Most health facilities in Bangladesh are being supplied with gaseous rather than liquid oxygen as it is more cost effective and easier to store. However, this may lead to an oxygen resupply crisis if the pressure of Covid-19 patients on hospitals increases, government officials have said.
The government at a meeting last week decided to install more gaseous oxygen storage tanks in hospitals in a bid to increase capacity, but this is not nearly as effective as liquid oxygen tanks.
On condition of anonymity, an official of the Directorate General of Health Services (DGHS) told Dhaka Tribune: “With the current pressure of Covid-19 patients, we will be able to keep hospitals supplied with oxygen. However, if patient pressure increases, we could have some serious problems. What is the point of having oxygen supply if there is no storage capacity?”
Liquid oxygen requires a more complex and expensive process, but it allows the storage of more oxygen in the same space as gaseous oxygen. If patient pressure increases and there is a reliance on gaseous oxygen, then hospitals may require refills more frequently than the central oxygen supply system can support, the official explained.
The demand for oxygen has already increased by 40% in comparison with the first wave of the Covid-19 pandemic last year, according to oxygen production industry sources.
Mugda Medical College Hospital Director Dr Asim Kumar Nath said the demand for oxygen at the hospital had increased by 20% from last month. The hospital is currently refilling tanks with 12,000 litres of gaseous oxygen daily.
Patients receiving oxygen at hospitals through regular means require about 2.5 litres of oxygen every minute. Patients receiving oxygen through High Flow Nasal Cannulas (HFNCs) require 60-70 litres of oxygen per minute.
A total of about 1,500 HFNCs are in operation across the country, according to the DGHS.
DGHS Director (Hospitals) Dr Md Aminul Hasan could not be reached for a comment.
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Companies producing oxygen
According to the oxygen production industries and the Directorate General of Health Services (DGHS), there is generally a demand for over 90 tons of oxygen every day at government healthcare facilities. However, the demand increased to around 140 tons a day in April.
Linde Bangladesh, a concern of Linde International, supplies around 90% of the total demand across the country, while Spectra Oxygen Ltd and Islam Oxygen Ltd are the other large production and supply companies.
According to the DGDA, which issues NOCs for medical oxygen production and supply, at least three companies have been producing oxygen from earlier and six more companies have received NOCs since July last year. Two among them got NOCs in 2021. After they got the NOCs, the Department of Explosives gave them registration.
Inspector of Explosives Abdur Raub said companies were permitted to produce, import and supply medical oxygen only after getting NOCs from the DGDA.
When asked how many companies were producing oxygen in the country, he said the responsible officer was currently on leave and the list could be provided once he returned.
The DGDA said at least three out of the six companies were in the production phase, and the other three were setting up the mechanism for production.
So far, so good for oxygen despite India’s export ban
In Bangladesh, Linde is the only company producing liquid oxygen.
Industry insiders said larger hospitals, such as medical college hospitals and private facilities Ever Care, United Hospital and Lab Aid, were being provided with the liquid oxygen. Most government hospitals are receiving gaseous oxygen.
According to Linde, it is providing oxygen to 97 healthcare facilities, including 47 that are receiving liquid oxygen and 50 that are receiving gaseous oxygen. It could not specify how many of them were government facilities.
The Spectra website said the firm was providing oxygen to 10 government hospitals and 13 private hospitals.
To meet local demand, some companies such as Linde Bangladesh, Spectra Oxygen Ltd , Islam Oxygen Ltd and AK Steel have been importing liquid oxygen through the Benapole border every year. Benapole is the only land port through which liquid oxygen is imported into the country.
However, India imposed a ban on industrial oxygen supply and oxygen exports from April 22 to meet its domestic demand.
Abdul Jalil, acting Director of Benapole Land Port, said the last oxygen shipment was imported on April 21.
He added that over 6,000 tons of oxygen were imported In FY2020-2021, but he could not specify how much oxygen was imported in previous years.
Sufia Akhter Oahab, manager (admin) of Linde Bangladesh, said the demand for oxygen had increased by almost 40% in the month of April compared to March.
Linde produces 90 tons of oxygen per day at two oxygen plants in Narayanganj and Chittagong. Islam Oxygen Ltd produces around 28 tons of oxygen per day and Spectra Oxygen produce 25 tons of medical oxygen per day.
All the companies have dedicated their entire production capacity to medical oxygen.