Dengue treatment cost mounts burden on patients

Ayan is 5 months and 20 days. He was diagnosed with dengue six days ago. He was taken to two different hospitals and now is undergoing treatment at Bangladesh Shishu Hospital and Institute in the capital.

Ayan's father Hafizur Rahman is worried about the costs of his son's treatment along with the expenses of their stay and meals in Dhaka.

Hafizur Rahman is from Shibchar of Madaripur district. His only child Ayan contracted fever last week. When he didn't recover from fever in three days, at the advice of the local physician, Hafizur Rahman came to Dhaka on 5 August and admitted his son to Ad-Din Hospital in Maghbazar. He was diagnosed with dengue the same day, but as the hospital didn't have a respiratory intensive care unit (RICU) for infants, the physicians advised Hafizur Rahman to take his son to a different hospital.

After paying a bill of around Tk 10,000 at Ad-Din Hospital, they got Ayan admitted to Dr Sirajul Islam Medical College and Hospital in Malibagh. But it was too expensive for them to keep Ayan there. On 10 August Ayan was brought to Shishu Hospital and placed in the RICU there. Meanwhile, Ayan's father had to pay bills of Tk 71,200 at the Malibagh hospital.

There are many dengue patients like Ayan who are getting admitted to hospitals for treatment. As it is, people are suffering due to the high cost of essentials, and now dengue treatment costs are an added pressure. According to a survey of the World Food Programme (WFP), in October last year it was revealed that 88 per cent of the people regarded high prices as a serious blow. The second hardest blow was illness and medical treatment costs.

There is no separate record of how many dengue patients are undergoing treatment at government and private hospitals around the country. But in Dhaka city this year, 40,764 dengue patients were admitted to government and private hospitals. Of them, 16,850, that is, 41 per cent, were admitted to private hospitals. As in the case of other illnesses, the treatment costs for dengue are also very high in private hospitals. Health economists fear that this year people's expenditure for dengue treatment will cross Tk 10 billion (Tk 1000 crore).

Ayan's father expressed his concern about the treatment costs. He was abroad and has been unemployed after returning to the country.

Speaking to Prothom Alo, Hafizur Rahman said, he is floundering under the costs of his son's treatment. He has already borrowed money from relatives for the purpose and will have to borrow more. He has no idea what he will have to eventually pay at Shishu Hospital. Then there are the daily expenses for three of them. He is having to pay Tk 750 daily for a small room they have rented in Mohammadpur. He lets out a heavy sigh, "I have no idea what we are going to do."

A woman of Dhanmondi in the capital was admitted with dengue to Anwar Khan Modern Hospital on 15 July. She had high blood pressure too. Two days later, her husband also got admitted there with dengue. He had diabetes and heart ailments as well. The couple was released from hospital six days later on 21 July. The wife's bill amounted to Tk 46,600 and the husband's Tk 65,034.

The couple's son is a computer engineer. He told Prothom Alo that he didn't want to risk his parent's health by keeping them at home. But he feels that the medical treatment costs were too steep.

There are reasons for differences in dengue treatment costs. If the stay in hospital is for an extended period, if the ICU facilities are used, if there are many tests, if the patient has other ailments, the costs are higher, according to private hospitals. It also depends on what sort of private hospital the patient is being treated at.

The 11-year-old daughter of a media person was admitted with dengue to a private hospital at Panthapath in the capital on 2 August. At one stage of the treatment, the girl has to be kept in ICU. She was finally released after eight days and went home on 10 August. Even after a discount of Tk 25,000, the parents had to pay a Tk 248,993 bill to the hospital.

This correspondent on Friday was told by Green Life Hospital on Green Road that the daily charges for a general bed was Tk 3,200, for a cabin Tk 8,400 and for a delux cabin, Tk 12,000.

A little further on from Green Life Hospital, there is LabAid Hospital. The information desk there said that the daily charges for a general bed was Tk 6,000 and for a cabin Tk 12,000. Next door to LabAid, Gonoshasthya Nagar Hospital's daily bed charges were Tk 1,200 and cabin charges Tk 7,000.

According to Prothom Alo's Chattogram office, bills come up to around Tk 50,000 to Tk 60,000 for four or five days' dengue treatment at private hospitals in the port city. The costs are more if the patient is kept in ICU.

The authorities of Shaheed Suhrawardy Medical College Hospital have opened a dengue ward comprising several rooms on the sixth floor. A visit there yesterday revealed there were no patients in one of the rooms. A patient's mother said that they had come from Kamrangirchar in the capital four days ago. The hospital's treatment was good. They had spent around Tk 3,500 in four days.

Treatment and drugs are supposed to be free of cost at government hospitals. Even so, some medicines have to be bought from outside. Some tests also have to be taken from outside. There are excessive crowds in hospitals for tests.

The costs of physicians, drugs, tests, bed charges are all very visible. But there are costs outside of this too. There is the fare to come to Dhaka or ambulance costs, costs to stay in Dhaka and food costs. There are the commute costs for going from here to there to carry out tests. If all costs are taken into account, the amount spent on a dengue patient are high.

Professor Syed Abdul Hamid and his associates at Dhaka University's Institute of Health Economics carried out a study in 2019 on dengue costs. This revealed that the average cost for a dengue patient at a government hospital in Dhaka was Tk 11,000. For patients coming from outside Dhaka, the costs were Tk 20,000.

The research placed private hospitals in three categories. In the costliest, that is Category A, the costs were Tk 200,000 on average. In Category B, costs were Tk 41,000 on average. And in Category C, this amounted to Tk 25,000 to Tk 26,000.

Compared to 2019, the prices of drugs, equipment for treatment, tests, bed charges, physician fees, transport fare and such had increased manifold. Dengue treatment costs have increased too.

Health economist Professor Syed Abdul Hamid, speaking to Prothom Alo on Friday, said, "During the 2019 research, we had said that Tk 4.5 million (Tk 450 crore) had been spent on dengue treatment. We have not begun our study yet this year. But we estimate that this year the treatment costs will exceed Tk 10 billion (Tk 1000 crore)."

Meanwhile, the government's expenditure in the health sector is on a steady decrease. People's living costs are on a rise. In the report 'Bangladesh National Health Accounts 1997-2020' of the health ministry's health economics unit in January stated that in 2020 people spent 69 per cent from their own pockets which was 64 per cent even in 2018.

Dengue has spread all around the country due to the lack of sincerity and the negligence of the government, particularly the local government. Also, within a few days' time, the number of patients in hospital will cross over 100,000. And the actual number of dengue cases will be a few hundred thousand. All of them have treatment costs.

Experts say, the government must take measures to cut these costs. The physicians in all government hospitals at a district and upazila level must be given training and the supply of saline and all medical equipment must be ensured. While there are beds vacant in many government hospitals in Dhaka, it must be seen why patients aren't going there and ensure that these hospitals provide dengue treatment. Monitoring private hospitals must be stepped up so that they do not take advantage of the situation.

Public health expert Abu Jamil Faisal, speaking  to Prothom Alo, said, "Treatment at home must be increased under by the physicians who have private practices. Credible alternative treatment of dengue must also be put to use. The main objective is to ensure less numbers of patients come to Dhaka and that less numbers of patients are admitted to hospital."