Uneven Health Services During Pandemic

Md Obaidullah 

There is a saying, "Health is wealth". Human beings have been living in this world on the basis of five basic needs. Health is one of them indeed. Even, the global goals "SDG" also emphasised on Good Health and Well Being.  However, one of the critical challenges in the 21st century is the grave threat of pandemic. No matter, this virus is a bio weapon or created by nature, the fact is that the world has been infected by it abruptly.

The world has been trembling poorly by the deadly virus COVID 19 since 2020 and Bangladesh is no exception to this. Fear has gripped the nation swiftly. The government of Bangladesh has tried to curb COVID 19, but perhaps the efforts have failed somehow. The core reason is the weak health sector and poor management. But how?

Everything is centralized in our country.  That means, education, employment opportunities, business and health facilities are capital city Dhaka-centric. It has become worse during the pandemic. Needless to say, the pandemic was very Dhaka-centric at one time, yet now it has spread across the country. It is disheartening that, death toll is rising every day. Almost 70 percent of the country's RT-PCR testing facilities are based in the Dhaka division, however, it is preposterous that the health facilities are just confined within Dhaka.

The attack COVID 19 is not only in Dhaka, but also the whole country. Then why is everything Dhaka centric? RT-PCR facilities are required for precise Covid-19 diagnosis. It is appalling that the remaining seven divisions of Bangladesh have only 39 PCR-RT machines with a total of 128 serving where ten of the facilities account for the Chattogram. No one bothers with this serious issue, this is a considerable threat for the country, the uneven health services. 

A grave situation came to light in last year's pandemic attack. What the authorities have done in one year. 6.8% of the budget earmarked for public and disciplinary security in this year's budget, whereas 8.4% for the defense sector. However, even after the virus had damaged the entire health system, the allocation is just 4.7 percent in this sector. How ridiculous it is.

In this situation, when the health sector should have been prioritized, our policy makers have given priority to the defense sector. Let's observe an audacious picture, the discrepancy in the number of ICU beds and emergency facilities combined with the lack of skilled staff, nurses and doctors has become very disgracefully sharp between Dhaka, other districts and towns. There are also disparities in the availability of oxygen and high flow nasal cannula. It is reported that over 50% of Dhaka and Chattogram's almost 11,000 oxygen cylinders are available in the country. In addition, there are very few central oxygen supply hospitals in the country.

It is sadistic truth, 38 districts that do not have RT-PCR testing facilities, but, the districts with extremely high positivity rates. Apparently, if massive scale tests are not carried out and contact tracing is implausible, it would be impossible to break down the transmission chain of the more hazardous delta that swells or even adequately diagnoses in the countryside of Bangladesh and then treats those with symptoms.

Furthermore, another dangerous variant "Lambda" is coming towards us. Scientists say, "It's more dangerous than delta." To prevent the spread of the virus, rapid and extensive testing facilities are necessary everywhere.  Identifying, isolating, and treating patients would be useless and meaningless without exhaustive testing.

Consequently, testing facilities must be enlarged as soon as possible. Other healthcare facilities should be obtained and added to the upazila, district and divisional hospitals in the meantime. Therefore, it's a clarion call to the government and policy makers to increase the health facilities to the country's peripheral areas so that we can withstand the onslaught of this awful disease and keep the contagion under control.


Md Obaidullah is a Research Assistant of Centre for Advanced Social Research, Dhaka, Bangladesh