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Saturday, June 13, 2020

Healthcare, humanity, and hospitals

Testing for coronavirus has been a nightmare for millions in Bangladesh, coupled with widespread corruption in medical supplies and poor transparency in healthcare management
A senior staff of a grocery chain outlet in capital Dhaka, along with many others, was hailed as “Corona Warriors” by the Business Standard published from Bangladesh. The paper was emphatic in celebrating the role of these “heroes” at a time when “our humanity, empathy, and responsibility is being tested by the coronavirus pandemic.”
Testing for coronavirus has been a nightmare for millions in the country. The government and private resources are inadequate, coupled with widespread corruption in medical supplies and poor transparency in healthcare management.

Desperate times
Shila Aktar, a Customer Relationship Supervisor at Agora grocery outlet, had fever and weakness, but other signs of coronavirus were absent. She went from one government hospital to another. On the fifth day, she decided to stand in a queue at another make-shift booth in the city. Finally, her sample was taken.
Shila had desperately tried all helplines – announced as public health messages on public and private televisions, FM radios, newspapers, SMS, as well as embedded ringtones on mobile phones. At last, she took to Facebook to share the suffering of hundreds of people who had to wait in long queues for several hours at the state hospitals to get themselves tested.
She recounted her terrible experience at the government-dedicated Mughda Hospital for COVID-19 patients, not far from her home. The Ansar Battalion guards sold Taka (BDT) 20 tickets at an exorbitant price of Taka 2,000 to 3,000 in connivance with hospital staff union leaders. Her angry Facebook post brought the matter to the attention of a local lawmaker, Saber Hossain Chowdhury. The following day, para-police guards were removed and additional booths were opened adjacent to the hospital to collect further 150 samples a day.
Then began the waiting period to get her virus test report. After four days, she received a heartbreaking message online and also via phone SMS: “Dear Shila Aktar, your test of coronavirus is positive. Please stay at home. Be positive.”
Shila was unknowingly wandering for more than nine days infected by the contagious virus.

Leadership lessons
Bangladesh Prime Minister Sheikh Hasina has been rated among the top 10 women leaders for their commendable responsibility in coronavirus management by the prestigious Forbes magazine. Despite working with goddess Durga’s ten hands, she was in a dilemma as to what should be her nation’s priority: lives or livelihood?
As the crisis in Wuhan grew, the ‘learned’ heath minister Zahid Malek assured the nation that the country is fully prepared for any eventualities to overcome the pandemic. Thousands of panicked migrants returned home from epicentres; they were checked with ancient thermal scanners and hand-held thermometers, which broke down in weeks.
Despite media warnings, based on inputs from infectious disease experts, the airport authorities and immigration department were lax in checking the entry of thousands of people, who didn’t follow the quarantine procedures.
When Bangladesh’s first virus infection was detected on 7th March, there were only a few ventilators, a couple of virus testing labs, and no dedicated hospitals for infected patients. While the government never officially announced a ‘lockdown’ or ‘curfew’, the police and civil administration in the country failed to keep the people safe at home or ensure that they maintained social distancing, wore masks, and practised hygiene.
The most worrisome part was that the doctors, nurses, and healthcare staff did not have enough Personal Protective Equipment (PPE) kits. The suppliers had no fear of delivering low-quality and even fake materials. Scores of doctors and nurses were infected and were either placed in-home quarantine, isolation centres, or hospitals. Nearly half a dozen doctors succumbed to the deadly virus.
Some state hospital senior doctors who took to social media to criticise the poor quality of medical supplies were punished. Even those who complained of poor living facilities in designated quarantine hotels were punished.
When Cyclone Amphan from the Indian Ocean struck southwest of Bangladesh in May, people were afraid to move to the shelters as they were not built with social distancing in mind.
Caught in a catch-22 situation, between lives and livelihoods, the government has partially opened offices, factories (including export industries), shops, public transport, domestic flights, and restaurants. For now, the fate of parks, cinema halls, convention centres, religious and cultural festivals is on hold.
Regular products that were once sold on the streets have vanished. Now we have hawkers selling hand gloves, sanitizers, face shields, PPE gowns, and goggles to eager customers, who are unaware of the quality of these products.

First published in the Health Analysis Asia, 12 June 2020

Saleem Samad is an independent journalist, health fact-checker in Bangladesh. Recipient of Ashoka Fellowship and Hellman-Hammett Award. He could be reached at; Twitter: @saleemsamad

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