The returnees complained about subpar conditions, including poor hygienic conditions and being crammed in small spaces. However, the authorities ignored the situation and the health risks it posed to those in quarantine.
by Anwar A. Khan
Bangladesh has a health crisis. The daily Covid-19 deaths reach all-time high in Bangladesh.
The lack of preparation in the United States and Europe that has spawned the ongoing crisis there still exceeds the preparedness of developing countries, such as, Bangladesh, which will have to battle the COVID-19 pandemic with limited financial resources and a legacy of poor healthcare infrastructure, especially for the urban poor.
Already one of the most densely populated countries in the world, Bangladesh also has thousands of stateless Rohingya housed in sprawling refugee camps in the southeastern region of the country, in conditions prime for rapid spread. Given its proximity to China and a large migrant population living in severely affected countries, such as, Italy, Bangladesh’s Ministry of Health and Family Welfare should have taken preventative measures when the Chinese government first shared news of the deadly virus. Unfortunately, precious time was squandered.
After the first reported death in Bangladesh from COVID-19, there was a mass religious gathering in the southern part of the country attended by tens of thousands of people. Such events have been discouraged by authorities, but communications need to be clearer and more forceful to be effective. There are several potential policies the Bangladeshi government can use in its response strategy to blunt the COVID-19 pandemic’s health and economic impact on Bangladesh.
The current situation
The Bangladeshi research institute spearheading the fight to test and detect coronavirus is the Institute of Epidemiology Disease Control and Research (IEDCR), a body under the Ministry of Health. The IEDCR has recommended that citizens avoid mass public gatherings.
Unlike in neighboring Nepal where the army set up a quarantine facility in Kathmandu as per the World Health Organization’s (WHO) recommendation upon the first positive COVID-19 test, the handling of quarantine measures in Bangladesh was inadequate.
The returnees complained about subpar conditions, including poor hygienic conditions and being crammed in small spaces. However, the authorities ignored the situation and the health risks it posed to those in quarantine. Subsequently, when the second batch of foreign returnees—over a hundred and forty Bangladeshis evacuated from Italy—arrived, confusion ensued when they were taken to the same inadequate quarantine spot. These returnees protested and were ultimately allowed to leave with the promise of “home quarantine.”
Such contradiction in policy guidance and lack-luster enforcement has wasted precious time for the government to shore up its limited public health system and to implement best practices for maximizing social distancing and minimizing community transmission of the novel coronavirus. The impact on Bangladesh’s economy due to these missteps is significant.
The Asian Development Bank (ADB) estimates that export industries will suffer and the country will lose 1.1% of its gross domestic product (GDP) growth due to the pandemic. The ready-made garments sector which accounts for more than 80 percent of Bangladesh’s manufacturing income has already suffered a loss of US$3 billion as major export destinations, such as, the United States, United Kingdom, and European Union are cancelling orders.
In addition, foreign remittances representing over 5 percent of GDP (close to US$17 billion in fiscal year 2019) has affected as half a million migrant workers who have returned home since the outbreak. The majority of these migrant workers were based in Middle Eastern countries which have been hit by declining oil prices.
Furthermore, daily wage labourers, such as, rickshaw-pullers, are the hardest hit as the closure of schools and colleges have led to lower demand for their services. For these workers—who survive hand to mouth daily—the consequences of quarantines and lockdowns, however, medically necessary, are dire without robust government provision of food and supplementary income.
Some encouraging news
Bangladesh’s government is hardly alone in not tackling the pandemic early enough. Fortunately, after a slow start, the government has begun to show signs of urgency. Following the mass religious gathering in southern Bangladesh, the government started enforcing social distancing measures.
The government encouraged low-income people to return to their villages where they would be provided with government aid or to take refuge in Bhashanchar, an island in the Bay of Bengal originally built to houseRohingya refugees. On March 20 last, the government authorized the Bangladesh Army to run two quarantine centers in Dhaka. One quarantine facility remains the same Ashkona Hajj Camp that has proved inadequate before. The other is a new one at Rajuk Apartment Project near Diyabari in Uttara.
In the medical arena, there has been progress as well. Isolation wards to treat COVID-19 patients have been set up in district-level hospitals across the country. Students and teachers of the Faculty of Pharmacy at the University of Dhaka have started making low-cost hand sanitizers due to market shortages in the wake of coronavirus fears.
Recommendations for tackling the situation
Policymakers in Bangladesh should gear up in anticipation of a deterioration of the situation. While the Asian Development Bank (ADB) has promised a US$6.5 billion package to address the immediate needs of developing member countries (DMCs), and India’s Prime Minister Narendra Modi has pledged US$10 million toward a special emergency fund to set up a rapid response team for the South Asian Association for Regional Cooperation (SAARC), Bangladesh will have to face this battle largely on its own. Over the past several days, the South Asia Center has consulted broadly with public health professionals and social scientists who study Bangladesh. Those conversations lead us to offer the following healthcare, social, and economic recommendations:
Health Care
Support initiatives to increase the local production of medical gloves, masks, and other medical kits for health care practitioners who, as the front line defenders, are the most vulnerable.
According to Health and Family Welfare Minister ZahidMaleque, as of now, Bangladesh has adequate testing kits and personal protective equipment (PPE), numbering around two hundred thousand units. On March 26, a large consignment of emergency medical supplies provided by the Chinese government arrived. This shipment included 10,000 testing reagents, 15,000 surgical masks, 10,000 medical protective equipment, and 1,000 infrared thermometers. But, as the grim lessons from other countries make clear, in the case of a mass outbreak, even more PPE will be required and more testing needs to be done.
COVID-19 testing facilities should be made available across both public and private medical centers with immediate effect. Once locally produced full-scale standardized and accurate kits are available, testing capabilities should be distributed to other locations in Dhaka and across the country.
Bangladesh should commit to mass testing on about one percent of its population to identify community spread of COVID-19. As of March 29, Bangladesh’s official COVID-19 tracker confirms forty-eight cases and five deaths. A press conference that day stated that 1,185 tests have been conducted thus far. This number is much lower in comparison to India and Pakistan, who as of March 29, have tested 27,688 and 14,336 cases respectively.
Implement awareness campaigns for the general public. Unless an individual is over sixty-five and/or has pre-existing health conditions, symptoms should be followed by a six to seven-day quarantine period and individuals should not go to health care facilities. If an individual’s health condition continues to deteriorate, they should then go for COVID-19 testing.
Emotional and mental health services, as well as financial support, should be provided for health workers. The medical community of the nation at this point are severely at high risk and are fearful.
Social
There must be tougher self-quarantine norms and if needed lockdown measures in certain areas of the country with higher concentrations of Bangladesh’s expatriates. Sri Lanka had instituted a stay-at-home curfew in eight districts of the country, where violation of this measure has led to the arrest of over 1,600 people. Now that the army has been summoned in Bangladesh, certain districts across the country can be asked to impose curfew-like restrictions, with violations leading to strict punishment and fines.
The government must utilize television, radio, and social media to counter the spread of fraudulent treatment methods through disinformation channels, and to raise appropriate awareness of COVID-19’s dangers for even otherwise healthy victims.
Village community leaders such as village elders should be involved in spreading information on countering COVID-19. Local non-governmental organizations (NGOs) and government officials have a list of such leaders and can centrally coordinate their response.
Private universities should be mobilized to provide premises for quarantine facilities and temporary hospitals, given that many of them have campuses located right outside Dhaka. Similar initiatives have been taken by higher educational institutions in the United States.
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The writer is an independent political analyst based in Dhaka, Bangladesh who writes on politics, political and human-centred figures, current and international affairs
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