Image: Shamjida (right), a Rohingya refugee from Myanmar, opted to vaccinate her baby against ten dangerous diseases through an immunization support program supported by CPI in Kutupalong Refugee Camp, Bangladesh. (Md. Dipu/CPI)
Rumors and misinformation fuel vaccine hesitancy among Rohingya refugees from Myanmar sheltering in Bangladesh. However, Rohingya community immunization volunteers use education and encouragement to transform doubt into acceptance.
Before coming to Bangladesh in 2017, Shamjida knew very little about vaccines. “We didn’t receive any in Myanmar,” she confirms.
Shamjida and her family were among more than 700,000 Rohingya people who fled across the border to escape violence in Rakhine State, Myanmar, in 2017. She now lives with her husband and three children in Camp 1W of Kutupalong Refugee Camp, Cox’s Bazar.
In 2020, Community Partners International (CPI) began training and supporting Rohingya community members to act as immunization volunteers in support of the Government of Bangladesh’s rollout of the essential program on immunization (EPI) for Rohingya refugees. The EPI provides children under two in Rohingya refugee camps with routine immunization for ten dangerous diseases: diphtheria, pertussis, tetanus, hepatitis B, Hib, polio, pneumonia, tuberculosis (TB), measles, and rubella.
The immunization support program reaches over 19,000 people in over 4,100 households in camps 1W and 4 of Kutupalong Refugee Camp.
Globally, immunization is estimated to have saved at least 154 million lives, including over 100 million children, over the last 50 years. That’s six lives every minute. With more than one million Rohingya refugees living in cramped and overcrowded camps, the risk of infectious disease is high. In September 2017, a measles outbreak infected more than 1,700 refugees before a rapidly-deployed vaccination campaign brought it under control.
A key reason for training immunization volunteers is to counteract rumors and misinformation circulating in Rohingya refugee communities that create vaccine hesitancy and make parents less likely to vaccinate their children. When CPI launched the program, only 40% of eligible children in the program’s coverage area in Camp 1W were enrolled in vaccination.
Shamjida had heard many rumors. “I heard from community members that children would have many problems if vaccinated. People said it would give them fever and pain, make them unable to sleep, make a tattoo appear at the place of injection, and make them lose their religion. I was afraid to give vaccines to my child.”
Being part of the refugee community, Rohingya immunization volunteers can build bonds of trust with community members that help them provide accurate information and support and encourage community members to change their minds about vaccination.
Sayed has been an immunization volunteer for three years and frequently encounters vaccine hesitancy. “When I visit households, many people don’t want to listen because of the rumors. They think vaccination doesn’t have any real benefits and that it causes disease.”
His approach? Education, education, and more education.
“I teach them about diseases, show pictures of their impacts, and explain how vaccines help fight disease in their children. I explain the side effects of vaccines, for example, that they can cause a brief fever, but that’s normal and a sign that the vaccine is working. If they are still unsure, I ask a local religious leader to come and speak with them to reassure them.”
Sayed was instrumental in changing Shamjida’s mind after she gave birth to her third child, a baby boy.
“When Sayed visited me, I didn’t believe him at first,” she recalls. “How could I believe one person over our whole community? But he told me how vaccines can help my child fight disease,” she continues. “He showed me pictures of diseases that the vaccines prevent. As I looked at the pictures, I saw they are common in our community, and I realized he was right. I also noticed that many other mothers in my area were choosing to vaccinate their babies, which also helped convince me.”
Mohammed Mehedi Hasan, a Surveillance and Immunization Program Officer supported by CPI, provides more insight into how the immunization volunteer program works.
“The volunteers are the bridge between the community and the vaccination centers,” he explains. “They identify who is eligible for vaccination, conduct vaccine education, and support them in coming to the vaccination center. They keep in touch to encourage parents to adhere to the full vaccination course.”
“The volunteers are an essential part of the process,” he continues. “They help challenge rumors, overcome vaccine hesitancy, and promote health-seeking behaviors. Because they are from the community, they understand people, and people understand them.”
The program has yielded remarkable results since CPI began training Rohingya immunization volunteers in 2020. It has supported complete vaccination courses for 3,432 children under two and 2,184 pregnant women. Vaccine adherence among eligible children in the program’s coverage areas has risen from 40% to nearly 100%.
“When we started working on the program in October 2020, our survey indicated a vaccine adherence rate of 40%,” confirms Mohammed Mehedi Hassan. “Now, the success rate is close to 100% in both camps. This success is largely due to the volunteers. We don’t see such high success rates in areas with no volunteers.”
For immunization volunteer, Sayed, helping to protect children’s health is a strong motivation in his work. “When I successfully encourage a family to choose vaccination, it makes me very happy,” he confirms. “It means I have protected one child from many diseases. I feel proud that I have done good for my community.”
Shamjida enjoys peace of mind knowing her baby boy is protected from many deadly diseases. “I am happy that my child is safe from those diseases. If I had known about vaccines earlier, I would have given them to all of my children. I will let others know that all the bad things we heard about vaccines didn’t happen to my baby. Instead, they protect him. I will advise them to please vaccinate their children so they can have a better future.”
Interviews have been edited for clarity, brevity, and flow.
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