 Contact Tracing in the World’s Largest Refugee Camp

Rohingya health volunteer Tofayel conducts COVID-19 contact tracing in Kutupalong Refugee Camp, Cox's Bazar, Bangladesh. (Md. Dipu/CPI)

"I feel that I am doing an important job for my community. No matter how hard it is, somebody has to do it. In this case, it’s me." Tofayel, Rohingya health volunteer​

As Bangladesh experiences a spike in COVID-19 cases, there is rising concern for the 700,000+ Rohingya refugees from Myanmar sheltering in Kutupalong Camp, Cox’s Bazar District. Cramped living conditions and limited access to health services make them especially vulnerable. Community Partners International (CPI) and local partner Green Hill are supporting Rohingya volunteers to trace contacts of confirmed COVID-19 cases and help to contain the spread of the virus within the refugee community.

“The camp is overcrowded and families live together in cramped shelters. A person with COVID-19 symptoms can’t separate themselves from their family,” explains Ariful Islam, Manager of CPI-Green Hill's Health Outreach Program.

In Camp 1E of Kutupalong Refugee Camp, CPI and Green Hill are supporting contact tracing for a population of nearly 40,000 refugees in coordination with other agencies providing health services. CPI and Green Hill help to train Rohingya volunteers, and assist them during the contact tracing process. Between January and June, the volunteers have referred more than 1,500 people with possible COVID-19 symptoms to health facilities, and monitored 71 people with confirmed COVID-19.

“Once we hear of a suspected case, we visit their house with our volunteer,” explains Ariful Islam. “We collect their sample and send it for COVID-19 testing and, if the test comes back positive, we bring them to an isolation and treatment facility. Meanwhile, the volunteer traces all the people with whom the infected person came into contact and instructs them to quarantine for 14 days.”

Ariful Islam, Manager of CPI-Green Hill's Health Outreach Program, in Kutupalong Refugee Camp, Cox's Bazar, Bangladesh. (Md. Dipu/CPI)

“The volunteer helps to make sure they stay in quarantine,” continues Ariful Islam “During this time, if any of the quarantined people show COVID-19 symptoms, the volunteer notifies us and we bring them to an isolation and treatment facility. The volunteer also helps supply quarantined families with their basic needs, like groceries or cooking gas, so that they don’t have to go out.”

Tofayel is a contact tracing volunteer with the Bangladesh Red Crescent Society who receives support from CPI. “When we instruct a household to quarantine, they usually follow our rules. We check on them three times a day. They let us know if they need anything, such as masks or sanitizer, and we provide it.”

But it’s not always that simple. “Sometimes we do face challenges, for instance when the patient or patient contact is a senior member of the community and doesn’t want to listen to us,“ reveals Tofayel. “In those cases, we take time to explain the situation to them and, eventually, they understand."

Ariful Islam and Tofayel discuss COVID-19 contact tracing in Kutupalong Refugee Camp, Cox's Bazar, Bangladesh. (Md. Dipu/CPI)

“The volunteers help us to overcome the language barrier,” explains Ariful Islam. “They understand the community better than us and can communicate well with fellow community members. As they’re embedded in the community, they can more easily follow up with quarantine and monitor their neighborhoods for COVID-19 outbreaks.”

“On rare occasions, people testing positive for COVID-19 give volunteers a false address,” reveals Ariful Islam. “In these situations, the volunteers check with local leaders to track down the person. Once they’ve found them, we cross-check their address to make sure it’s the right person.”

For their and the community members’ safety, volunteers are provided with personal protective equipment including face masks, gloves and sanitizer. However, their work does expose them to some infection risk.

“I live with my wife and two children and I don’t have any place to isolate myself,” explains health volunteer Tofayel. “At the end of the day I go back to my family. I fear for them because I know how contagious this disease can be. But I don’t have any other option. So, I shower immediately, wash my clothes, and try to keep my distance.”

But Tofayel is determined to continue contact tracing. “I feel that I am doing an important job for my community. No matter how hard it is, somebody has to do it. In this case, it’s me.”