The Financial Express

Management of ailing health sector

Management of ailing health sector

When the first case of Covid-19 was detected on March 8 last in the country, it was a new experience for most people. None had ever encountered such a health emergency in the past. To the health authorities also, the particular virus was unknown. Nor could they comprehend then how devastating the pathogen would be.  

 No place on earth has been spared. The virus that reportedly originated in the Chinese city of Wuhan has wreaked havoc around the world. It has been truly devastating, in terms of economic shock, loss of employment, rise in poverty etc. The pandemic has already taken away nearly a normal year from the mankind. What it has instilled in the minds of billions is fear--- fear of sufferings and death.

When the epidemic first struck the country, it was not unusual for the health authorities to make a few mistakes. The Directorate General of Health Services (DGHS) and relevant others had committed a few.  Health officials did not know how to deal with a highly infectious disease that has no known cure.

Treating patients is one thing and making the right decisions---administrative or otherwise---to stop the spread of a highly infectious disease is another. The health authorities faltered on both counts. Their lack of preparation and indecisiveness became too glaring in the initial days of the pandemic. That drew scathing criticism from different quarters. However, the hospitals--- both private and public--- have overcome their initial shock and gradually improved their skill in handling Covid patients.

When infection was at its peak, the government Covid-dedicated hospitals could not accommodate critical patients because of the shortage of ICU beds. These hospitals also faced the scarcity of ventilators and high-flow nasal cannulas, oxygen concentrators and cylinders.

The ICU beds in Covid-dedicated government hospitals, according to the statistics circulated daily by the DGHS, are now almost full.  A resurgence of the infection might prove truly difficult for Covid hospitals to accommodate critical patients.

Amidst such a situation, the media reports on the availability of ICU beds in government hospitals and stockpiling of the same and some other medical equipment have evoked both surprise and shock.

According to the reports, there exists a serious mismatch between the actual number of ICU beds in Covid hospitals and the number mentioned earlier by the DGHS during the media briefing. What has transpired during media investigation is that the DGHS took into account the number of ICU beds that it had planned to make available to the hospitals under a procurement plan.

There are other issues also. As many as 212 very sophisticated ICU beds, 413 high-flow nasal cannulas, 150 ventilators, about 2000 oxygen concentrators and 8,500 oxygen cylinders meant for Covid patients are reportedly lying with the central medical storage depot (CMSD) of the government. 

The CMSD says that the relevant government hospitals seem not to be interested in availing of the medical equipment. Then again, a few hospitals despite having the necessary infrastructure and manpower are not interested in taking new ICU beds to avoid extra workloads. Some others do neither have infrastructure nor manpower to make use of additional ICU beds.

The Ministry of Health and the DGHS, from time to time, have been unveiling plans and programmes on handling the pandemic. One can well remember the government's plan on the zoning of Dhaka, based on the intensity of infection. It did nothing barring the initiation of a pilot project at Razabazaar. There are some other instances where the health authorities failed utterly.

The health ministry and the DGHS should consider themselves rather lucky as the country despite being densely populated has experienced low infection and death rates. The higher percentage of young population and possible built-in immunity might have played a key role here. The pandemic, however, has done all the damage to economy, education and all other social sectors.

If one devotes oneself into the job of preparing a list of the failures on the part of the country's health authorities, it would be a long one. It has made lots of tall promises since the start of the pandemic, but, in most cases, failed to deliver.

For instance, some weeks back, they announced that the government would fix fees for private hospitals treating Covid patients. However, no action has been taken as yet.

Also, the health authorities have not been consistent in the matters of trials and procurement of vaccines. What has happened to the Sinovac vaccine trial is still not clear. Nor is there a clear idea about the availability of vaccines developed until now.

There have been lots of talks about poor health budget. Enhancement of allocation to the health sector, undoubtedly, is essential. But unless and until the quality of the health management is improved through necessary reforms, most of the higher allocation would go waste.

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