AILSA CHANG, HOST:
There are some places where social distancing seems nearly impossible to enforce. Take refugee camps, where conditions are crowded and people have to leave their homes for toilets and water. It's a major concern in Bangladesh, which has the world's largest concentration of refugees - the 1 million Rohingya who fled violence and abuse in neighboring Myanmar. NPR's Malaka Gharib introduces us to one local aid worker who is not deterred by the fear of an outbreak.
MALAKA GHARIB, BYLINE: Every day, Shah Dedar drives two and a half hours outside his town of Cox's Bazar to work in one of the Rohingya refugee camps. The 32-year-old is with HelpAge, an organization that provides health care and other services to the elderly and disabled.
(CROSSTALK)
GHARIB: We asked Dedar to walk through one of the 34 camps where he works and describe what makes this such a complicated place for disease control.
SHAH DEDAR: Right now I'm standing in camp 80. In this camp, over 29,000 Rohingya people are living with 6,000-plus families.
GHARIB: People here live in crowded makeshift housing. It stretches as far as the eye can see.
DEDAR: I can see here, in the fierce sun, narrow roads, tiny houses.
GHARIB: And under that fierce sun, in those tiny houses are families of up to eight crammed together in huts about the size of a small dining room. Clean water is scarce, and people have to share dirty bathrooms. For a disease that thrives on close contact and unsanitary conditions, this is a paradise.
DEDAR: If spread in the camp, we cannot control. It will be out of control.
GHARIB: Fearing an outbreak, the Bangladeshi government in March imposed a lockdown across the country, including inside the camps. Dedar says it's very quiet here now.
DEDAR: There is no loud noise of children. Playgrounds are empty. Shops are closed. It is like everyone is panicked. What a tense atmosphere.
GHARIB: To make things more difficult, the refugees are cut off from the outside world. There is no Internet at the camps. The Bangladeshi government shut it down in September to crack down on illegal activity. But without access to information, refugees aren't sure what to do to protect themselves, what to do if they get sick. And rumors abound.
SALIMULLAH: (Non-English language spoken).
DEDAR: (Non-English language spoken).
GHARIB: Dedar records a conversation on his mobile phone with a 70-year-old refugee named Salimullah.
SALIMULLAH: (Through interpreter) We are very much worried with coronavirus because there is no testing facilities in the camp. There is no treatment, even, for us. We heard that it is not even available in Bangladesh.
GHARIB: So far, there are 20,000 cases in Bangladesh. And though there is at least one confirmed case inside the camp, Dedar suspects there are many more.
DEDAR: We do suspect there are many more. That's because sample collection is very limited. Testing is very limited.
GHARIB: If refugees become sick with COVID-19, aid workers say it could be a death sentence. Inside the camp, there are few isolation centers, only 200 hospital beds and three ventilators. And to protect refugees from getting infected by outsiders, authorities are only allowing workers that provide food and medical care into the camps. Dedar says there is not enough personal protective equipment for the health workers, so he just wears a simple disposable mask. On this day, when an 80-year-old man comes to pick up some heart medicine from the HelpAge clinic, Dedar asks him whether he knows anything about the pandemic.
DEDAR: I asked him, so, Grandfather, did you hear about coronavirus? He told me that, what the coronavirus is? Allah will save us. God will save us.
GHARIB: Dedar tells the man, you need to stay in your house.
DEDAR: He told me that, I'm living alone in my house. I need to come out for medication, in fact. So there is no one. So while he was explaining his situation, I mean, he was almost crying.
GHARIB: Shah Dedar says he's committed to helping those refugees in spite of the risk of getting sick himself. After all, he says, these are the most vulnerable people.
Malaka Gharib, NPR News, Washington. Transcript provided by NPR, Copyright NPR.
