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A young Rohingya refugee collects water from a muddy puddle in the newly built Kutupalong Makeshift Camp in a Rubber plantation, Cox's Bazar, Bangladesh.

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Remarks attributable to Maya Vandenant, Chief of Health, UNICEF Bangladesh.

GENEVA/DHAKA, Bangladesh/HONG KONG, 6 October 2017 - This is a situation update from Maya Vandenant, Chief of Health, UNICEF Bangladesh, – to whom quoted text may be attributed – for today's press iefing at the Palais des Nations in Geneva. Key Facts • 515,000 new Rohingya arrivals into Cox’s Bazar, Bangladesh since 25th August; • 225,000 of new arrivals are living in new spontaneous settlements with very limited Water, Sanitation and Hygiene (WASH) infrastructure due to an absence of planning; • 60% of new arrivals are children and 30% are children under 5 years old; • In the last week, 5011 cases of diarrhoea have been reported; • Since 25th August 2017, over 300 tube wells and 3,000 latrines have been constructed to improve WASH within both the extended existing makeshift settlements and the new spontaneous settlements; • UNICEF has launched a response plan to prevent an outeak of Acute Watery Diarrhoea and Cholera; • There are high levels of severe malnutrition amongst child refugees which exacerbates the risks associated with an outeak of acute watery diarrhoea and cholera.

“What we are seeing is that people are exhausted and children are at a heightened risk of diseases. There are real risks of acute watery diarrhoea and cholera outeaks. We are very concerned, and therefore, we are mounting an urgent response across the health sector.

“Planning of the extension camps is largely absent and there is no infrastructure in terms of ensuring good sanitation and drainage. We see that after the rains, water flushes through the camps everywhere, including the toilets. Additionally, the camps are now subject to high population densities. These factors increase the risk of disease outeak and transmission.

UNICEF Response “UNICEF has launched a response plan to prevent disease outeaks including Acute Watery Diarrhoea and Cholera. The response plan focusses on both prevention and treatment. The children caught up in the emergency are at very high risk for diarrhoea. UNICEF is working to scale up efforts in WASH, but the task in hand is immense.

“UNICEF’s response focusses on the following areas:

-         Improving WASH in settlements -         Participation in cholera prevention initiatives -         Reaching communities with life-saving awareness raising and prevention messages

Scaling up WASH “UNICEF is focusing on the immediate provision of safe water, basic sanitation and community engagement around hygiene practices.

“UNICEF is working around the clock to provide sufficient quantity of safe water to the target population of Rohingya refugees (in compliance with Sphere standards) through a combination of tube-wells and where no other immediate solutions are available, water distribution points with storage tanks replenished by water trucks. This will include ongoing monitoring of water quality on a regular basis. Priority is based on vulnerability and assessed risk of disease.

“UNICEF is working as fast as possible to ensure that:

- 2,625 new water points are installed - 15,750 new latrines are installed - 21,000 hand washing devices are constructed / distributed - Safe water supplies are provided at health centres - Latrines at health centres and in the communities are disinfected for infection control - Ongoing hygiene promotion activities are implemented that focus on specific safe water handling at the household level and waterborne diseases such as acute water diarrhoea prevention messages.

Cholera Prevention Initiatives “UNICEF and partners, namely WHO, ICDDRB (International Center for Diarrhoeal Disease Research Bangladesh), MSF, and others are working as fast as possible to scale up access to safe water and sanitation, especially at health centres, and to make information and resources on water handling available to households.

“An oral cholera vaccination campaign targeting all children over 1 years old is planned in October, and 900,000 doses of the vaccine are expected to arrive in Bangladesh on October 7. The vaccination campaign is expected to start on October 10.

“At three UNICEF-supported health centres, measures are also being implemented to ensure early screening for possible cholera cases and efficient onward referral to specialized treatment centres as well as to stockpile oral rehydration salts (ORS) to assist in the management of diarrhoea cases. ORS are being strategically located at key intervention delivery points to ensure that they reach those in need efficiently. We are also continuing to grow the network of UNICEF supported health camps across the makeshift settlements. Additionally, staff at nutrition centres will screen and refer children with suspected cholera cases.

“We will be primarily targeting the new influx, the extension areas as well as the pre-existing arrivals and targeting some of the host communities as well.

Reaching Communities with ife-saving awareness raising and prevention messages “Life-saving preventative and assistance information will be oadcast through mass media, by religious leaders, volunteers and youth will support awareness-raising campaigns on how to prevent and detect suspected cholera cases, and where to go for treatment.

“A ‘Model Mothers’ programme has also been established to reach communities with key preventative lifesaving messages. 20 model mothers have so far been trained and are now working in the makeshift settlements as an extension to the UNICEF Information and Feedback Centres (IFCs). These community-based workers work to disseminate key lifesaving messages throughout settlement communities including information on the upcoming oral cholera vaccination programme, awareness raising of acute watery diarrhoea and other health concerns as well as other community-centred campaigns. The 2 established Information and Feedback Centres (IFCs) provide critical information about service points, disseminate community information, demonstrate model behaviours and also conduct community consultations and meetings to ensure the needs and concerns of settlement communities are understood and acted upon.

“We are also working to establish additional IFCs to further increase reach to at risk communities.”