APPAREL WORKERS AND PUBLIC

Risk of social isolation and greater health crisis

by Taslima Akhter | Published: 00:00, Apr 06,2020

 
 

People, mostly apparel workers, headed for Dhaka crowd at a place at Uthali in Manikganj on Saturday amidst a public holiday aimed at staving off the novel coronavirus threat. — New Age

I  feel compelled, I feel obliged to share the insufferable experience of two friends from the past weeks — the lived experience of fear of the novel coronavirus that changed their lives. One of them is an organiser of women’s movement and the other is an organiser of workers’ movement in the apparel industrial sector. One of them is in hospital with COVID-19-like symptoms and the other is homebound with critical heart disease. Both are my dear ones. Their experiences are haunting me like trauma. However, it is important to share a few words about the current situation of apparel workers and the COVID-19 outbreak in Bangladesh before I move on to their stories.

 

I

LOCALLY and globally, the COVID-19 pandemic is taking a new turn every day, alongside escalating fear and uncertainty. It is signalling an economic recession and severe health insecurity. The total death toll of the pandemic has crossed over 64 thousand. On International Women’s Day 2020 (March 8), the first case of COVID-19 was confirmed in Bangladesh. Since then, as of April 4, 70 are infected and eight people are dead. Developed countries in Europe and America are struggling to contain the spread of the virus.

Bangladesh, from the very beginning, has been rather laid back in responding to the crisis. From government announcements, it appeared as if nothing serious would happen. The national plan to prevent the spread of the virus including the declaration of a ‘general holiday’ was rather sudden. Then began the panic buying — middle-high income groups begun stockpiling three to six months’ worth of food supply. All educational institutions closed, government and non-government offices suspended their business activities. Ever crowded Dhaka slowly became deserted, rural areas also became desolate. The military took to the street along with the police. New forms of societal and state harassment begun. People with COVID-19-like symptoms and their families are harassed by neighbours, burials of COVID-19 victims are obstructed, workers are beaten by the police in the name of teaching ‘social distancing’ and government officials are humiliating people by making them do sit-ups holding their ears for violating government directives on coronavirus prevention.

The national economy is also affected. The president of Bangladesh Garment Manufacturers and Exporters Association in a video message called the European and American retailers to reconsider the large number of orders they cancelled and suspended so far. Labour organisations demanded that industrial owners, the government and global buyers take the responsibility of the 41 lakhs workers’ health safety and announce paid leave during the outbreak. Still, in the prime minister’s national address on March 25, no declaration came on the question of shutting down the production line. But, an announcement came of a stimulus package of Tk 5,000 crore for export oriented industries. The following day, the president of BGMEA, instead of announcing the factories closed, ‘personally requested’ owners to consider temporary factory closure. The president of Bangladesh Knitwear Manufacturers and Exporters’ Association also made similar requests. This is how began the phase of ‘killing time.’ Workers feared the contagion. They became anxious about losing jobs and their struggle for economic survival. Some factories were closed at owners will. In some places, when workers refused to work, factories were closed. This is how the ploy of keeping the factories ‘close and open’ continued. And the work order cancellation by international retailers may cost the apparel sector about $3 billion.

A research of the Workers’ Rights Consortium shows that 10 lakh worker may lose job in the near future. Many workers are already losing job. Meanwhile, the government has extended the public holiday from April 4 to April 11. The president of the BGMEA, referring to the government, has said that factories can be opened on the conditions that the ‘health rules’ are followed.  In fear of losing jobs, on April 4, thousands of workers began walking to their workplaces from distant districts. On the way to work, two apparel workers were killed in a road accident in Mymensingh. This inhuman scenario shocked the nation. In the face of fierce criticism, later at night on April 4, leaders of the BGMEA and the BKMEA requested to keep the factory closed, but it was already too late.

Questions arise, who benefited from this ploy of ‘killing time’? Isn’t it absolutely irresponsible that the government and the factory owners brought the workers back to factories disregarding their health safety concerns? What is the real reason behind the supposed disunity between industrial owners? Why has the prime minister remained silent on workers’ health issue? Why has the attention been diverted to the prime minister’s address or to the BGMEA’s announcement? Is it to complete pending orders, to keep the production line open? Why haven’t they thought of making personal protection equipment before? Why have the local and international media including the New York Times and the BGMEA been lamenting the loss that Primark, Zara and H&M incurred or may incur during this pandemic? Workers sweat and hard work brought fortune for the global buyers and local owners, and helped the country to earn 84 per cent of its export earnings. These workers are the primary capital of our national economy, of buyers and industry owners. Why such negligence towards their lives? If their health and livelihood are not protected, can the industry survive?

We could have made a historically unprecedented example by ensuring workers’ health security through creating an emergency fund from a share of the profit from global buyers and local industry owners, financial assistance from the government and other sources. If necessary, the government could have taken the lead in this regard. Not just because of ‘humanity and ethics’, but in the interest of industry and national economy, all three parties benefitting from this sector could have taken up a special plan to protect these workers. In this way, despite the predicted economic recession, the industry could have better managed its finances in the long run. Sadly, in our socio-economic system, it is normal that such possibilities are not considered. Instead, we are witnessing a decline in social empathy and solidarity. Society is teaching us, in this time of crisis, to selfishly stay safe, ‘alone’.

 

II

LET’S return to the stories of my friends. I will begin with labour organiser Aminul Islam Shama’s (36) story. He is a known face in industrial areas as the organising secretary of Garments Workers Solidarity. Nine years ago, because of his illness he had to leave the factories. In a complicated surgery, two of his heart-valves were replaced. Many physicians refused to do the surgery, but in 2011, Dr Prashanta Kumar Chanda of National Heart Foundation Hospital had agreed to do the surgery. Now, his valves are not functioning properly leading to breathing difficulty, cough and accumulation of water in the lungs.

Every day of the past two weeks was passed by worrying about Shama’s future. On March 15, around midnight, Julhas Nayeen and I took him to the NHFH as he was having serious breathing difficulty. Physicians there told us that he has congestive heart failure. He needs immediate replacement of heart-valves. There is not enough time in hand, but there is no seat available to admit him. We need to take him somewhere there is an Intensive Care Unit or to the heart institute. By then the fear of the coronavirus has gripped the city.

After visiting another private hospital, at last, around 2:30am, we were able to admit him to the National Heart Institute. The institute had no seat in their PCCU. Shama was accommodated on a mattress laid on the floor by the bathroom. Shama’s breathing difficulty intensified, he begun to vomit. The ward was already overcrowded. We started to worry. What if he catches the virus in this unsafe hospital environment? We waited until 2:00pm the next day to get him a seat. But then, to avoid the crowd, we took him to Dhaka Community Hospital at our own risk. Physicians there tried to improve his heart condition and address his breathing difficulty.

Fear has heightened at hospitals. Some hospital authorities were making announcement on PA system urging attendants to leave. A day later, they arranged for hand washing and sanitising dispenser at the entrance of the DCH. Because of Shama’s condition, he needed to be in the hospital, and he urgently needed a second surgery. On the other hand, there is the risk of being infected. At DCH, number of patients begun to decline. Our fear of the virus intensified. Amid confusion and fear, instead of taking Shama to the NHFH, he was sent back to his rented home in Ashulia on March 20. We thought, in the current situation, home is the relatively safer option for him.

A few days later, Shama came to see cardiac medicine specialist, Mir Ishrakuzzaman at the NHFH. That is when we realised that the entire health system is on the verge of collapse. Security guards prevented us from entering the premise. No physician would see outdoor patients. With the help of a friend, Dr Anika Nawar, we finally managed to find the doctor. He tried to comfort Shama, gave him courage.  We felt really ‘lucky’. There were not that many outdoor patients. Patients were not attended to outside of the emergency. Security guards were extra alert. The hospital authority couldn’t even think of admitting new patients, let alone doing surgery. The situation appeared as if the ICU and the emergency ward may also face lockdown and the majority of the doctors will go on leave. Later, we heard, except for the emergency unit, the NHFH is under ‘lockdown’.

In this trying time, Dr Prashanta Kumar Chanda, Dr Mir Ishrakuzzaman, Dr Anika Nawar of the NHFH, Dr. Haun-ur-Rashid of Dhaka Community Hospital, Dr. Sayema Sadia in Chattogram helped in so many ways. We are immensely grateful to them. Shama and I spoke to Dr Prashanta this week. He gave us courage. We talked about the preparation for an impending surgery. But, waiting is all we could do now. Some physicians gave us hope, but some didn’t want to see him again. It is because the majority of physicians are left unprotected in this time of a pandemic. There is fear, and it is justified. It is not easy to fight an invisible virus. Without access to PPE, any physician could get infected. They could spread the infection to others. Dr Abdul Wadud Chowdhury is an example. After treating a patient in Tolarbagh, he had to stay in ‘self-isolation’ for 14 days with COVID-19-like symptoms.

 

III

NOW, the story of Mina (45), an organiser of women’s movement. She is also a patient suspected of being infected with COVID-19. Since March 26, she has been admitted in a hospital designated for coronavirus treatment in Dhaka. The report of her COVID-19 test has not arrived yet, so she has been treated for pneumonia. Mina works for a private organisation with a meagre salary. Her husband is a small entrepreneur. With two of their incomes they barely manage their household. Their two daughters are students. I am left with no choice but to introduce her with a pseudonym — Mina. I did so to prevent any further harassment and humiliation of her family.

On March 25, her husband Apu (pseudonym) left home with a critically ill Mina to see if he could get her admitted to a hospital. The harrowing experience of the next 13 hours, visiting from one hospital to another, 11 to be exact, is something he will never forget. We must know the backstory of Mina and Apu, or else we will not know the grave crisis that is awaiting us.

Mina has preexisting chronic condition of high blood pressure, diabetes and asthma. In past weeks, she has also developed cough, breathing difficulty and fever. In a CNG, Apu took the critically ill Mina to a nearby clinic. There they told him to take her to BIRDEM since she has high diabetics (sugar level 31). In BIRDEM, they saw it was rather deserted. Instead of treating the patient, they sent her to Dhaka Medical College Hospital.

Once arrived at DMCH, a chill went down Apu’s spine. As if they had arrived at a haunted place, there was no sign of the familiar hustle and bustle. ‘In my 52 years, never have I witnessed such silence in DMCH’. After buying a ticket from the emergency, they went to the ward number 512 on the 5th floor. There was not even a single patient. Just one physician and a few nurses. They provided Mina with oxygen support and nebulised her before doing an X-ray and ECG. After viewing the test reports, the physician said, ‘Mina has excess fluid in her lung, and she is a suspected COVID-19 patient. As the DMCH does not have treatment for her, they must go to a designated hospital for treatment’.

Apu took her to another hospital near their house before going to the designated hospital. There, he learnt, it will take 4–5 days to start treatment. Helpless, as it is, he took her to the hospital where she is now admitted. This time they were able to manage an ambulance.  In the first attempt, the hospital authority said, ‘Mina’s condition require ICU treatment, she should be transferred to a hospital with ICU facility’. By then, the family has already visited five hospitals. The run from hospital to hospital begun, again. Mina was in an ambulance with oxygen support. They went to a hospital in Sayedabad, but they did not take her. The ambulance driver recommended a hospital in Shanir Akhra. After two hours and an X-ray, they said, ‘For the sake of other patient, they cannot keep her there, Mina is a suspected [of corona] patient, and she needs to be taken elsewhere.’

It was past midnight by then. Apu desperately took her to the IEDCR. They told him that tests are done only between 10:00am and 5:00pm. For the second time, they went to the designated hospital, and this time around, they said, ‘Mina is a cardiac patient. They should go to the heart foundation hospital.’ So, they went to the NHFH. At the heart foundation emergency unit, after an ECG, they said, ‘Heart is fine’ and wrote, ‘suspected corona, immediate admission’. Then, for the third time, they went back to the designated hospital. It is only after doing 11 rounds in different hospitals they were able to earn the sympathy of the physicians there. They finally admitted Mina. Apu asked, ‘If they were going to admit her in the end, why refuse her so many times? Why such harassments?’ No response.

Momentarily, her family was relieved. Finally, they were able to get her admitted to a hospital. The elder daughter is staying with her mother as attendant. Physician comes once a day. But they do so from a distance, hesitate to come close. Nurses leave medicine and food by the door. Apu visits every day. From a three 9 feet distance, leaves food for their daughter, even managed a PPE for her.  Mina’s family is still grateful to the physicians and nurses.

A day after the admission of Mina to the hospital, her family was socially harassed. The Facebook posts of Mina’s concerned friends come to the notice of her neighbours. By the next morning, 8am to be precise, they received eviction notice. Apu and Mina’s daughters got anxious. Where are they going to go? What will they manage, hospital or the landlord? A few friends spoke to the landlord and managed to stop the eviction notice. They were allowed to stay on the condition that they will follow the ‘rules’. When all these were going on, one of the nights, the designated hospital was out of syringe for insulin. They couldn’t get it to Mina, even after trying for hours. This is how it is. Eight days have passed but the result of the COVID-19 test still has not arrived.

The insufferable experiences of Mina and Shama tell us that the country is awaiting a serious crisis. I know of many physicians who will work tirelessly to help patients like Mina and Shama. Until and unless, physicians and hospitals are supported with proper protection from the contagion individual commitment will not do much. Many will discourage patients needing urgent care. Stating different flimsy excuses such as, seats are there, can’t admit patients, physicians are on leave, or patient will not suffer much in this condition, they will signal us their limitations. Perhaps, Shama will be able to gain some access using her organisational contacts. But, as we wait for his operation, will he be able to survive only on medication? Will he get a chance to do the second surgery? Shama or his physician, will they be able to get out of their home to reach hospital? If Mina is tested positive, what will happen to her nurse and physician? Will they go even further away? What will her neighbours do? We are all walking towards an extremely uncertain future.

A deafening siren is ringing. It is reminding us, no matter how many times we say the words like ‘health security’, ‘nutrition’, ‘warning’ ‘home quarantine’, ‘hygiene’, these words only make meaning for the ruling elite.  For the working class, public and private sphere are equally unsafe. Still they try their best to stay home for safety. To protect the country, its people and its economy, the government must put in its highest effort. The government must protect people from corona. It must ensure that patients with diseases other than corona are not left to die and more importantly, people are not left to starve. A united effort to tackle this emerging crisis is the demand of the time.

 

Taslima Akhter is the president of the Garments Workers Solidarity and photographer.

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