RTM International works in the field of public health which may be endangered any time by floods, cyclones, salinity, fall in water level, epidemics and many such catastrophies. The organization is always ready to respond to such national and local emergencies at a short notice. It has trained workforce, experienced professionals and physical resources which may be mobilized instantly. Through its linkages with grass-root level NGOs RTM can start relief operation immediately after an emergency liaising with the district and upazila administration.

In the event of an emergency affecting human lives, RTM’s emergency preparedness would be led by two of its senior management and program professionals who have personal and institutional experience of working in disasters. One is a high-ranking retired naval officer who has taken part in relief and rehabilitation effort while in the service. The other is a retired civil servant who was directly involved in planning and execution of government relief operations.

• Programs for Myanmar Refugees
• Response to SIDR cyclone
• Activities in Cyclone ROANU, MORA and Flood affected areas

Research, Training and Management (RTM) International is a nationally recognized resource organization providing technical, managerial and support services in the implementation of health, education, water and sanitation, post disaster management and other development program including research, training and technical assistance.  RTM International is implementing development assistance support including health care services in different parts of Bangladesh Cox’s Bazar District. RTM International is also providing reproductive health (RH) services to the people residing in Taknaf and Ukhia Upazillas (registered and undocumented refugees and local population). RTM is the only Bangladesh-based NGO involved in health sector activities and working with the local population, UNMs and in the two refugee camps (since 2008). It has been implementing reproductive health programs for Myanmar Refugees in the two official refugee camps at Teknaf (Nayapara) and Ukhiya (Kutupalong) upazillas of Cox’s Bazar district since the year 2007. Over 32,645 refugee population is being given services. The programs under the project SRH-FP Information and Services through RTM International (Ensuring Reproductive Health (RH) Service Delivery in Nayapara and Kutupalong Refugee Area) were financially supported by UNFPA. All the activities conducted and services performed by RTM International during the period from January to December 2015 have been briefly described below:

RTM International operated two birthing units (one in each camp) for providing maternal health (ANC, safe delivery, PNC and referral to Cox’s Bazar Sadar Hospital) newborn care services and clinical management of rape survivors to the refugees in the camps. Qualified and trained doctors and nurse/midwives were available round the clock to conduct the deliveries and onward referral of the complicated cases to the Sadar hospital Cox’s Bazar. RTM also has one ambulance with driver, ready at all times to carry the referral patients. There were 14 Community Health Assistants (CHAs) who were working to assist the Nurses/Midwives during managing a patient under labor and also in the postnatal period. As a result of the awareness development through Community Based Outreach Network (CBON) and the provision of quality service delivery  by the trained nurse/midwife and doctors, the delivery in the birthing units  under skilled attendants increased from 0.5% (2007 before taking over by RTM) to 91.30% (2011 during RTM’s period) and 99.00% in the year 2016. This remarkable result has been possible due to the confidence of the refugee population in the service provided in the Birthing Units (BU) and the community awareness programs through community involvement and timely referral of the delivery cases to the BUs by the CBON. During the period January - December 2016 total 1019 births took place in both the camps, out of which 986 were delivered in the facilities (birthing units- 887 and Cox’s Bazar Sadar Hospital- 99 complicated cases referred from birthing units) and 33 cases were delivered in the camp shed (home delivery).

RTM started providing ANC and PNC services from July 2013. Total 4057 ANC services (1121 - 1st visit, 912 - 2nd visit, 822 - 3rd visit, 851 - 4th visit and 351 - more than 4 visit) and 4014 PNC services (1019 - 1st visit, 1005 - 2nd visit, 987 - 3rd visit, 1003 - 4th visit were provided in both the camps from 1st January to 31 December, 2016.

In this year RTM International also provided screening and follow up of cervical cancer through VIA for the 711 refugee women in the 2 official camps and 290 women in Teknaf and Ukhiyaupazilas.

FP services were conducted in the camps in collaboration with FP Department of Bangladesh Government. Temporary methods (pill and condom) were distributed to the community people by the CTBAs and the field workers after proper screening by the trained doctors/paramedics in the FP service point. Injectables were also provided by the trained paramedics in the service point of RTM International in the camps. For permanent (Tubectomy and NSV) and long term methods (IUD & Implant) the clients were referred to the Upazila Health Complexes in Ukhiya and Teknaf through existing referral system. Through this system RTM ensured provision of comprehensive FP services to the refugee population in the camps. The result was the increase of Contraceptive Acceptance Rate (CAR) from 28% (2007 before RTM’s period) to 70 %( 2011). In July 2011 RTM was awarded with a certificate from the Ministry of Health and Family Welfare as the best performing NGO on Family Planning activities in Cox’s Bazar district. RTM also received certificates for being best performing NGO in Teknaf and Ukhiyaupazillas in the year 2012, 2013 and 2014. In the year 2015, Contraceptive Acceptance Rate (CAR) was found 74.00%. Total eligible couples in both the camps were 4771; out of them 3547 couples were receiving FP methods.

RTM International is operating two adolescent and youth corners (one in each camp) for dissemination of RH information since 2012. The corners remain open from 10 am to 4 pm for 5 days a week. There is provision of game materials (chess, Ludu, Carom etc) also some musical instruments for attracting them. There are BCC materials having RH related information available in the corners. A total of 185 numbers of girls and 229 boys attended the corners during the year 2016. Doctors, paramedics disseminated messages to them on RH and discuss and support them for getting services for any RH issues. Total 23 adolescents received treatment for any RH problem.

This program was initially supported by UNHCR from 2007 to June 2013.From July 2013 the program is being supported by UNFPA. RTM initially selected educated refugee and trained some volunteer groups from the refugee community in the year 2008.The groups were – Community Trained Birth Attendants (CTBAs)-22, Youth and Adolescent Volunteers (YAV)-168, Peer Educators(PE)-34. All these refugee groups together formed a Community Based Outreach Network (CBON). The function of this network is to build awareness on reproductive health and other general health issues and disseminate messages focusing on RH, child health, Family Planning, HIV/AIDS, general health and hygiene. Early referral of sick children, maternal cases for ANC, Safe delivery and PNC to the health facilities of RTM and also to the OPD/IPD managed by Refugee Health Unit (RHU) under the Ministry of Disaster Management and Relief (MDMR) in the camps. CTBAs were also responsible for distribution of oral pill and condom for family planning and referred clients to the RTM-FP service points for Long Acting and Permanent Methods (LAPM). Follow up to the ANC/PNC mothers and the new born child and also to the clients who received Long Acting and Permanent Methods (LAPM) were being given by the CTBAs. They also maintained an important bridge between the service providers, service recipients in the refugee population in the camps. This CBON remained active throughout the year 2016.

During the year 2015 the following training and orientation were provided:

•    Provided 2 weeks residential training for 2 nurse/midwives working in the refugee camps on Safe Delivery and Newborn Care was organized in OGSB Dhaka.
•    One day orientation to the parents on adolescent sexual and reproductive health (ASRH) at camp levels
•    Refreshers training to CHA (Community Health Assistant 1 Year trained, theoretical/practical on RH/FP) & CRHW at camp levels
•    Life skill education (3 month certificate course) on ASRH provided to the RTM staff and also the staff of other agencies including GoB facilities working in Cox’s Bazar, Teknaf and Ukhiya upazilla
•    A 5 day training on Syndromic Management of RTI/STI for RTM staff (Doc-1, MA-2, paramedics-FP-2, Nurse/Midwives-8) at camp levels

vi)  In the month of December 2016 RTM International organized one Stakeholders workshop on RH needs of refugees in the official camps, Undocumented Mayanmar Refugees (UMR) and host population in Cox’s Bazar, Teknaf and Ukhiya and developed an action plan for providing services in coordinated way

vii) Established 5 Adolescent Friendly Health Services in 2 in refugee camps, 1 in Teknaf Upazila Health Complex (UHC), 1 in Ukhiya UHC and 1 in MCWC Cox’s Bazar.

Iron deficiency affects about two of every three children/women. This was identified as the most prevalent cause of anemia. The refugees residing in the two camps of Nayapara and Kutaplaong solely rely on the food basket distributed for subsistence which is not always enough to provide the necessary nutrients required. To prevent iron deficiency, RTM International with the support from UNHCR implemented a program “Combating Nutrition Deficiency through Sprinkle Distribution” focusing pregnant women, adolescent girls and young children in the two official refugee camps (Nayapara and Kutupalong) in Teknaf and Ukhiya upazillas of Cox’s Bazar district from June, 2008 to May, 2009. That was a community-based intervention to distribute and promote consumption of weekly supplements and to provide nutrition education/awareness for reducing the prevalence of anemia among adolescent girls (13-17 yrs) in the refugee camps. The program was also supervising and monitoring the distribution and consumption of sprinkles to pregnant and lactating mothers and to under-five children. The distribution and monitoring activities were being utilized through use of Adolescents and Youths (Y&V) in the refugee camps. Besides this specific program, RTM International has been providing education on nutrition to the pregnant, lactating women(coming for receiving Ante Natal Care, Safe Delivery and Post Natal Care) and also to the adolescents attending in the “Adolescent Corners”  in the refugee camps since the year 2008. It is a continuous activity of the RTM intervention.

RTM International is operating two adolescent and youth corners (one in each camp) for dissemination of RH information since 2012. The corners remain open from 10 am to 4 pm for 5 days a week. There is provision of game materials (chess, Ludu, Carom etc) also some musical instruments for attracting them. There are BCC materials having RH related information available in the corners. A total of 185 numbers of girls and 229 boys attended the corners during the year 2016. Doctors, paramedics disseminated messages to them on RH and discuss and support them for getting services for any RH issues. Total 23 adolescents received treatment for any RH problem. RTM Established 5 Adolescent Friendly Health Services in 2 in refugee camps, 1 in Teknaf Upazila Health Complex (UHC), 1 in Ukhiya UHC and 1 in MCWC Cox’s Bazar

With the support of UNHCR and funding from UNICEF, RTM International implemented the Basic Education Program (BEP) in Kutupalong and Nayapara camps for Rohingya Refugees. Project already handed over to VERC-SAVE THE CHILDREN in the mid-year of 2012.

With the support of UNHCR during the period (January – June, 2013) 1391 persons were counseled. Among them, 577 survivors, 204 perpetrators, 371 family members of the survivors, 201 family members of the perpetrators were counseled.

xii) HIV/AIDS Program:

With the support of UNHCR two-to -three group sessions were held in both the camps every week with female sex workers and peer educators. As many as 14008 participants attended the sessions. Among them, 1155 participants attended in weekly group session with high risk groups including relevant Peer Educators and 12853 participants attended in Field based daily basis group and one to one contact (General refugee, sex worker and their clients, drug user, mobile people including MSM). RTI/ STI treatment were providing by trained Doctors and Medical Assistants following the National Guidelines of Syndromic Management of RTI/STI. A total of 762 STI cases were treated; among them 225 partners were treated. In short 39.85% partners received treatment. Now, HIV program is handed over to MoH on 30 June, 2013.

In order to provide the adult and educated refugees with livelihood opportunities, RTM introduced the Community Technology Assess (CTA) project in the two camps with effect form 23 September 2009. The objective of the component is to enhance for refugees in terms of empowerment, Vocational training, employability and self-reliance through access to technology. Fifteen computers are placed in each camp with 30 persons covered under a 10-week training program. Likewise 5 batches go on simultaneously in each camp. This training course is repeated 3-4 times each year with new student recruitment. The program was completed in June, 2012.

Cyclone SIDR was a tropical cyclone and one of the worst natural disasters in Bangladesh in 2007. On 15 November 2007, Cyclone Sidr struck the south-west coast of Bangladesh with winds up to 240 kilometers per hour. The category 4 storm was accompanied by tidal waves up to five meters high and surges up to 6 meters in some areas, breaching coastal and river embankments, flooding low-lying areas and causing extensive physical destruction. The cyclone was the second natural disaster to affect Bangladesh in twelve months. Responding to this situation,  RTM International built the capacity of partner NGOs (PNGOs) of Helen Keller International working in SIDR cyclone affected areas, to meet the needs and rights of the affected people and to ensure the organizational sustainability of the PNGOs during Mar 2009 - Dec 2010. RTM conducted organizational capacity assessment of the PNGOs using the participatory capacity assessment tool (POCAT) and prepared an action plan for providing TA to the organizations. The TAs included providing training on “Institutional Capacity Building”, covering the various aspects of organizational management Financial and Administrative Management, Monitoring and Evaluation as well as proposal writing.

RTM International has participated in many humanitarian and development activities during the last 20 years. RTM has a policy to work with the concerned government departments and development partners in case of emergency responses. Recently, RTM has responded to both the post disaster ROANU and MORA and placed midwifes in the worst affected areas. Cyclone Roanu made landfall in the southern coastal region of Bangladesh on the 21 May 2016 at midday. The affected coastal districts are; Chittagong, Cox’s Bazar, Barguna and Patuakhali. Women and girls of reproductive age, and particularly pregnant and lactating women and newborn babies need immediate access to life-saving maternal and newborn health services. These urgent services include quality antenatal, intrapartum, postnatal, and newborn care, for detection of emergencies, linkage to health facilities, and skilled birth attendance. This is a region of the country that is known to be conservative. In this context conservatism correlates with more gender inequity, and less health seeking behavior in women. To support the reproductive Health services especially pregnant women, newborns and to maintain the dignity of women and girls, RTM International with the financial and technical support from UNFPA has started working in those cyclone ROANU affected areas coastal areas since July 2016.

In addition, with the financial support from UNFPA, 45 midwifes are placed at the GOB health facilities (UHFWCs and UHC) and hard-to-reach areas to provide SRH services including emergency obstetric and newborn care. These midwifes are providing services to cyclone-affected women and girls and, especially those among the undocumented Myanmar National (UMN) refugees staying in Cox’s Bazar district. UNFPA has also made available Clean Delivery Kits and Dignity Kits for distribution among UMNs through RTM that include all essential equipment for child delivery in hard hit areas.

Few illustrative examples of activities/interventions under this emergency response are stated below:

•  Deployment of midwives in Union Health & Family Welfare centrs (UHFWCs) in the coastal areas of Chittagong, Cox’s Bazar, Barguna and Patuakhali;
•  Distribution of RH kits; distribution of dignity kits;
•  Establishment of Women Friendly Space (WFS) in Pekua of Cox’s Bazar and Galachipa upazila of Patuakhali districts;
•  Formation of Community Support Group (CSG) for identifying and referral of GBV cases to WFS;
•  Distribution of emergency medical supplies like ORS, saline, sanitary products, bandages, cotton, medicine for limited curative care (e.g. water-borne diseases, fever, deworming tablets, etc.).