FOR MÉDECINS SANS FRONTIÈRES, or Doctors Without Borders (MSF), renowned for providing immediate medical care to those most in need, the Covid-19 pandemic has meant quick adaptation, upscaling ongoing projects and starting new initiatives worldwide.
Since January 2020, the organisation has committed substantial resources to dedicated Covid-19 projects, while addressing healthcare needs and aiding health ministries in many countries in gearing up – and buttressing against – the pandemic. This includes large-scale health promotions and awareness-raising activities. MSF also supported the provision of personal protective equipment and hygiene kits to the more vulnerable populations.
Marginalised Groups Side-lined Further
The pandemic’s unfolding witnessed how refugees living in camps in Greece and Bangladesh, or conflict-affected populations in Yemen and Syria struggle with protecting against the virus. Many live in harsh, overcrowded and often unsanitary conditions, with limited access to healthcare.
But even in countries like Malaysia, MSF has observed how refugees and asylum-seekers have not been spared its effects. Their lack of status and rights prevents them from coming forward for testing and treatment. This is due partly to the twenty-year-old Health Circular 10/2001, which requires healthcare providers to report undocumented migrants to the police and immigration services; and the string of immigration raids, roadblocks and several targeted approaches enforced since May 2020 has engendered the fear of arrest, driving many deeper still into hiding.
At the MSF clinic in Penang, a medical doctor assesses a Rohingya patient accompanied by her husband. She has tremors and coordination problems, and will be taken to the hospital as a matter of urgency.
Secondary consequences of the pandemic have seen stigma against refugees and migrants strengthened; and their poverty rate aggravated further with the restriction of movement and loss of income. Patients who depend on long-term treatment or drug supply to manage illnesses like diabetes and HIV are also deterred or delayed from seeking treatment.
Maintaining physical distancing is a challenge as well since for social support and to reduce rental costs, many refugees share living quarters with relatives and community members. The general exclusion from the public health response to Covid-19 leaves these marginalised communities confused by the constantly changing SOPs and afraid to seek healthcare. Hygiene products are considered a luxury – many find face masks, soaps and sanitisers too costly for purchase when access to food itself is a struggle.
As one participant in a MSF survey on the impact of Covid-19 confided: “Sometimes we can’t afford to buy soaps and sanitisers because I can see [my] children [..] crying for food daily. Food is more important than healthcare for us at the moment.”
MSF in Penang
In response to the pandemic, MSF provides support to the refugee communities in Penang by conducting daily health education sessions in the Rohingya and Burmese languages, to explain necessary prevention measures and public health guidelines.
But some endeavours by the organisation were suspended following the initial MCO imposition, including the provision of weekly mobile clinics in Penang. This severely affected those in the more remote parts of the state, in particular those dependent on regular medication. To get around this, MSF ensured the medications’ safe delivery to patients’ homes instead.
A pharmacist at the MSF clinic in Penang explaining to a Rohingya patient the required medication dosage.
Alongside translation services through its network of Rohingya community volunteers at public hospitals, the MSF team in Penang also recorded several videos on Covid-19 prevention measures such as step-by-step hand washing techniques in the Rohingya language as part of its health education efforts. These videos are now watched by Rohingyas around the world, including those in the refugee camps in Bangladesh.
Together with local NGOs, MSF distributes food to vulnerable refugee families, and hygiene items have been dispatched to several Immigration Detention Centres (IDCs) in the country as well. Due to overcrowding, the detainees at the IDCs are at an even higher risk of being infected with the virus.
MSF is reiterating its call for a more inclusive response to the pandemic, by appealing to the Malaysian government to repeal the Ministry of Health Circular 10/2001 and to halt targeting migrants and refugees in immigration raids. Head of Mission Dirk van der Tak explains, “It is not in the public interest to exclude an estimated two to three million undocumented migrants from healthcare, as it will hamper an effective response to the pandemic and other infectious disease outbreaks that require access to healthcare and testing for all.”
Through its Access Campaign, MSF is urging governments worldwide to waive the patents related to Covid-19 vaccines, drugs and diagnostics, and other technology for the duration of the pandemic until global herd immunity is achieved.
In the meantime, MSF will continue to support vulnerable populations, including refugees and asylum-seekers in Penang, contributing to the efforts made by many other local organisations to ensure these communities do not fall between the cracks.