Power crisis disrupts healthcare across the country

Fifty-eight-day-old Hafsa Jahan is struggling to breathe. She was admitted to Matlab South Upazila Health Complex in Chandpur last Saturday after developing pneumonia. She is supposed to receive nebuliser treatment several times a day to ease her breathing.

But because there was no electricity at the hospital, she could not receive the treatment properly. The ceiling fan above her bed was also not working. The heat was making her breathing difficulties worse. Her mother, Kamrun Nahar, was holding her sick daughter and waiting for the electricity to return. This was the situation on Sunday.

Like Hafsa's mother, mothers and children in different parts of the country, including Patiya in Chattogram and Raipur in Lakshmipur, are also having to wait for electricity.

Mofassir, a one-and-a-half-year-old pneumonia patient in Patiya, is supposed to receive nebuliser treatment six times a day. But he received it only three times last Saturday. In Raipur, four-year-old Minu Akter, who has pneumonia, needs nebulisation four times a day, but the treatment cannot be provided regularly because of power outages.

Other healthcare services are also being disrupted at upazila-level hospitals.

When electricity goes out, nebulisers, X-ray machines and ECG services stop at some hospitals. Pathology tests are also suspended. In some hospitals, power cuts during surgery have forced staff to switch on generators. In other hospitals, generators are available but there is no fuel.

As a result, patients and their relatives who come to hospitals for treatment have to wait for the electricity to return. During power outages, patients and their attendants also have to endure extreme heat.

These conditions were found during visits to one district hospital and 13 upazila health complexes across the country on Saturday and Sunday, and through conversations with patients, relatives, physicians and healthcare workers.

Alongside a gas shortage, Bangladesh has been facing an electricity shortage for more than a month. Load-shedding decreases occasionally when it rains and increases when temperatures rise. Initially, the power cuts were entirely outside Dhaka. Since the night of 12 August, load-shedding has also been enforced in Dhaka following government instructions. Although the plan was to impose one hour of load-shedding once a day in an area of Dhaka, the schedule is not being followed.

According to data from the Bangladesh Power Development Board (PDB) and Power Grid PLC (PGCB), electricity generation is falling short of demand because of fuel shortages. The effects have now reached upazila-level hospitals.

A caesarean section was being performed at Bagmara Upazila Health Complex in Rajshahi about a week ago. The power went out shortly after the surgery began. The sudden darkness caused panic among the patient and her relatives. Eventually, staff used mobile phone lights and quickly bought fuel to start the generator and complete the surgery.

The 50-bed hospital treats a large number of outpatients every day. A visit to the facility on Sunday found that X-ray, laboratory and ECG services were also being disrupted because of load-shedding.

Shankar Kumar Biswas, health and family planning officer at Bagmara Upazila Health Complex, said all hospital activities, including diagnostic tests, come to a standstill when there is no electricity.

Power sometimes goes out even after surgery has begun, creating serious risks. Although one generator has been repaired, it cannot be kept running regularly because there is no allocation for the necessary fuel.

Power outages are also occurring during surgeries at Nilphamari General Hospital.

During a visit to different departments of the hospital on Saturday morning, it was found that power disruptions were causing difficulties with diagnostic tests, surgeries and patient admissions.

Around 1:00pm, relatives of patients crowded outside the operating theatre. A woman named Shapla Begum was taken into the operation theatre for a caesarean section.

About 15 minutes after the surgery began, the electricity went out. Shapla gave birth to a baby girl at that point. The baby was taken out of the operating theatre, but the mother's surgery had not yet been completed and she was still being stitched. The generator was started after a short while and the remaining procedure was completed.

Senior staff nurse Brishti Roy, who is responsible for the operating theatre, said four to five caesarean sections were performed there every day. But because of the power crisis, they can now perform no more than one or two.

"One was performed today (Saturday)," she said.

She said the hospital normally performs five to six surgeries of different types every day, including orthopaedic, ear, nose and throat (ENT) and general surgery. The number of surgeries has fallen because of load-shedding.

Bidhan Chandra Roy, in-charge of the operating theatre, said surgery requires a suitable environment. When the electricity goes out during an operation, the generator has to be switched on. The air conditioner cannot be operated in that situation. If a physician or nurse on duty sweats in such conditions and sweat falls onto the surgical wound, there is a risk of infection.

Hospitals are supposed to have generators as an alternative source of power during outages. But several hospitals have generators without fuel.

The only generator at Matlab South Upazila Health Complex in Chandpur is out of service because of a lack of fuel. It requires 15 to 20 litres of fuel a day to operate, but there is no budget allocation to purchase it.

Rajib Kishore Banik, resident medical officer at Matlab South Upazila Health Complex, said the hospital had been experiencing long power outages for several days, with frequent load-shedding.

X-ray, ECG and nebulisation services were being disrupted, he said. The overall delivery of healthcare at the hospital was being affected by the electricity shortage.

Raipur Upazila Health Complex in Lakshmipur also has a generator, but it cannot be operated when needed because there is no allocation for diesel.

Some hospitals do not have generators at all.

At Bera Upazila Health Complex in Pabna, for example, patients and their relatives suffer when the electricity goes out because the hospital has no generator.

Golam Sarwar, in-charge of the pathology department, said diagnostic tests have to be suspended during power outages, leaving patients waiting.

At Kulaura Upazila Health Complex in Moulvibazar, candles have to be lit when the electricity goes out at night. Physicians examine patients in the wards using the flashlights on their mobile phones.

Juri Upazila Health Complex has an IPS backup system provided by a private organisation. It can power one light bulb in each of two wards at night.

Diagnostic services are facing the most direct impact of power disruptions.

At Sakhipur Upazila Health Complex in Tangail, the X-ray machine sometimes stops working because of both load-shedding and low voltage.

During a visit to the hospital on Saturday, Rafiqul Islam from Gargobindapur village was found seeking treatment after being injured in a motorcycle accident. But because the X-ray machine was not functioning, he had to go to a private clinic and pay Tk 500 for the test.

The same test would have cost Tk 55 at the government hospital.

SM Amirul Islam Momen, a medical technologist in the X-ray department at Sakhipur Upazila Health Complex, said the X-ray machine sometimes stops functioning because of low voltage as well as load-shedding.

Kamrul Islam went to Raipur Upazila Health Complex in Lakshmipur on Sunday for an X-ray after fracturing a finger. He waited for about an hour, but the electricity did not return, so he left without undergoing the test.

"I came to the hospital from Charbangshi in Raipur to have an X-ray. I waited for an hour. There is no certainty about when the electricity will return. So I am being forced to leave," he said.

At Manikchhari Upazila Health Complex in Khagrachhari, most X-ray services remain suspended because of low voltage, a visit on Sunday found. Patients are being advised by physicians to go to private clinics and diagnostic centres.

Abdul Wadud, a resident of Matlab South Upazila headquarters, waited for two hours on Sunday after bringing his elderly mother to the health complex for an X-ray. He eventually decided to take her to a nearby private hospital.

Load-shedding is not only shutting down equipment. It is also making life difficult for patients admitted to hospitals.

At Bera Upazila Health Complex in Pabna on Sunday, 18-year-old Ashik Hossain was suffering from fever while his mother, Asma Khatun, sat beside him continuously fanning him with a hand fan.

She said the electricity had gone out repeatedly at night. The heat had made her son and other patients restless.

Aleya Khatun, whose 70-year-old husband Amzad Hossain was suffering from diarrhoea, said the repeated power cuts at night had caused her husband considerable discomfort and prevented her from sleeping properly.

At Taraganj Upazila Health Complex in Rangpur, electricity was unavailable for a total of four hours and 45 minutes in five separate outages during the 12-hour period from 7:30am on Saturday.

During a visit to the hospital on Saturday, Shamina Begum, who was suffering from breathing difficulties, said she had been admitted for three days. Her breathing became more difficult whenever the electricity went out.

The nebuliser could not be operated, she said, forcing her to use a hand fan. The electricity sometimes remained off for one and a half to two hours.

Patients and relatives at Kulaura and Juri health complexes in Moulvibazar said electricity was unavailable for eight to 12 hours a day, including at night.

At Kulaura Health Complex on Saturday, patient attendant Popy Rani said she had been staying at the hospital for four days with her two-year-old child, who had pneumonia. When the electricity went out at night, they had to use candles.

Load-shedding has increased over the past two to three months in six upazilas of Lakshmipur.

Shafiul Alam, general manager of Lakshmipur Palli Bidyut Samity, said the area was receiving 30 to 35 per cent less electricity than demand.

At Bera in Pabna, according to the local Rural Electrification Board, electricity demand is around 9 megawatts during the day and 12 to 13 megawatts at night.

Against this demand, there is a shortfall of 25 to 30 per cent during the day and 35 to 40 per cent at night, said Uttam Kumar Saha, deputy general manager of the Bera zonal office of Pabna Palli Bidyut Samity-2.

According to data from the Bangladesh Power Development Board (PDB) and Power Grid PLC (PGCB), electricity generation is falling short of demand because of fuel shortages. As a result, load-shedding has not eased even during the weekly weekend break.

The highest load-shedding on Saturday was recorded at 3:00pm, at 3,612 megawatts. The previous day, Friday, the highest load-shedding was recorded at midnight, at 3,244 megawatts.

The Rural Electrification Board (REB), the country's largest electricity distribution agency, said its highest load-shedding on Friday was 2,673 megawatts. At that time, the electricity deficit in the Mymensingh region stood at 46 per cent.

[Staff Correspondent, Khulna, and correspondents in Khagrachhari, Nilphamari, Lakshmipur, Noakhali, Patiya, Chattogram, Bera, Pabna, Matlab South, Chandpur, Bagmara, Rajshahi, Taraganj, Rangpur, Juri, Moulvibazar and Sakhipur, contributed to the report.]