Dengue patients being treated on the floor, behind nurses' desk in Barguna

Although entomologists at the beginning of this year had said that there was a risk of Aedes mosquito proliferation in Barguna, the administration took no preventive measures. As a result, dengue has become a serious issue due to this negligence in Barguna.

People in Barguna have been affected by dengue for several years. Currently, the Barguna District General Hospital is overcrowded with dengue patients. More than 50 dengue patients are being admitted to this 250-bed hospital daily. Regular platelet count tests are necessary to monitor the patients’ condition.

However, the hospital is not equipped to conduct all the required tests. As a result, many patients are being forced to go to private clinics in town for testing. This is difficult and increases health risks. It also raises the chances of spreading the disease. Not all patients are even receiving proper meals. Their families have to bring food from outside.

This was the situation at the hospital in 16 June. Conditions conducive to mosquito breeding were also noted in the town. Construction work was visible in various areas, containers with stagnant water were seen in front of homes in narrow alleys, and water had accumulated in front of many houses.

In Thanapara, members of a household admitted that they themselves do not manage or store water properly. In that area, mosquito pesticide was last sprayed about a month ago. A tea vendor in Sahapara said that several people have already died. Maybe now people will finally become aware, he added.

Last year and at the beginning of this year, entomologists had warned that there was a risk of a rise in dengue cases in Barguna. However, the municipal authorities did not prioritise mosquito control or public awareness. The health department also failed to make adequate preparations for treatment. Now, the administration says that representatives from the Institute of Epidemiology, Disease Control and Research (IEDCR) have arrived in Barguna. They will investigate and provide insights into why dengue is so prevalent in the area.

According to data from the Health Emergency Operation Centre and Control Room of the Directorate General of Health Services (DGHS) on Tuesday, a total of 244 new dengue cases were reported across the country in the past 24 hours. Of these, 82 cases were from Barguna district alone. As of Tuesday, a total of 6,466 people have been hospitalised nationwide due to dengue this year, with 30 deaths reported. In Barguna, 5 people have died and 1,831 have been hospitalised due to dengue. This district accounts for 28 per cent of the total dengue cases in the country. As of Tuesday, 233 dengue patients were admitted to the Barguna District General Hospital.

The health department has designated the sixth floor of Barguna District General Hospital for dengue wards. On Monday at around 11:00am, a long line of people was seen in front of the lift at the hospital. Most were relatives of patients, while some were patients themselves. Even before reaching the sixth floor via the stairs, the hallway was already crowded with people, making it difficult to pass.

Pushing through the crowd to enter the ward, it was seen that there was hardly room to move. The hospital authorities had arranged 50 beds for dengue patients, but each patient was accompanied by multiple family members or visitors. One male patient lying on the floor in the male ward was accompanied by five people—his father, mother, wife, sister, and a small child.

Due to the shortage of beds in both the male and female wards, many patients are being treated on the floor, behind the nurses’ desk, and in the ward corridors. Beside or above each patient's bed are household items like plates, glasses, buckets, water bottles, clothes and towels, food containers, medicine packets, and hand fans.

Every patient seems to have brought a small household with them. In addition to the patients and their families, the space is also crowded with physicians, nurses, Ansar personnel, ward boys, volunteers, and journalists from various media outlets.

Ali Hossain, a clothing trader from the Fuljhuri area of Barguna town, and his son Mohammad Prince, a twelfth-grader, are both dengue patients. Both father and son have been admitted to the hospital and are staying in the corridor.

Ali Hossain told Prothom Alo that his son caught a fever on 9 June. On 10 June, a test at a private diagnostic centre confirmed that his son had dengue. That same day, he was admitted to the district hospital. The next day, while checking his son’s platelet count, Ali also got himself tested for dengue — and his result was positive too. Since then, both father and son have been sharing the same bed and receiving treatment.

Ali Hossain said that all of their blood tests are being done at private clinics. Since their admission, they had not received any food from the hospital as of that day.

The patient next to them, Md Yasin, lives on Dhanshiri Road. He works in vehicle repair and has a shop in front of the Barguna upazila parishad. He told Prothom Alo that he was admitted to the hospital four days ago. None of his tests were done at the hospital — all were conducted at private clinics. He has eaten home-cooked food brought from his house every day.

Apart from Ali Hossain and Md Yasin, several other patients also said that they had to visit different clinics in town for medical tests. One patient mentioned that someone from a clinic came to collect his blood sample after he returned home.

In both the male and female wards, mosquito nets were seen over some beds. However, most of the nets were either folded or left hanging loose. One patient in the male ward said he doesn’t use the net because it is larger than his bed.

Meanwhile, patients lying on the floor, in the corridors, in front of the wards, or behind the nurses’ desk were not using mosquito nets. There was no arrangement in place to hang nets in these areas.
Public health experts warn that hospitals treating dengue patients can become hotspots for the spread of the disease. They recommend that mosquito nets be used to prevent mosquitoes from spreading the virus from infected patients. They also emphasise the need to reduce overcrowding in hospitals. However, the reality is that none of these recommendations are being followed at Barguna District General Hospital.
Md Rezwanur Rahman, the superintendent of Barguna District General Hospital, told Prothom Alo that it’s true many tests are being done outside the hospital. “But the limitations of resources must also be considered,” he said. “When a 250-bed hospital has 600 admitted patients, it’s not always possible to provide food for everyone.”

According to data from the District Civil Surgeon’s Office, dengue has been reported in all six upazilas of the district—Amtali, Betagi, Patharghata, Taltali, Bamna, and Barguna Sadar. Outside of the Sadar upazila, the highest number of cases has been identified in Patharghata, where 77 people have been infected so far.

The District Civil Surgeon’s Office has identified 36 areas where 10 or more people have been infected. The World Health Organization (WHO) assisted in this effort.

According to the WHO's list, the highest number of hospital patients are coming from the Lakurtala and Sadar Road areas of the town, with 137 patients each. Other areas with a high number of cases include Monsatala, College Road, Gaurichanna, Char Colony, Kathpatti, Town Hall, Thanapara, DKP Road, and Khejurtala. From each of these areas, 30 or more patients have been admitted to the hospital for treatment.

The presence of dengue in Barguna is not new. According to government data from recent years, the district has had dengue cases before. In 2022, 485 people were hospitalised with dengue in the district. The following year, in 2023, 4,592 people were admitted, and 7 of them died. Last year, 2,434 were hospitalised and 4 died.

When asked why dengue is more widespread in Barguna this year, the district's Civil Surgeon, Dr. Mohammad Abul Fattah, told Prothom Alo, “We have invited researchers from IEDCR to investigate the matter. They will look into three key aspects: which of the four dengue virus types is most prevalent among patients, whether there has been any genetic mutation in the Aedes mosquito, and why Barguna has become a hotspot.”

The reason for Barguna being a hotspot was, in fact, previously explained by entomologist and professor of zoology at Jahangirnagar University, Dr. Kabirul Bashar.

He told Prothom Alo, “At the beginning of last year and this year, I had already said that there would be a surge in dengue cases in Barguna. That’s because we detected a high presence of Aedes mosquitoes there. In nearly 50 per cent of water containers used for storing rainwater in people’s homes, we found mosquito larvae.”

Storing rainwater for year-round use is a long-standing practice in the southern districts of the country. So why is the dengue outbreak concentrated only in Barguna, and not in other coastal districts?

Dr. Kabirul Bashar explains that dengue has surged in Barguna due to the convergence of three key factors. Rainwater has created an ideal environment for Aedes mosquitoes to breed. The dengue virus was already present in the human population. And there is also a high density of mosquitoes. The combination of environment, infected individuals, and abundant mosquitoes has led to the outbreak. He warns that if immediate action is not taken, districts like Barisal, Chattogram, and Cox's Bazar could soon face a situation similar to Barguna.

However, local residents view the issue somewhat differently. Hasanur Rahman, president of the local civil society group Health Rights Forum, told Prothom Alo, “The local district administration and health department have not acted responsibly. The public is unaware, and the authorities are merely putting on a show.”

He also pointed out that several unused government plots and water bodies in the town have become safe havens for mosquitoes.

The day before Tuesday, cleaning staff were seen working in several areas of Barguna town. Around 11:00am, mosquito control workers were seen preparing to begin fogging near the Deputy Commissioner’s office.
Animesh Biswas, administrator of the Barguna District Council, told Prothom Alo, “The administration has taken the dengue situation seriously. Spraying of mosquito repellents is being carried out regularly.”

However, residents of at least two neighbourhoods said that mosquito spraying is done very infrequently. An official from a volunteer organisation, speaking on condition of anonymity, said that the administration only started taking the issue seriously about a month and a half ago. An NGO representative added that a request for proper measures against dengue was made at the district law and order committee meeting at the beginning of the year — but the administration did not take any action at the time.

No private hospital or clinic in Barguna provides dengue treatment, although diagnostic tests for dengue are conducted. One day after admitting his son to the hospital with dengue, Ali Hossain from Fuljhuri Bazar in the town began feeling feverish. On his own initiative, he got tested at a private diagnostic centre, and the result confirmed he had dengue. He is now hospitalised.

Hridoy Chandra Das from Thanapara said his grandfather, Gosai Das, died of dengue on 11 June. Three days later, Hridoy caught fever and a cough. He underwent a medical check-up at another private centre, which confirmed he had dengue.

Six people shared similar stories — they had themselves tested at private clinics. One person reported receiving two different platelet count results from two separate clinics.

According to the Civil Surgeon’s Office, there are 41 private clinics in this small town. Of these, 14 either have not renewed their registration or have suspended registrations. As dengue cases have surged, so has the crowd seeking testing and treatment at these clinics. Some even send staff to the district hospital to collect samples from patients.

Dr. Mohammad Abul Fattah, the Civil Surgeon of the district, told Prothom Alo, “Many tests are being done outside the hospital. But we are vigilant to ensure that no one conducts unnecessary tests or issues reports without testing. Last week, we held a meeting with clinic owners and made it clear that no one should exploit the situation.”

Maulana Muhammad Abu Hasan, general secretary of the Barguna unit of the Bangladesh Private Hospital and Diagnostic Owners Association, told Prothom Alo, “We’ve also received some complaints. We've formed a small committee that will visit several clinics daily. The committee will talk to the clinics, give instructions, and ensure irregularities are avoided. We’ve also requested the civil surgeon to make sure the public hospital is free from brokers. If the public hospital is free from intermediaries, corruption outside will also decline.”