Eight experts, members of the health directorate’s advisory committee, have suggested that the lockdowns in various areas of the capital city must continue and be strictly implemented in order to tackle the spread of coronavirus. They feel this is the only way to control the transmission of the virus. They have also said that the two Dhaka city corporations can enforce curfew in the city before and after Eid.
These eight members of the advisory committee came up with these proposals at a meeting on 15 May and sent the recommendations to the director general of the health directorate. There are specific recommendations for Dhaka North and South city corporations. It was said that it was not possible for the health directorate to tackle the coronavirus situation alone. The local government ministry must also be involved in the task.
Experts said that the lockdowns in the city’s Tolarbagh and BUET areas managed to successfully curb the spread of the virus and these experiences could be replicated in other areas of the city.
Three of the experts spoke in detail on the matter with Prothom Alo. They said that each ward of the two Dhaka city corporations should form a taskforce. Each task force will comprise the local member of parliament, ward councilor, physicians, imam of the local mosques and other important persons of the locality. The law enforcement agencies will also be with them. They will work together to ensure effective lockdown in the areas.
A member of the team of experts and former director general of the health directorate, Shah Munir, speaking to Prothom Alo, said, “We feel that the city corporations need to pay more attention to tackling the spread of coronavirus. If the spread of the virus can be controlled in the big cities, then the incidence will lessen all over the country.”
The experts said that the lockdowns in the city’s Tolarbagh and BUET areas managed to successfully curb the spread of the virus and these experiences could be replicated in other areas of the city.
The team of experts includes two former DGs of the health directorate, MA Faiz and Shah Munir, public health expert Abu Jamil Faisal, senior researcher of icddr,b Anwar Iqbal, former director of Rangpur Medical College Hospital, Moudud Hossain, former consultant of Unicef during the Ebola outbreak in Uganda, Tarik Hossain, executive director of the Centre for Injury Prevention and Rehabilitation Bangladesh, Fazlur Rahman, and vice chancellor of Bangladesh University of Health Sciences, Liaquat Ali.
Speaking to Prothom Alo, Mayor of Dhaka North City Corporation (DNCC), Atiqul Islam, said, “The city corporation is prepared to take part in any work to tackle coronavirus. We will join in the work as soon as we get any proposal or directives from the health ministry or any other quarter.”
According to the records of the government’s Institute of Epidemiology, Disease Control and Research (IEDCR), till 16 May, 57 per cent of the coronavirus cases are in Dhaka city. From the very outset, the rate of infection has been highest in Dhaka. With the opening of the readymade garment factories, the relaxing of the lockdown, and the opening of shops from 10 am till 4pm, social distancing rules have been flouted in the city. The kitchen markets are crowded and traffic jams have reemerged on the roads.
Public health experts feel that unless strict measures are taken, crowds will increase further on the roads and in the markets. This will increase the risk of the virus transmission. They stress the need to adopt stringent cautionary measures.
The experts have submitted their proposals to the DG of the health directorate, Abul Kalam Azad. His reaction could not be taken as he is unwell. Additional secretary (services division) of the health ministry, Habibur Rahman Khan, speaking to Prothom Alo on Sunday, said that the recommendations have not reached the ministry as yet. Before implementing these, the proposals will first have to be discussed by the national committee. It is difficult to impose curfew in a democratic country, he said. This will required a decision from the highest level of government.
Concerning the proposal for curfew, home minister Asaduzzaman Khan on Sunday night told Prothom Alo that no one had breached the matter with him.
Meanwhile, IEDCR consultant and public health expert Mushtaq Hossain told Prothom Alo that isolation or quarantine centres were needed at a community level. Also, consideration had to be given to employment for youth in the poorer areas. The youth can work alongside the law enforcement in these areas. These are ways to handle the situation.
Former principal of Dhaka Medical College and member o the expert team, MA Faiz, speaking to Prothom Alo, said that community involvement is highlighted in the case of natural calamities. Bangladesh is a successful example in this regard. Community involvement can play an important role during this health crisis too.
He said, “There is need to prepare hospitals, keep up the supply of equipment for COVID-19 treatment. But involvement of the people and more ministries of the government is necessary.”
We worked intensely in Tolarbagh. The IEDCR health workers went there and conducted contract tracing. The local people, member of parliament and everyone were involved in tackling the spread of the virus. The city corporation was active. The law enforcement was also active.
The World Health Organisation (WHO) from the outset has been saying that tacking the pandemic is not the task of health ministry alone. All ministries and agencies of the government must r involved. It will be difficult to handle the pandemic unless the entire government machinery is involved. In Bangladesh, however, no ministry seems involved in the matter other than the ministry of health.
The health directorate has no programmes at a local level in the city corporation areas. The local government ministry implements the urban primary health programmes in these areas. Shah Munir said, it will not be possible to prevent coronavirus with the involvement of the local government ministry or the mayor and councilors on the city corporation areas.
Initially, a number of coronavirus deaths occurred in Tolarbagh of the capital city and the IECDR health workers carried out extensive contact tracing in the area. The area was locked down. There were, at the time, 17 coronavirus cased and 2 deaths in the area.
The lockdown in Tolarbagh proved successful because of the active involvement of the local member of parliament, ward councilors, the home owners associations and representatives of the civil society there. There was no coronavirus case in Tolarbagh in Sunday.
IEDCR director Meerjady Sabrina told Prothom Alo, “We worked intensely in Tolarbagh. The IEDCR health workers went there and conducted contract tracing. The local people, member of parliament and everyone were involved in tackling the spread of the virus. The city corporation was active. The law enforcement was also active.”
Tolarbagh had an advantage in its location. It could easily be isolated from other areas, said Meerjady Sabrina.
The IEDCR director went on to say that Tolarbagh can be used as a model to be replicated in other areas. She said, community involvement and coordination in the work is most important.
Dhaka city it the country’s economic and administrative hub. It has a dense population and a high number of working people. Experts feel that lockdown in clusters would be relatively more effective in the city.
Shah Munir said, “We have said a locality should be locked down if it has over 10 coronavirus cases. So within one large area, a few small areas can be separately locked down. This is cluster lockdown.”
According to IEDCR, here are 103 localities in Dhaka city where there are more than 10 patients. Experts said that if the local government and people’s representatives were committed, it would be possible to lockdown all 103 areas. Contact tracing as well as testing for the virus would be carried out continuously in the areas. They said these matters needed to be discussed immediately.
Economist and former caretaker government advisor Hossain Zillur Rahman told Prothom Alo that community involvement was undoubtedly necessary. The awareness of the entire community must be mobilised and they must be involved in tackling coronanvirus. They should be encouraged to distribute relief, take persons to the hospital and carry out other such tasks.
* The report has been rewritten in English by Ayesha Kabir