Establishment of Two Free Community Health Clinics on Bhasan Char
1. Rationale and Needs Assessment
Despite the presence of basic infrastructure on Bhasan Char, access to timely, comprehensive healthcare remains insufficient, particularly for emergency cases, maternal and child health, and chronic conditions. Reported gaps include:
• Delays in emergency medical response due to isolation from the mainland
• Preventable deaths linked to lack of advanced or urgent care
• Inadequate coverage for maternal health, childhood illness, and chronic disease
• Limited mental health and psychosocial support for trauma survivors
• Barriers to care for women, elderly persons, and people with disabilities
Geographic isolation, movement restrictions, and weather-related access challenges necessitate on-island, community-based healthcare services that are reliable, free, and culturally appropriate.
2. Program Goal and Objectives
Overall Goal: Ensure equitable, continuous, and free access to essential healthcare services through two fully operational community health clinics.
Specific Objectives
• Establish two fixed primary healthcare clinics strategically located to maximize coverage.
• Provide free, essential healthcare services to all residents regardless of status.
• Strengthen maternal, neonatal, and child health outcomes.
• Ensure emergency stabilization and referral capacity.
• Deliver mental health and psychosocial support for trauma-affected populations.
• Integrate disease prevention, health education, and community outreach.
3. Clinic Model and Coverage
Clinic Locations
• Clinic A (North Zone): Serving approximately 16,000 residents
• Clinic B (South Zone): Serving approximately 16,000 residents
Locations will be selected in coordination with camp management, UNHCR, and local authorities to ensure accessibility, safety, and proximity to high-density residential areas.
4. Scope of Free Healthcare Services
All services provided through the clinics will be free of charge.
A. Primary Healthcare
• Diagnosis and treatment of common illnesses
• Management of chronic diseases (diabetes, hypertension, asthma)
• Basic laboratory testing
• Essential medicines distribution
B. Maternal, Neonatal, and Child Health (MNCH)
• Antenatal and postnatal care
• Safe delivery support and referral
• Newborn care and growth monitoring
• Childhood illness management
• Nutrition screening and referrals
C. Emergency and Urgent Care
• 24/7 emergency stabilization capability
• First aid and trauma care
• Acute illness management
• Emergency referral coordination with higher-level facilities
• Emergency transport coordination during weather windows
D. Preventive and Public Health Services
• Vaccination support (in coordination with MoH and UN agencies)
• Communicable disease surveillance
• Health education (hygiene, nutrition, reproductive health)
• Outbreak preparedness and response
5. Clinic Infrastructure and Facilities
Each clinic will include:
• Outpatient consultation and emergency stabilization room
• Maternal and child health room
• Pharmacy and medical storage
• Counseling and MHPSS room
• Waiting area with gender-segregated seating
• Sanitation facilities (gender-sensitive)
• Cold chain storage for medicines and vaccines
Clinics will be designed to be cyclone-resilient and climate-adapted.
6. Staffing Model (Per Clinic)
Each clinic will be staffed with a multidisciplinary team, combining professional healthcare workers and trained Rohingya community health workers. Staffing will be gender-balanced to ensure women’s access to care.
| Role | Count |
|---|---|
| Medical Officer / Physician | 1 |
| Nurses | 2 |
| Midwife | 1 |
| Mental Health Counselor | 1 |
| Pharmacist / Dispenser | 1 |
| Community Health Workers (Rohingya) | 2 |
| Clinic Administrator | 1 |
| Cleaner / Support Staff | 1 |
7. Community Health Worker (CHW) Program
Village Home will recruit and train Rohingya refugees as Community Health Workers, responsible for:
• Health promotion and disease prevention
• Early identification of high-risk cases
• Referral follow-up
• Community trust-building and outreach
This model enhances sustainability and cultural appropriateness.
8. Coordination and Partnerships
• Close coordination with UNHCR, Bangladesh Ministry of Health, and humanitarian health clusters
• Alignment with national treatment protocols
• Referral agreements with mainland hospitals
• Integration with nutrition, WASH, and protection actors
9. Monitoring, Quality Assurance, and Accountability
• Daily service utilization tracking
• Health outcome indicators (MNCH, morbidity, mortality)
• Patient satisfaction and feedback mechanisms
• Regular clinical audits
• Incident reporting and safeguarding protocols
10. Expected Outcomes
• At least 70–80% of Bhasan Char residents access primary healthcare annually
• Reduced preventable morbidity and mortality
• Improved maternal and child health indicators
• Increased early detection of chronic and mental health conditions
• Strengthened community trust in healthcare services
11. Sustainability and Exit Considerations
While displacement remains unresolved, the clinics are designed to transition to joint management with humanitarian partners, build Rohingya capacity through CHW programs, integrate into future repatriation or relocation health systems, and serve as scalable models.
12. Alignment with Durable Solutions
This medical component does not normalize permanent displacement. Instead, it ensures the basic human right to healthcare is upheld while refugees await a safe, voluntary, and dignified return to Myanmar.