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Hospitals in 37 districts lack ICU facilities

bdnews24.com | Saturday, 19 June 2021


After Abdus Samad, 68, and his wife Husne Laila, 58, from Thakurgaon were diagnosed with COVID-19, Samad ended up in Thakurgaon General Hospital.

A sexagenarian with comorbidity, including diabetes, Samad required high flow oxygen, which is available in Rangpur.

But he had to stay back in Thakurgaon as no bed at the Intensive Care Unit was available in Rangpur with his oxygen saturation dropping below 90, a worrying level, for the past four days.

“He became quite feeble as he could not eat properly,” said Samad’s daughter Sharmin Samad. Also, he is not in the condition to travel to Dhaka for better treatment.

According to the government data, 47 of the 93 samples tested in Thakurgaon on Thursday came back positive, yielding a positivity rate of 50.53 per cent.

Samad’s case is not different to the others, with the districts bordering India have been seeing a rapid surge in COVID-19 cases for quite a few days amid worries over the spread of a highly transmissible Delta variant of the coronavirus.

Although the authorities decided to provide more general bed facilities, district hospitals are yet to have enough ICUs for the COVID-19 patients, are still unprepared to combat a COVID-19 surge more than a year after the pandemic began.

As many as 37 out of the 64 districts in Bangladesh have no ICU facilities for the treatment of COVID-19 patients, according to the Directorate General of Health Services.

Among them, five are in Dhaka division, eight in Chattogram, six in Rangpur, two in Sylhet, four in Barishal, four in Khulna, six in Rajshahi and two districts are in Mymensingh division.

A total of 2,420 ICU beds are available in the country with 1,218 of them in Dhaka Metropolitan and 59 in Chattogram Metropolitan. The rest are available in 25 districts.

The government considers hospital beds with high flow nasal cannula facility as equivalent to ICU beds. As many as 11 districts do not have nasal cannula facility.

HIGH DEMAND OF ICU BEDS IN RAJSHAHI

Rajshahi division has only 46 ICU beds with 20 of them in Rajshahi Medical College Hospital.

All of the 20 beds were occupied as of Thursday morning. Among the patients in those beds, 12 tested positive for the coronavirus while the rest had symptoms of COVID-19.

The hospital recently doubled its ICU capacity to tackle the surge in coronavirus cases, but the efforts are far from sufficient.

As many as 70 patients were waiting for the ICU beds, said Brig Gen Shamim Yazdani, director of the hospital.

Once a patient’s physical condition improves, they are quickly shifted to the general ward. A bed also falls vacant when the occupying patient dies, he said. The patients from waiting list are then called chronologically.

Every day, seven to 10 patients are admitted to the ICU, he said. “Accordingly, a patient with the serial No. 70 will have to wait for more than a week to get into the ICU.”

Patients from Rajshahi, Chanpainawabganj, Natore, Naogaon, Joypurhat, Pabna, Sirajganj, Kushtia, Meherpur and Chuadanga come to Rajshahi Medical College Hospital seeking treatment.

Rangpur division has only 25 ICU beds, including 10 in a hospital dedicated for coronavirus patients and the rest in M Abdur Rahim Medical College Hospital in Dinajpur.

Only three of the ICU beds were vacant, according to government data.

But doctors said all the beds had patients.

Families of patients were trying to persuade the authorities with social influence to get a bed.

General beds are available for COVID patients and the authorities are working to increase the number of units to tackle a possible surge in infections, said Zakirul Islam, deputy director of the DGHS in Rangpur.

ICU and oxygen supply are also not scarce, he claimed.

ICU FAR OFF

Chuadanga General Hospital does not have the approval for ICU beds. Initially, the authorities asked for the approval of eight ICU beds but later reduced the number to four.

It is still uncertain when they will get the approval.

Currently, the hospital authorities recommend the patients who need ICU support to travel to Rajshahi or Dhaka, said Dr Awliar Rahman, medical officer at Chuadanga Civil Surgeon Office.

But most of the patients do not remain in a condition to travel to Dhaka, which is 240 km away from Chuadanga, or Rajshahi, 165 km away.

Abul Kalam Azad, chairman of Uthali union council, said he “strongly” feels Chuadanga General Hospital needs ICU beds. He was admitted to the hospital with COVID-19 and had to receive oxygen support.

Jhenaidaha Central District Hospital has no ICU either and the authorities have sent a proposal to Dhaka to set up ICU beds, said Civil Surgeon Dr Selina Begum.

The proposal is yet to be approved.

Any patient who needs ICU support has to travel to Jashore or Faridpur which are 50 km and 100 km away.

MANY PATIENTS, BUT NO ICU IN FENI

After the coronavirus pandemic broke out, the DGHS’ Chattogram divisional unit inaugurated the ICU project in Feni General Hospital.

Although the infrastructure remains available, the ICU unit could never run due to a lack of equipment and workforce in the past year.

Only two of the 10 ICU beds can provide services with ventilator support, said Ripon Nath, resident medical officer at the hospital.

“To run an ICU unit, we need two consulting doctors, 10 medical officers and 20 trained nurses. Currently, we are running the unit with two doctors and eight nurses.

“We can run the entire ICU unit if a liquid oxygen tank is available.”

GOVERNMENT DECISION

Prime Minister Sheikh Hasina ordered to set up ICU units in all district hospitals in the ECNEC meeting on Jun 2 last year.

Two projects were approved in the meeting as well.

One of them, COVID-19 Emergency Response and Pandemic Preparedness, was designed to upgrade the health system enabling the health workers to diagnose COVID-19 and testing.

The aim was to train 3,500 health workers and purchase equipment to set up PCR labs and ICUs, besides PPE and masks.

The project, however, has not shown any progress as of now.

In some of the hospitals, setting ICU unit had started but never completed, while in some hospitals, it is yet to start.

The government would set up ICU units in all district hospitals, late health minister Mohammed Nasim had said seven years ago, but no progress has been visible as of now.