In the Rohingya refugee camps in Cox’s Bazar, home to over one million refugees living in densely populated, resource-limited conditions, access to safe water, adequate sanitation, and robust Infection Prevention and Control (IPC) measures are essential to safeguard the health of both patients and healthcare workers. Since 2018, the World Health Organization (WHO), through its WaSH-FIT initiative and in collaboration with RedR Australia and the Health Sector, has trained a total of 514 professionals. These include health facility managers, doctors, nurses, and focal persons for WaSH, IPC, and healthcare waste management (HCWM) across 198 healthcare facilities in the camps. Additionally, during the COVID-19 response, WHO trained 43 IPC Master Trainers, who subsequently supported the capacity building of more than 3,600 frontline healthcare workers, including IPC focal staff, medical assistants, cleaners, nurses, and supervised health volunteers, across various camp-based facilities
Building on these efforts, WHO, in collaboration with the Health Sector and the Civil Surgeon’s Office, conducted a training from 14–16 July 2025 to further strengthen IPC and WASH practices. More than 100 participants, including medical staff and IPC/WaSH focal points, were trained on key topics such as water chlorination, healthcare waste management, disinfection, sterilization, and IPC service delivery. The training utilized a combination of interactive lectures, hands-on demonstrations, and group exercises to enhance practical understanding and application.
Bar graph showing WaSH conditions in health facilities across Rohingya refugee camps, Health Sector Assessment, Cox’s Bazar, 2024
WaSH conditions in health facilities across Rohingya refugee camps, Health Sector Assessment, Cox’s Bazar, 2024.
Recent assessments conducted by the WHO-led Health sector have identified significant gaps in WASH services across health facilities in the Rohingya camps. According to the 2024 WaSH-FIT assessment, the majority of health facilities were classified as having “No Service” status, primarily due to reliance on distant or unimproved water sources and inadequate chlorination of drinking water. Additionally, 45% of facilities reported limited healthcare waste management and sanitation services, 41% lacked basic decontamination capabilities, and 73% did not provide essential health and safety protections for staff. Field visit reports further revealed widespread confusion and limited technical knowledge regarding the appropriate use of various chlorine-based disinfectants. “This training directly addresses critical gaps identified in WaSH, IPC, and waste management within health facilities across the camps. Your active engagement is essential to improving service delivery and preventing the spread of diseases such as cholera,” said Dr Orwa Abdulla, Health Sector Coordinator to all the training participants.
To assess the effectiveness of the training, WHO conducted pre- and post-training assessments. The results demonstrated a significant improvement in participants’ understanding of IPC and WaSH practices. Assessment scores increased by 27 percentage points, rising from an average of 55.5% before the training to 82.9% afterward. “This training is vital for both our safety and that of our patients. The hands-on sessions helped clarify best practices in waste management, WASH, and IPC. I’m eager to share this knowledge with my team to help to improve the quality of care,” said Israt Jahan Keya, Field Manager at Dhaka Community Hospital Trust, Camp 14.
The training directly supports the Cholera Preparedness and Response Plan 2024-2025 and contributes to broader efforts to reduce infection risks, such as hepatitis C, through safer injection practices and improved waste management. “Healthcare workers play a crucial role in setting the standard for safe practices both within health facilities and in the wider community. Tackling challenges in waste management and eliminating unsafe practices, such as the improper disposal and reuse of needles, are essential steps to prevent the transmission of blood-borne diseases like hepatitis C. The skills gained through this training must be actively applied to safeguard patients, healthcare workers, and the environment,” said Dr Jorge Martinez, Head of the WHO Sub-Office, Cox’s Bazar.
A participant practices proper packaging of sterilized medical instruments as part of the infection prevention training
WHO will conduct follow-up field visits in the last quarter of 2025 to carry out the WaSH-FIT assessment, monitor implementation progress, reinforce skills, and provide additional support. By equipping frontline health workers with practical tools and updated knowledge, WHO and its partners are working to deliver safer, higher-quality healthcare for the Rohingya population.
For more information on this publication, please email Terence Ngwabe Che, External Communications Officer at WHO Cox’s Bazar Office, Bangladesh, at chet@who.int.
