NOTE: Unavoidable Service to Unnoticeable Risks: A Study on How Healthcare Record Management Opens the Doors of Unnoticeable Vulnerabilities for Rohingya Refugees

Secure management of healthcare records in dynamic contexts requires an understanding of the overall infrastructure of record flows and poses more challenges for vulnerable environments such as amongst the Rohingya refugees in Bangladesh. Understanding the overall infrastructure of how health clinics are providing medical treatments and how they are collecting and storing patient records is crucial as any changes or mismanagement in these records enables misuse or deliberate misinterpretations of medical data on various levels amongst individuals and Rohingya communities. Through an extensive field study in the Rohingya refugee camps in Bangladesh, we explored the management of healthcare records in different organizations. Over the course of our fieldwork, we interviewed 22 medical service providers from nine healthcare organizations connected to the Rohingya camps. Based on our findings, we design an abstract record management model and analyze it using a data provenance approach to identify the limitations of the existing record management. Our study shows vulnerabilities in ID management and security practices in healthcare record management. We further illustrate potential exploitation of these vulnerabilities through political, financial, and social lenses. To the best of our knowledge, this study is the first to discuss vulnerabilities in Rohingya refugees’ medical record management from political, social and economic views.