In the 13 hours between 8:00pm Thursday and 9:00am Friday at the Mohammad Ali Hospital in Bogura, seven coronavirus patients died. These patients had been suffering from severe respiratory problems. Their families complain that they died due to a lack of high flow nasal cannula, required to supply oxygen.
The hospital’s superintendent ATM Nuruzzaman also admitted to the crisis of high flow nasal cannula. Speaking to Prothom Alo on Friday, he said there are complaints that patients have died due to the lack of high flow nasal cannula. He said the hospital did not have the capacity to provide oxygen to more than two patients at a time by means of high flow nasal cannula. In a note issued Friday night, the Bogura deputy commissioner Ziaul Huq also said that the shortage of high flow nasal cannula was creating difficulties in the management of critical patients.
Inquiries made following the deaths of coronavirus patients in Bogura, revealed that there were discrepancies in the information provided by the Directorate General of Health Services (DGHS) regarding high flow nasal cannula.
According to DGHS, there are 1,690 high flow nasal cannulas for coronavirus patients all over the country. But inquiries around eight districts Friday revealed that there were not as many high flow nasal cannulas as shown in the hospital-wise figures provided by DGHS.
Other than high flow nasal cannula, many hospitals faced a crisis in oxygen supply. There are allegations that 5 patients died in Satkhira Medical College Hospital due to the crisis in oxygen. Two inquiry committees have been formed to look into the matter.
Coronavirus patients have a difficulty in oxygen intake as their lungs are affected. A large number of these patients require supplemental oxygen. High flow nasal cannula supplies oxygen at higher rates of 60 to 70 litres of oxygen per minute, while a patient receives at the most 15 litres of oxygen through a non-breather mask.
Seven deaths in Bogura
Abdul Matin Chowdhury of the village Badshail in Badalgachhi upazila of Naogaon is one of the seven coronavirus patients who died in Bogura. He had been admitted to the corona-dedicated Government Mohammad Ali Hospital in Bogura. He developed severe respiratory problems on Thursday night and his body’s oxygen level had fallen to 70. He required a high flow of oxygen, but this was not possible.
Retired headmaster of Badshail High School, Abdul Matin died at 8:30am Friday. His son Moshtaq Hossain told Prothom Alo that he had rushed around the hospital to arrange oxygen for his father, but to no avail. He could not manage to get a high flow oxygen cannula.
Lily Talukdar of the village Chilgachhi of Sirajganj sadar was also admitted to hospital. Her son Enamul Huq said his mother’s oxygen level had fallen to 68, but no high flow oxygen cannula could be arranged.
On Friday 230 patients had been admitted at the Mohammad Ali Hospital. Around 25 of them were being treated for severe respiratory problems.
Hospital sources said that in March last year, the Mohammad Ali Hospital was declared to be a corona-dedicated hospital. Till April this year they had to rely on cylinder oxygen. Later a central oxygen supply was set up in the hospital. On 27 June the number of beds was increased to 200. With the pressure of patients mounting, on Friday the hospital authorities decided to increase the number of beds by another 25.
According to DGHS, there are 4 high flow oxygen cannulas at the Mohammad Ali Hospital. However, the hospital authorities say only 2 are functional. The other two have not been put into use.
Superintendent of Mohammad Ali Hospital ATM Nuruzzaman told Prothom Alo that it hadn’t been possible to use the allocated two high flow oxygen cannulas. DGHS had been informed of the matter and a request had been made for more. The health directorate had not responded.
200 high flow oxygen cannulas at Narail
A hospital-wise account of high flow oxygen cannula is given at the regular coronavirus-related bulletin of DGHS. According to the directorate, there are 200 high flow oxygen cannulas at the Narail district sadar hospital and the technical training centre dedicated to coronavirus patients. In reality, there are only 2 high flow oxygen cannulas at the hospital, but even these are not functional. So critical patients in Narail cannot be administered high flow oxygen supply.
Communicable disease control officer at the Narail district civil surgeon’s office, Shafiq Tomal, expressed his surprise hearing about the 200 high flow nasal cannulas. He told Prothom Alo this week they received 2 high flow nasal cannulas as these have been provided to the district sadar hospital. Superintendent of the district sadar hospital, Abduls Shaker, told Prothom Alo they received 2 cannulas on Sunday, but these hadn’t been put to use as yet.
There is no functioning high flow nasal cannula at the Naogaon sadar hospital. According to DGHS, there are three there. There are no high flow nasal cannulas at Natore Sadar Hospital and Sirajganj’s Bangamata Fazilatunnessa Mujib General Hospital. But according to the health directorate, there is one each in these hospitals.
There is a lack of responsibility at every step. It must be specified whether the DG, DGHS or the department of health engineering or PWD is responsible for the crisis in oxygen supply. Unless it can be specified where the problem lies – in the system, in individuals or in the law—this will not be resolved.”Be-Nazir, former director, disease control, DGHS
While records show there are two high flow nasal cannulas at Joypurhat Sadar Hospital, in reality there are none. Critical patients in this district go to Rajshahi or Bogura.
DGHS says that there are 24 high flow nasal cannulas at the M Abdur Rahim Medical College in Dinajpur. But inquires Friday night revealed there were 16 there.
There were allegations that five patients died at Satkhira Medical College Hospital on Wednesday due to the lack of adequate oxygen. Here too there are discrepancies in the account of high flow nasal cannula. DGHS says there are 38 high flow nasal cannulas there, while the hospital authorities claim there are 30 functioning cannulas.
DGHS spokesperson and director of disease control, Nazmul Islam, told Prothom Alo that they would look into the discrepancies regarding the number of high flow nasal cannulas. He said about Narail that there may have been a typo. Then again, high flow nasal cannula may have been supplied to many places but were out of order and the directorate had not been informed.
Many hospitals have none
Many hospitals designated to treat coronavirus cases, do not have even a single high flow nasal cannula. Records of the directorate show that there are no high flow nasal cannulas at Kurigram Sadar Hospital, Gaibandha Sadar Hospital, Brahmanbaria Sadar Hospital, Netrakona Sadar Hospital, Shariatpur District Sadar Hospital and Madaripur Sadar Hospital.
Former director, disease control of DGHS, Be-Nazir told Prothom Alo, “There is a lack of responsibility at every step. It must be specified whether the director general of DGHS or the department of health engineering or PWD is responsible for the crisis in oxygen supply. Unless it can be specified where the problem lies – in the system, in individuals or in the law—this will not be resolved.” The public health expert went on to say that in the cities, if patients do not get oxygen in one hospital, they can go to another. The people in the village do not have such facilities.”
(The staff correspondents and correspondents of the concerned districts assisted in the compilation of this report.)
* This report appeared in the print and online edition of Prothom Alo and has been rewritten for the English edition by Ayesha Kabir