Four months after the first confirmed case of Covid-19 infection was confirmed in the country, the Ministry of Health and Family Welfare and Directorate General of Health Services (DGHS) is now focusing on restoring regular health services and treatment for all.
The principal wing of the ministry could not direct its efforts to ensure healthcare services for all patients as the pandemic had created a hurdle in providing all regular health services and treatment, especially in the critical treatment management for Non-Communicable Disease Control (NCDC).
Health experts said if previous committees and monitoring bodies had worked properly, then there would have been no such allegations from patients of being denied treatment at hospitals for not having a Covid-19 test report.
At the same time, extended nationwide programs on immunization, vaccination of communicable diseases, neonatal and adolescent health care were hampered heavily by the pandemic.
At the beginning of the pandemic, the DGHS and Health Ministry formed more than 30 committees to ensure better health services in the country. However, only the PPE and testing committee were found to be working actively while the other committees took a much more lenient approach.
Ensuring regular medical treatment
On June 27, the DGHS formed 10 new committees focusing on ensuring regular health care services, mental health services and better flow of information.
One of these committees was on increasing availability of treatment at government and non-government hospitals. The then member secretary of the committee Dr Aminul Hasan told Dhaka Tribune that the committee had a meeting where several decisions were taken.
He said, regardless of Covid and non-Covid patients, hospitals have been instructed to ensure treatment for all and to ensure the directives were being followed; the DGHS’s Hospital and Clinics Unit formed 11 teams to monitor the hospitals in Dhaka city and asked all the divisional director to form four-member divisional monitoring committee and a four-member monitoring committee in every district.
He, however, could not confirm the accurate number of committees formed in this regard.
Asked about allegation of denying treatment to patients in critical conditions, especially with heart and kidney diseases, he said they have already instructed all directors, superintendents of the hospitals, and civil surgeons to take necessary measures to prioritize such patients after a High Court directive.
According to the hospital unit, the High Court passed the directive on July 6 and the director wrote to the respective hospital chiefs on the following day.
Ministry focused on fixing controversy, implementing recommendations
After a number of officials from the Ministry of Health and Family Welfare were shuffled in June, the ministry formed a new management group – Covid-19 Management Group – on June 29 and later reformed it on July 26.
After the reform, the group started working with holding their first meeting on July 29.
Additional Secretary (Public Health) Mostafa Kamal, the convener of the committee, said they have already agreed to formulate a resolution at their first meeting on how they would carry out their activities.
“We have three focuses – verifying licenses of the health care facilities, checking hospitals' Covid-19 testing facilities and ensuring that the recommendations made by the National and DGHS advisory committee are implemented,” he said.
“We are also going on field visits as well. As the 500-bed Shaheed Tajuddin Ahmed hospital has only two patients, the hospital was announced as non-Covid hospital on Wednesday after an inspection,” he added.
The next meeting would take place on August 12, the official said.
Talking to Dhaka Tribune, Prof Dr Rashid-E-Mahbub, chairman of the National Committee on Health Rights Movement and former president of the Bangladesh Medical Association, welcomed the newly-formed committee, saying that being late is much better than never.
“Patients and health service seekers will be much benefited if these committees work effectively from the beginning. We want constant monitoring and bold actions from them,” the professor said.
Resuming regular health care services remains a challenge
The newly-formed committee – Essential and regular health care committee – has already held at least two meetings.
Officials said due to Covid-19 situation, the field-level survey to evaluate the present healthcare status in the country along with vaccination programs came to a halt.
One of the members of the committee, Line Director (TB-L and ASP) Professor Dr Shamiul Islam said due to the pandemic, they were not able to conduct a survey to identify new tuberculosis (TB) patients.
“Some 290,000 patients are receiving treatment at government hospital and interestingly very few of the patients were infected by Covid-19,” he said, adding that medicines for all patients have been arranged through UNICEF.
Besides, some 190 high-tech diagnostic machines – GeneXpert – have already reached the country, taking the total number of such machines to 450.
“We want to ensure at least one machine for every two upazilas and two in every district hospital before the end of December 2020,” the line director said.
Meanwhile, Program Manager (EPI) Dr Mowla Baksh Chaudhury said field workers were able to accomplish 45 to 50% of their target in April, 70% in May, and 116% in July.
Target achievement came more than 100% as those who dropped out in May and June came to take the services, he added, saying: “Our workers and unit officials were so dedicated that although around 4,500 of the work force was infected, most of them rejoined the program after recovering.”
Deputy Program Manager (Malaria and Aedes Transmitted Disease) Afsana Alamgir Khan said they are working restlessly and till now the dengue prevalence is low.
However, the government hospital authorities have been asked to conduct dengue test even if the patient is found Covid 19 negative.
Deputy Program Manager (ARC and Hepatitis) Dr Aninda Rahman said after completing the first installment of cholera vaccine, the second installment could not take place due to Covid-19.
“We are hoping to resume it again after the Eid holidays,” he said.
Program Manager (Adolescent and School Health Program) Dr Sabizur Rahman and NCDCs Assistant Director Ayesha Akther also told Dhaka Tribune that their services also came to a halt due to the pandemic although their activities were only limited into campaigns.
