Crushing poverty and hardship is ever-present inside the Kutupalong Rohingya refugee camp.
More than 1.1 million people had come to the valleys of Bangladesh from its next-door neighbor, Myanmar, where they were fleeing genocide in their home country.
Their friends and family members had been brutally slain, their previous lives were in ruins and now they lived in a permanent state of uncertainty, with no place to call home.
Yet even in this dire situation, glimmers of hope shone — unexpected opportunities, a chance to pull themselves up to a better life, the dream to one day go back to their home country. It was this attitude that touched a group of local physicians.
“When they saw that you can lift yourself up from this place of poverty and despair, that education is the way out; that was inspiring,” said Dr. Adam Paarlberg, associate program director for Franciscan Health’s Family Medicine Residency program.
For two weeks in early November, Paarlberg and five other doctors from Franciscan Health Indianapolis volunteered their services in the camp’s medical clinics. They helped treat familiar maladies such as diabetes and high blood pressure, as well as tackling conditions they had only read about in medical texts, such as typhoid, measles and fungal skin infections.
At the same time, the physicians were able to work together with officials from nonprofit organizations such as Doctors Without Borders to learn about vital issues such as getting refugees freshwater and sanitation services.
The group returned with not only a fresh perspective on issues facing the Rohingya people, and all refugees, but a reinvigorated dedication to the field of medicine in general.
“Coming back, it rejuvenated me and reminded me why I went into medicine, why I chose this field,” said Dr. Hira Naqvi, a second-year family medicine resident. “When we were out there, we didn’t have all of these different resources that we use here. It was your medical knowledge and your brain and bouncing these ideas off of each other.”
The group’s focus was aiding the Rohingya people, a Muslim minority group from Myanmar. The humanitarian emergency surrounding the Rohingya people has become one of the largest and fastest-growing refugee crises in the world, according to the United Nations Refugee Agency.
Refugees started fleeing government-led violence and genocide in Myanmar in the 1990s, but renewed aggression and oppression starting in 2017 drove a new wave of people out of their homeland.
Much of that group has settled in northern Bangladesh in refugee camps. Makeshift shelters, made of bamboo poles, tarps and any other materials they can find, spread out across the valleys, stretching as far as you can see.
“It’s a very challenging thing to wrap your head around, that something like this exists,” said Dr. Gregory Specht, a third-year family medicine resident who went on the trip.
Since October 2017, OBAT Helpers has been working inside the camp to help improve access to health care, education and economic empowerment to the Rohingya population. OBAT Helpers is an Indianapolis-based nonprofit founded to care for refugees in Bangladesh.
Their two medical centers treat up to 400 patients each day. That is where the Franciscan Health group practiced during their trip.
A connection with OBAT Helpers is what set the Franciscan Health trip in motion. Paarlberg’s wife works for the organization, and he helped present the idea of serving a medical mission at the Rohingya refugee camp to others at Franciscan Health’s Family Medicine Residency program. In the end, six doctors signed on to take part.
In addition to Paarlberg, Naqvi and Specht, the team consisted of Dr. Jeffrey Jones, a family physician for Franciscan Health’s TravelWell Medicine clinic in Greenwood; Dr. Kami Smith, a family physician practicing in Greenwood; and Dr. Kevin McNulty, a third-year family medicine resident.
The group traveled to Chicago on Nov. 1, on a flight bound for Dubai, then Dhaka, Bangladesh, and finally a small airport in northeast Bangladesh.
“It was about 41 hours of travel each way,” Paarlberg said. “Each leg was five airports in two days.”
The doctors stayed in a hotel about 1 ½ hours away from the refugee camp, traveling back and forth each day on the only road into the area. When a cyclone struck the area, the trip more than doubled in time.
But the grueling travel was worth it once they arrived at Kutupalong.
“It was a very eye-opening experience,” Specht said. “You get to see what these people in this part of the world — in this kind of adversity — are going through. It is a devastating situation, and to see the scale of it all, how big this refugee camp is is overwhelming.”
The physicians treated between 30 and 40 patients each day, dealing with common conditions as well as diseases more common in areas with a large amount of people living in close proximity, such as tuberculosis and skin infections.
Practicing in the United States, most doctors never have a chance to see those kinds of cases, Specht said.
“We don’t have a lot of exposure to that. You’re tested on it in medical school, but you never see those things,” he said. “Having the chance to treat those things — though I wish the situation wasn’t there — it was an eye-opening experience to not just see it on paper, but to see the pathology itself.”
In order to interact with their patients, the physicians were assigned translators, refugees themselves who knew the Rohingya language as well as English.
The Franciscan team relied on them greatly, and by the end of the two weeks had formed close bonds with them.
“It was very humbling. Just to see the translators working all day in the clinic, then at night teaching English, because they really see that education is the future, the way to move up. Yet they’re stuck; they can’t go anywhere,” McNulty said. “The way they keep their hopes up in a hopeless situation was hard to see, but a very rewarding experience.”
One young woman they worked with at the clinic had dreams of being a doctor herself. Prior to becoming a refugee, that was something that would not have been allowed; the Rohingya culture discourages women from those career opportunities.
But in working for OBAT Helpers, she sees hope, McNulty said.
“She’s working to get educated and move up. Her family has been supportive of that, so hopefully someday she can get the chance to go to medical school,” he said.
Every day in the refugee camp was enlightening for the group. But their education didn’t end when they left.
Jones helped his fellow doctors navigate unfamiliar aspects of tropical medicine.
Often in the evenings, the group would gather in Jones’ hotel room, where he used a portable projector to deliver presentations about conditions they had encountered that day.
“Being residents who were learning, he’d offer lectures at the end of the day,” Specht said. “He’d present different kinds of tropical medicine topics to go through with us, which was a great way to add to the learning.”
Coming back to Indiana, the group of physicians have brought with them additional perspective in their own medical careers.
They also have a better understanding of the plight of refugees all over the world, including in the United States.
“I always considered myself an advocate for refugees, but have I really been? Coming back, I really want to find a way to be an advocate for refugees,” McNulty said. “So many of the individuals we worked with would be a great asset to our society, if we would allow them to come here.”