Salina Khatoon
Health Associate
Duty Station: Damak, Nepal

I am addressing the challenge of how we can strengthen the medical nighttime emergency services for refugees from Bhutan in Nepal.

The Association of Medical Doctors in Asia (AMDA) with the support of UNHCR is providing nighttime emergency medical services through the emergency unit of the primary health care centre in each camp to address the emergency medical needs of refugees at night. Nighttime medical emergency services are run by medical assistants who need technical support from the camp medical officer to provide disease-based treatment to the refugees in the camps. However, the camp medical officer is only available during the day. Even though we’ve run several awareness programs in the camps to encourage refugees to visit the health centre during the day for non-emergency services, there are still many refugees (on an average 5,556 per month) who visit the health centre at night. This is because many of them work outside of the camp during the day, and can only visit the health centre after work. Because there aren’t skilled medical experts working during the night, about 30% of the cases that can be treated at camp level are referred to a hospital. This ultimately increases the medical referral health costs. We need to find a creative response to strengthen the nighttime medical emergency services by maximizing the available resources.

I want to find a solution to this challenge because healthcare is a prioritized need for refugees, as it is for everyone.

If we could enhance the capacity of nighttime medical emergency staff so that they could manage non-emergency cases in the camp health centre we’d be able to provide refugees with a higher quality of healthcare within their own camp environment. This in turn will save them the time and effort required to visit a referral hospital for repeated problems, and reduce overall healthcare costs.