and neighbors helped me to get to the healthcare facility twice. But the
doctors gave me the same medicines. The last time I went to the healthcare
facility, they told me to come up with the money to go to the hospital in
Noakhali [on the mainland] as my situation had deteriorated very badly. I
do not have my own money and I feel shy to ask for help from the
neighbors. It’s better now I die here with my family. 140
Several of those interviewed by Human Rights Watch who were referred for emergency or
secondary care on the mainland were required to bear the cost of transportation, and
sometimes the laboratory and medicine costs. For instance, Sofika, 28, said that her
mother, Aklima, 57, was transferred to the hospital in Noakhali for respiratory support, but
they had to pay for transportation and treatment. When, after nine days, no longer able to
afford the hospital, she and her mother returned to Bhasan Char, her mother’s condition
deteriorated and she was unable to walk to the healthcare facility on the island. However,
there is no ambulance service on the island and so Aklima was unable to access
emergency medical care. When Sofika went to the healthcare facility and begged the
doctor to come provide emergency care for her mother, she said he replied that “it is not
his duty to go into the shelter and check patients.” Aklima died in her shelter soon after. 141
No Capacity for Emergency Medical Care
The island does not have facilities to respond to medical emergencies. Authorities need to
transport seriously ill persons either by boat or helicopter to the nearest hospital on the
mainland, Noakhali Sadar Hospital, which is three hours away by boat plus an additional
two-hour drive by car. Transport by helicopter is faster, but difficult to access.
To obtain emergency care off the island, refugees said they are required to first get a
reference from the doctor indicating that they need to be transferred. Next, they need to
get permission from the one Camp-in-Charge on the island who is responsible for over
18,000 refugees. Next, because there is no ambulance service on the island, if the person
is unable to walk, they must obtain permission from the police to arrange a police vehicle
for transportation to the dock. Finally, if the police agree and they are able to make it to the
dock, they must negotiate a rate for a boat to transport them to Noakhali port.
140 Ibid.
141 Human Rights Watch interview with Sofika, Bhasan Char, Bangladesh, April 7, 2021.
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HUMAN RIGHTS WATCH | JUNE 2021