Critical patients are suffering immensely due to the lack of ICUs in hospitals across the country. The number of ICUs stands at only 399
While the number of Covid-19 cases and deaths in the country are gradually increasing, health authorities are grappling with the crisis to render proper treatment to patients, particularly in intensive care units (ICUs).
Critical patients are suffering immensely due to the lack of ICUs in hospitals across the country as the number of ICUs stands at only 399 so far, and many of them remain non-functional.
According to the Directorate General of Health Services (DGHS), there are 218 ICU beds in Dhaka city, 47 in Dhaka division, 34 in Chittagong, 28 in Rajshahi, 18 each in Khulna and Barisal, 16 in Sylhet, 13 in Rangpur, and seven in Mymensingh division.
Of them, only 69 ICUs are functioning in Dhaka city at the moment to deal with the pressure of a continuous flow of critical patients, exposing the sorry state of health facilities in the capital.
Although on paper, there are 218 ICU beds in various hospitals dedicated to treating Covid-19 patients in the city, only seven hospitals are providing treatment with barely 69 ICUs.
Of the 218 ICUs, the DGHS said, 137 are in public hospitals and 81 in private ones.
According to the World Health Organization (WHO), 20% of Covid-19 patients -- 15% with severe symptoms and 5% in critical condition -- require ICU and ventilator support. In addition, the elderly with other chronic diseases also need ICU support as well.
Experts said Bangladesh is only testing people showing symptoms, but it is very much expected that the number of extreme patients is higher in the country.
Hospitals authorities said they are forced to return five to 10 patients each day due to the scarcity of ICUs. They also said due to the shortage of manpower and necessary equipment, services at the ICUs cannot be expanded.
Prof Sohel Reza Choudhury, of the Department of Epidemiology and Research at the National Heart Foundation Hospital and Research Institute, said as the number of critical or severe condition patients rises in the country, hospital management, including its ICU services, will become a critical issue in the upcoming days.
But unfortunately, although the country has had almost three months after the first detection of Covid-19 patients, it has made very slow progress in terms of setting up ICUs.
Of the dedicated hospitals in the city, at present, some nine hospitals have facilities to provide intensive care.
One of them has been designated for very important persons (VIPs) and diplomats, which is yet to admit any patient, while another hospital will start a five-bed ICU this week.
Also, Anwer Khan Modern Medical College Hospital is no longer a dedicated hospital for Covid-19 patients and has now dedicated its 10 ICUs for other non-Covid-19 patients.
Of the 69 functional ICUs, 10 are at Kuwait Bangladesh Friendship Government Hospital, 10 at Kurmitola General Hospital, 14 at Dhaka Medical College and Hospital (DMCH), 10 at Mugda Medical College and Hospital, 10 at Regent Hospital (five each at Mirpur and Uttara branch),10 at Holy Family Red Crescent Medical College Hospital and five at Sajida Foundation Hospital.
Dr AJM Faisel, one of the members (Sylhet division) of an eight-member technical committee formed in March, said: "The number of patients is increasing and may increase further as the lockdown has been lifted. So, hospitals have to increase the number of ICU beds and oxygen supply, especially for elderly and critical patients."
Dr Md Aminul Hasan, DGHS director (hospitals)and focal person of the hospital and patient care group under the integrated control room at DGHS head office, said they have ensured some 218 ICUs in the city.
When he was informed about the number of functional ICUs, Aminul said some of the ICUs are not functioning for many reasons and some 100 are being installed.
"Once they become functional, the situation will change," said Aminul.
Hospitals with non-functional ICUs
Sheikh Rasel Gastroliver Institute and Hospital has been said to be the most equipped hospital, but most people will not have access to it as it has been designated for VIPs and diplomats.
Meanwhile, DMCH said they have facilities of 48 ICUs but only 14 are functional at DMCH 2. ICUs in the Medicine Department have also been adopted.
The 10 ICUs at the burn unit building will start functioning from this week, said DMCH Director Brig Gen AKM Nasir, adding that in fact, all the ICUs will be operational from this week.
"Manpower remains a problem for us as we have to manage the ICUs in four different places in the hospital," he added.
Kuwait Bangladesh Friendship Government Hospital Superintendent Dr Shihab Uddin said: "Of the 26 ICUs, only 10 are in operation as they are installing others. Manpower is also becoming another crucial issue for management."
Meanwhile, officials at Kurmitola General Hospital said they are installing 17 more ICUs but the procedure has come to a halt as the health directorate is yet to provide the remaining equipment.
Authorities of Mugda Medical College and Hospital and Mohanagar General Hospital in Babubazar echoed the same issue.
Dr Anisur Rahman, head of ICU Department at Mugda Medical College and Hospital, said: "A patient in ICU recovers in 10 to 16 days generally. Sometimes it takes more days. If anyone dies or recovers within that time, a bed becomes vacant.
"We have to refuse some three to 10 patients every day for the scarcity of facilities."
Dr Anisur said they have sent a demand letter to the hospital director several times but the equipment and manpower they need are yet to be provided.
Meanwhile, the Director of Mirpur Lalkuthi Hospital, Dr Shamsul Karim, also the program manager of Field Service Delivery Unit under the Directorate General of Family Planning, said they lack manpower and would not be able to start ICUs for Covid-19 patients.
"We have recently trained manpower for running the ICUs and the process is under trial. We hope the five-bed ICU will be ready to start this week," he added.