covid-19 medical facilities in bangladesh
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The COVID-19 pandemic has had a severe impact worldwide. Developed countries, such as the United States, United Kingdom, Italy, and Spain, had their highly efficient medical infrastructure greatly stressed and suffered from high death tolls. Similarly, Bangladesh, a poverty-stricken South Asian country, is losing its battle against the pandemic, but mainly because of its incompetent healthcare system. The casualties are escalating and public sufferings are becoming unimaginable. On this backdrop, this perspective piece discusses the healthcare crisis in Bangladesh during the pandemic. This article also identifies three responsible issues for the country’s deteriorating health care: 1) poor governance and increased corruption, 2) inadequate healthcare facilities, and 3) weak public health communication.
Surprisingly, whereas many developed countries, including the United States, the United Kingdom, Italy, and Spain, have suffered greatly during the COVID-19 pandemic even with their highly efficient healthcare systems, many less developed countries with inadequate healthcare systems are surviving the crisis more easily.1 Where is the magic? Unfortunately, no magic is there. Rather, behind this mysterious façade, the reality tells a different tale. This pandemic reveals the incompetent health care of many less developed countries engulfed by intense corruption, and Bangladesh is one of them. As one of the world’s most densely populated countries (1,115 people/km2) with 21.8% of people living below the poverty line,2 Bangladesh has a healthcare system that lacks reliability, responsiveness, and empathy, and that has already been proved inadequate to deliver proper health care to the public on many occasions.3,4 Moreover, medical facilities are concentrated in urban areas that create a healthcare divide depriving rural areas.3,5 Amid such a situation, the COVID-19 pandemic reveals many loopholes in the healthcare system that can be summarized under three themes: 1) poor governance and increased corruption, 2) inadequate healthcare facilities, and 3) weak public health communication.
After detecting the first COVID-19 case on 8 March, in the following 2 weeks, more than 0.63 million overseas workers entered the country without proper screening, facilitating community transmission.6 Furthermore, a few of the government’s delayed decisions were found less effective that worsened the pandemic situation. For example, the government declared a general holiday for 10 days from March 23, 2020 to April 2, 2020 without restricting transportations and public movement. As a result, a crowd of more than 12 million people left Dhaka immediately after the notice that expedited the community transmission.7 Moreover, none of the two existing laws, Disaster Management Act 2012 and Infectious Disease (Prevention, Control, and Elimination) Act 2018, were brought into action properly to control such massive mass mobilizations and gatherings.6 In such a situation, many private medicals around the country were either unwilling or abstained from treating COVID-19 patients, and thus healthcare denial intensified.8,9 A survey found that 77.3% of patients receive healthcare facilities from private medicals.6 Consequently, a large share of the population suffered, and many of them died without proper medical supports.10 Improper synchronization among the responsible bodies, the Ministry of Health and Family Welfare (MoHFW), the Directorate General of Health Services, and test laboratories’ executives and workers, could be a reason for such mismanagements.11
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