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The world's largest refugee camp is in Bangladesh. And workers there have launched a massive immunization drive to try to protect the Rohingya who live there from contagious diseases. Despite that effort, there have been outbreaks of measles and diphtheria and recently an eruption of chickenpox. NPR's Jason Beaubien reports.
JASON BEAUBIEN, BYLINE: At a small health clinic in one of the refugee camps in Bangladesh, Somadu Katu is clutching her 3-and-a-half-year-old son, Yassin. Yassin is running a fever. And he's got small, red dots all over his body.
SOMADU KATU: (Foreign language spoken).
UNIDENTIFIED INTERPRETER: She's scared because this baby's very young. So he's not about to tolerate that pain.
BEAUBIEN: Katu says her son started getting sick about four days earlier. At first, she thought it was just a common cold. And then the menacing rash emerged. Yassin's older sister also got sick. Katu had no idea what this disease was or how bad it might get. The young mother says she'd never heard of chickenpox before and even says there's no disease like this back in Myanmar. Late in 2017, Katu, along with nearly 700,000 other refugees, fled from Myanmar to Bangladesh to escape attacks by pro-government militias. The Rohingya are a long-persecuted ethnic minority. Despite having lived in Myanmar for generations, the Myanmar government refuses to recognize them as citizens.
Dr. Ahsanul Kabir runs this clinic that was set up by a local Bangladeshi NGO. Dr. Kabir says chickenpox does exist in Myanmar. But he says the Rohingya were so isolated that many may have never been exposed to it. What is clear, Dr. Kabir says, is that the Rohingya had very limited access to health care.
AHSANUL KABIR: They didn't get any vaccine. They don't know the vaccine because before coming here, they don't have any idea about vaccine.
BEAUBIEN: And not just the chickenpox vaccine. Dr. Kabir says the Rohingya weren't even getting the basic childhood vaccines that the World Health Organization has been recommending since the 1970s - vaccines for easily preventable diseases like diphtheria, whooping cough, measles, tetanus and polio.
KABIR: Because these people, you know - they are not treated well. They are not treated rationally. So the Myanmar military regime people - they are not at all bothered - these people.
BEAUBIEN: Soon after the Rohingya arrived in Bangladesh, health agencies launched massive vaccination campaigns to try to get kids immunized against the most serious and potentially fatal illnesses, like diphtheria and measles. Chickenpox wasn't on the top of that list. Dr. Kabir says he first started seeing a few kids with chickenpox here in December. By the end of March, there were nearly 65,000 cases reported throughout the sprawling refugee camps. Chickenpox is highly contagious. And the virus can move among family members as people touch each other or share blankets or even touch the same table. It can also spread directly through the air. There's not much Dr. Kabir can do for these kids. He can help ease their fever, encourage the kids not to scratch, drink lots of fluids. And the disease will usually clear up in a week or so. What's difficult for him is the terrified parents and having to calm their fears that this horrible rash could be fatal.
KABIR: Chickenpox is not at all fatal, not at all fatal. There is no death or anything happened so far. So don't worry. They're afraid sometimes - very much afraid.
BEAUBIEN: Medically, he says, the worst chickenpox cases actually aren't the crying, speckled young kids. It's the adults, like 30-year-old Sodul Amin. He's also waiting to be seen at Dr. Kabir's clinic. After both of his kids had the disease, he came down with it four days ago.
SODUL AMIN: (Through interpreter) At first, my whole body ached. And I felt dizzy. Then I got a high fever. Then rashes started to come out on my skin.
BEAUBIEN: The rashes covered his entire face. Dr. Kabir says the pustules around his eyes and mouth are particularly painful and prone to infection. The refugees often bathe outside at open water pumps. And keeping these sores clean can be a struggle. But overall, conditions in the camps are improving. Refugees have far better access to clean water and pit latrines than they did a year ago. But so long as so many people - 650,000 - in one camp alone are packed so closely together, health officials say, disease outbreaks are going to be a challenge. And while mass vaccination campaigns against chickenpox aren't yet planned, there are ongoing efforts to get Rohingya kids immunized against a half-dozen other vaccine-preventable diseases. Jason Beaubien, NPR News.
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