The COVID-19 outbreak has exposed the inefficiency, mismanagement and deep-rooted corruption in the health sector as the sector has largely been blighted by lack of monitoring and accountability for years.
The epidemic finally spurred the government to spend money on public health, but the mismanagement and incapacity to best utilise the money, while a greater portion of it got lost into the corrupt system, failed to yield expected results, according to experts.
They also felt that government’s failure to send proper messages to the people and to engage them in the prevention of the novel coronavirus spread are linked to the overall inefficiency of the health ministry and Directorate General of Health Services officials.
All this, according to experts, led to the half-hearted implementation of the policy decisions.
Bangladesh on March 8 confirmed the first COVID-19 cases and the country so far tallied 3.27 lakh cases with over 4,500 deaths.
In the past six months, the country did not experience the COVID-19 health catastrophe that many initially feared would happen, but the uncertainty and vulnerability regarding the spread of the disease still remains due to the absence of epidemiological data about the strange new virus that already wreaked havoc in several nations across the globe.
‘COVID-19 exposed our muddled, weak and corrupt health system,’ said World Health Organisation former regional adviser Muzaherul Huq.
‘Six months into the outbreak, we are still living in uncertainty and are clueless about the future as well as the course the COVID-19 epidemic might take,’ he said.
Since the novel coronavirus emerged in China in late December, Bangladesh’s preparedness was marred by incapacity to run tests and develop infrastructures for patients to be placed on isolation and inadequate treatment of all the affected.
Add to that the refusal to admit patients in hospitals, including those that are designated COPVID-19 facilities.
The government and donors allocated funds for the preparation and purchases of medical supplies, but the big scams and shady deals undermined the process since the start.
Regent Hospital hogged headlines after the Rapid Action Battalion exposed the irregularities, including the shady business of issuing fake COVID-19 certificates, and undue privileges enjoyed by its owner because of his political clout.
Hard on the heels of the irregularities in fake N95 masks supply by a company favoured by government officials and the busting of the virus test scam by Regent, more such scams surfaced.
The JKG Healthcare was busted for issuing fake coronavirus test reports.
Involvement of officials in the scams led to major changes in Directorate General of Health Services, including the removal of its director general, but the health ministry officials, who are also accused of their involvement in the irregularities, remained untouched and even the health secretary was promoted to a senior post.
The corruptions in World Bank-funded emergency COVID-19 project kept surfacing one after another, but no measure was taken accept for the removal of the project director.
According to media reports, auto parts trader, garments trader and electronic items traders secured deals involving crores of money with the DGHS for delivering medical supplies.
Some of the suppliers delivered substandard products, while others just made fortunes supplying fake items as well as by providing less items than the number mentioned in the contract.
Transparency International Bangladesh executive director Iftekharuzzaman said that some quarters and people took the COVID-19 epidemic as a means to make quick money illegally.
Mismanagement in the country’s health sector got exposed one after another following the COVID-19 outbreak.
Meanwhile, patients with the symptoms of COVID-19 were hard put to access healthcare, get tests done, secure isolation beds while contact tracing was marred by mismanagement.
While patients failed to get quality care at the COVID-19 dedicated hospitals, there were others who were refused treatment adding more deaths to the national tally.
The situation shook the confidence of the people, prompting them to turn away from the hospitals.
COVID-19 patients died at homes after deciding not to go to hospitals.
Since May 17, at least 635 COVID-19 patients died at homes and 31 died on the way to hospitals, accounting for 14.75 per cent of the total COVID-19 deaths occurring outside hospitals.
The government failed to implement its own directives during the lockdown and after businesses reopened as wearing masks, maintaining social distancing at markets and public transports are issues that remained unattended.
Public offices and hospitals still lack adequate handwash facilities. The ones that were propped up across the capital on the roadside now lie in disrepair.
The government did not follow or failed to comply with the recommendations of the National Technical Advisory Committee.
The committee, back in July, recommended use of antigen kits which they believed would give good results within 20 minutes, but the government did not pay heed.
As was the case with any other suggestions related to testing and maintenance of health directives, including deferral of the reopening of the garment sector at a time when the number of infections were multiplying daily.
The government lately withdrew the restriction of public movement from September 1 when the risks of COVID-19 still remained in place.
DGHS additional director general Meerjady Sabrina Flora said that the country was now witnessing a decline in COVID-19 positivity rate but the situation may overturn if people started rampant movement ignoring the health guidelines.
The country’s COVID-19 data are also missing which left experts clueless as to how to predict the course of the new disease.
The information about tests, infections and deaths of COVID-19 are missing, including the proportionate of tests and cases at geographical locations.
Bangladesh is still among the list of countries with lowest number of tests. The current rate of COVID-19 tests per million in Bangladesh is 9,969, which puts Bangladesh on the 160th position among 215 countries and territories in the world, although it is now on the 14th position in terms of highest COVID-19 cases.
Currently, the case positivity rate is 19.90 per cent which put Bangladesh among the top 10 countries with highest COVID-19 case positivity rate.
The case positivity rate in recent weeks showed a declining trend: from 23.85 per cent in 22nd week to 21.08 per cent in 23rd week, 20.06 per cent in 24th week, 17.35 per cent in 25th week and 15.89 per cent in the 26th week.
The case positivity rate in the past two days of the ongoing week (27th) is 14.17 per cent.
The case fatality rate increased in the recent weeks from 1.34 per cent in the 23rd week to 1.56 per cent in the 24th week, 1.83 per cent in the 25th week, 1.65 per cent in the 26th week and 1.82 per cent in the ongoing 27th week.
The overall case fatality rate is now 1.38 per cent, which is lower that the global rate of around 3.3 per cent.
In South Asia, many countries including Nepal, Bhutan, Sri Lanka, Vietnam and Thailand succeeded in containing the COVID-19, but India topped the list of COVID-19 cases and Bangladesh is on second position with highest cases in the region.
As the infection rate declines slightly, the government officials, including the health minister, is now claiming that the country’s COVID-19 situation is under control.
Experts, however, said that the country was now still in the first wave of infections and the situation might spiral out of control if the government fails to implement the health guidelines set by the World Health Organisation to control the epidemic.
World Health Organisation former regional advisor Muzaherul Huq said that the lack of data and improper actions to contain the novel virus put the country in the course of uncertainty.
He said that the tests are not equitable and not well proportionate in all geographical regions.
‘The contact tracing of patients after testing are seriously lacking, which push the country to uncertain future in regard to COVID-19,’ he said, adding that the virus will linger in the country.
Muzaherul said that the country was now in the first wave of infections and there is still time to prepare for the second wave.
Health Secretary Abdul Mannan and DGHS DG ABM Khurshid Alam could not be reached or comments. They did not receive phone calls. DGHS additional DG (admin) Nasima Sultana refused to make any comments.
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