Using local materials to build health facilities

Most health facilities in the camps are built out of bamboo, with surprising benefits

World Health Organization
World Health Organization

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Bamboo distribution point near Rohingya camps in Cox’s Bazar ©WHO/Mehak Sethi

Amidst the narrow alleys of the the Cox’s Bazar camps hosting the nearly 900'000 Rohingya refugees who have fled Myanmar, there are bamboo huts, bamboo bridges, bamboo shops but also entire health facilities built with this local and affordable material.

The Médecins Sans Frontières (MSF) diphtheria treatment center in Rubber Garden in Cox’s Bazar opened its door to patients in November 2017, shortly after the first cases of diphtheria appeared in the camps. Bamboo is used to build the roof, wards, and the disinfection units. “It is a local material and surprisingly, it is strong. It is also better and cooler than plastic. We use Rubb Hall (large plastic tent) in Syria for patients or in Democratic Republic of the Congo for Ebola treatment facilities. Maybe because of the natural materials used, this health facility is a more pleasant place to work in,” said Prue Coakley, MSF Rubber Garden Project Coordinator.

Triage area in MSF Rubber Garden Diphtheria Treatment center facility, where patients are registered.

The Samaritan’s Purse acute treatment centre in the Balukhali camp was one of the first health facilities in the area, rapidly erected in the final days of 2017. “We got permission and officially put a shovel in the dirt on December 21. We opened the facility on December 31. So it was a fast and furious 10 days,” recalls Sara Philips, who served as the medical project manager for Samaritan’s Purse at that time.

Sara Phillips speaking to WHO colleagues. ©WHO/Mehak Sethi

She has worked in many health facilities in emergency situations, across Africa and in Haiti. But the one in the Balukhali camp is a special one for her. “I have told our engineers over and over that this facility is the most aesthetically pleasing place I have ever worked in. It is a little haven in the midst of a place that isn’t pretty, isn’t nice. And it is a little haven with flowers and benches and a bit of respite from the chaos of the world around it,” she says.

Beds ready for patients inside the facility. ©WHO/Mehak Sethi
A worker adding the final touches to a bamboo ceiling at Samaritan’s Purse facility. ©WHO/Kate Marshall

When the Samaritan’s Purse facility opened, it was used as a diphtheria treatment centre and in June 2018, when the needs of the community changed, the facility shifted to treat acute watery diarrhoea cases. Damon Elsworth, the civil engineer who designed the site, recalls that when he started looking for materials, he soon realised that bamboo was not only locally available but there was local knowledge on how to build with it.

A man walks past one of the 255 health facilities in Rohingya camps. ©WHO/Rima Marrouch

As the Rohingya refugees worked to build the health center, Elsworth recognized their facility in using bamboo. “Most of the facility is built out of various sizes, with structural elements, secondary elements. Their ability to connect different joints and structures was brilliant. The bamboo will need replacing after about 12 months, but it is fantastic material and we can build with it very quickly,” says Elsworth.

In emergency settings, the ability to erect health facilities quickly is a crucial part of the response. Many health workers working in Cox’s Bazar remember how only a year ago, there was no infrastructure at all. Today, in the 34 camps hosting most of the almost 900 000 Rohingya refugees, there are 255 health facilities, built thanks to the skillful hands of the Rohingya people themselves.

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World Health Organization
World Health Organization

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