Six months have passed since the first case of coronavirus was detected in the country. In these six months, rather than any planned action against the pandemic, it is the weaknesses and corruption in the health sector leadership that have loomed large. The government has failed to inspire confidence in the people about tacking the virus. Uncertainty concerning the pandemic prevails.
No country anywhere in the world was prepared for this pandemic. However, Bangladesh did have the time to prepare. Bangladesh Public Health Foundation’s executive director, Taufiq Joarder, told Prothom Alo that it was towards the end of December that reports of this novel virus appeared. On 8 March this year a coronavirus case was first detected in Bangladesh. Bangladesh had over two months to prepare, but it did not. Joarder said that the government has spent the last six months aimlessly. The lack of coordination at the outset prevails, and has increased in many cases.
Public health experts, based on the history of pandemics, say that pandemics are not permanent and eventually weaken. The outbreak of coronavirus has not been the same in all countries of the world. There are indications of the transmission of the virus lessening in some countries. The outbreak of the virus in densely populated Bangladesh has not been as severe as in many other countries and the death rates have been comparatively lower. Public health experts have been unable come up with a scientific explanation as to why the transmission of the virus and deaths have been less in Bangladesh. Over the past two weeks the number of coronavirus cases has begun to fall and the number of deaths has begun to lessen in the last one week.
Taufiq Joarder said the government, rather than taking any effective measures, has to a greater extent simply left things up to nature. On the other hand, the World Health Organisation (WHO) has said that the virus will not just go away on its own accord.
Continuous lack of coordination
WHO from the very outset has said that tackling the pandemic was not the responsibility of the health ministry alone and it would not be possible for it to handle the crisis single-handedly. The entire government machinery would have to be involved. Coordination was vital. But there has been a gaping deficiency in coordination in the country.
The first visible step against the pandemic appeared on 1 February when 312 Bangladeshis returned from China. They were taken to the Hajj camp at Ashkona in the capital city, but there were all sorts of complaints about their quarantine. Officials of the Directorate of Health Service (DGHS) said that the civil aviation ministry and the ministry for religious affairs did not give them any effective support.
Over the past six months there has been a continuation of such lack of coordination. There is a lack of coordination within the health ministry itself. The authorities of various hospitals, DGHS and the health ministry got embroiled in differences over which hospitals would be designated for Covid treatment.
Recently an expert committee formed by the health ministry spoke in favour of antibody tests. Yet the health minister Zahid Maleque declared that the government has no plans for antibody testing.
Corruption in the health sector is nothing new. But it was hardly imaginable that corruption would also take on pandemic proportions during the coronavirus outbreak.
DGHS sources said that at this critical time, personal protective equipment (PPE) and oximeters were lying at the Hazrat Shahjalal International Airport simply because it wasn’t specified who would pay the duty on these items. Acting director general of the health directorate, Abul Bashar Mohammad Khurshid Alam, speaking to Prothom Alo on Monday, said initiative had been taken to release these goods.
Corruption revealed
The lack of coordination has also revealed corruption. In the last week of March, a company supplied the health directorate low-quality masks in the name of N-95 masks. The superintendent of Khulna Medical College and the director of Mugda Medical College Hospital protested against this.
Corruption in the health sector is nothing new. But it was hardly imaginable that corruption would also take on pandemic proportions during the coronavirus outbreak. Speaking to Prothom Alo recently, executive director of Transparency International, Bangladesh (RIB) Iftekharuzzaman, said that no other country had had such corruption in tacking coronavirus.
The number of coronavirus cases began to rise steadily from the beginning of April and all sorts of complaints arose about the treatment of Covid patients in hospitals. The number of deaths also increased at the hospitals. Many patients, after trying in vain to get admitted to any hospital, passed away without treatment. This created fear in the public mind. People heard hospitals had no vacant beds and there was a shortage of oxygen. Then came the scams of JKG and Regent Hospital.
DGHS, in violation of the rules and regulations, had given these two institutions approval to carry out COVID-19 tests and also to treat Covid patients. Later financial corruption was revealed in this connection. TIB pointed out that this could not have happened without the involvement of officials and employees of the directorate.
Corruption emerged in donor-funded projects too. The health ministry took up two projects to tackle coronavirus, funded by the World Bank and the Asian Development Bank. Each project was of Tk 8.5 million (Tk 850 crore). Weak leadership in the health sector became glaringly visible in these instances.
Leadership crisis
The keynote at an online seminar of the Bangladesh Public Health Foundation, held on 5 September concerning coronavirus and the health system, stated that public health experts were not in leading positions in the fight against coronavirus. And the political leadership in the health sector was in disorder.
Former WHO regional advisor for Southeast Asia, Muzaherul Huq, speaking to Prothom Alo, said that the work carried out during the pandemic has carried out by bureaucracy-dependent leadership. This leadership had no idea or knowledge about preventing and controlling the transmission of coronavirus.
Meanwhile, various incidents had created conflict among officials of the health ministry and the health directorate. They became embroiled in conflict over how JKG and Regent got permission, who was to control the control room, and so on. Their fracas brought to halt several tasks related to controlling coronavirus. Many are of the opinion that all this would not have happened if the health ministry had been in the right hands.
In wake of various problems and allegations of corruption during the pandemic, the first big change was made in the health ministry. Secretary of the health services department, Md Asadul Islam, was transferred to a different ministry. The additional secretary Habibur Rahman was also transferred. Next, DGHS director (hospitals) Aminul Hasan and director (development) Iqbal Kabir, were made officers on special duty (OSD). Then the DGHS DG Abul Kalam Azad resigned.
Public health experts have said that the pandemic hasn’t come to an end and there is still time to tackle it. There must be continued efforts to ensure people wear masks, follow rules of hygiene and maintain social distancing.
Many feel that such changes in key positions at a critical time of the pandemic hampered the work to tackle coronavirus. Also, certain comments made by persons at top levels in the government, led to trivialising the pandemic.
Speaking at an event on 21 March at a programme in Dhanmondi in the capital, Awami League general secretary and minister for bridges, Obaidul Quader said, “We are more powerful than corona.” On 3 March at the health ministry’s conference room, health minister Zahid Maleque had told newspersons, “If coronavirus somehow manages to come to Bangladesh, there is no reason for alarm. We are already prepared in advance.”
Sheer negligence
Such statements made by top functionaries of the government were totally out of touch with reality, lacked in directives and have served to dampen the enthusiasm of the health workers at the grassroots. From the very outset in Bangladesh, primary tasks like identifying Covid cases, arranging for their treatment, contact testing, quarantining, isolating and so on, were not done properly. These still are not being carried out properly.
When asked what work was currently being carried out to tackle and control the pandemic, the DGHS DG Abul Bashar Mohammad Khurshid Alam told Prothom Alo, “All the work that was being done before is continuing. Soon sample testing will be increased and awareness-raising will be taken up anew. The expanded programme on immunisation which had been stalled, is also being started up. A Tk 8.5 billion (Tk 850 crore) project is being taken up to bring in the coronavirus vaccine.”
Public health experts have said that the pandemic hasn’t come to an end and there is still time to tackle it. There must be continued efforts to ensure people wear masks, follow rules of hygiene and maintain social distancing. The health directorate can take advice from the experts in this regard. The government must also give priority to obtaining the vaccine.