3 years of IEDCR Cox’s Bazar Field Laboratory: establishing laboratory quality amidst a humanitarian crisis

Three years back when over 850,000 Rohingya refugees reached Cox’s Bazar fleeing violence in Rakhine State in Myanmar, there was no laboratory in Cox’s Bazar - a southeastern District of Bangladesh - with the capacity to help health professionals and public health coordinators prevent, detect and control major outbreaks of communicable disease.

Soon after, the World Health Organization (WHO) supported the Institute of Epidemiology, Disease Control and Research (IEDCR) in establishing a field laboratory at the Cox’s Bazar Medical College. In the years since, the field laboratory supported the early detection of outbreaks.

Supported by WHO, the laboratory is now instrumental to provide testing and timely diagnosis for COVID-19 for Cox’s Bazar, Bandarban and part of Chattogram districts, including the densely populated Rohingya refugee camps.

WHO Laboratory Officer, Debashish Paul is supporting the lab’s coordination, including  over 20 laboratory staff, equipment, consumables and technical expertise, at the IEDCR Field Laboratory in Cox's Bazar Medical College - WHO Bangladesh/ Tatiana Almeida

“The work of WHO in humanitarian crisis is to keep people safe and serve the vulnerable, in the context of these dramatic events. Our role is to assist the Government to reduce mortality and morbidity. The work of the staff at the IEDCR Field laboratory speaks volumes in this emergency crisis when so many lives were saved”, explains Head of the WHO Cox’s Bazar Emergency Sub-Office, Dr Kai Von Harbou.

Those living in the camps are vulnerable, particularly to outbreaks of communicable diseases, due to high population densities, poor WASH conditions and immunization uptake. Outbreaks in the past years have included diarrhoeal diseases, measles, diphtheria, chickenpox and respiratory infections like COVID-19.

In the past three years, the IEDCR Field Laboratory in Cox’s Bazar was able to support public health interventions to prevent and respond to outbreaks through timely testing.

Every day, patients’ samples from all parts of Cox’s Bazar District, including the Rohingya refugee camps, are delivered to the IEDCR Field Laboratory at the Cox's Bazar Medical College - WHO Bangladesh/ Tatiana Almeida 

Laboratory personnel extracting RNA from a COVID-19 sample, as one of the lab procedures. This is a delicate process that needs to be carried out carefully - WHO Bangladesh/ Tatiana Almeida

The first case of COVID-19 in Cox’s Bazar was confirmed on March 23^rd 2020. Since then, the laboratory has increased the number of tests conducted day by day. As of 16 August 2020, around 30 000 laboratory tests for COVID-19 have been conducted here.

Sonia Afroz, Assistant Professor at the Cox’s Bazar Medical College, interpreting COVID-19 test results at a computer - WHO Bangladesh/ Tatiana Almeida

The capacity of the Field Laboratory of the Institute of Epidemiology, Disease Control and Research (IEDCR) in the Cox’s Bazar Medical College to expand testing in response to COVID-19 and other public health priorities, is a result of three years investing in human resources, capacity building, equipment, supplies/consumables and technical and operational expertise from WHO.

The establishment of the laboratory has been made possible with the generous support of various donors, including the World Bank, UK Department for International Development (DFID), the Bureau of Population, Refugees, and Migration in the US, BPRM, the European Commission Directorate General of Humanitarian Aid and Civil Protection (ECHO), among others, including funding from the UN.

*PCR stands for Polymerase chain reaction, a method widely used to rapidly make millions to billions of copies of a specific DNA sample, allowing scientists to study in detail.