District Hospitals Ill-Equipped: Vital oxygen supply equipment missing
With the novel coronavirus infections spreading across the country, critical patients outside the capital and divisional headquarters are increasingly becoming vulnerable due to ill-equipped district hospitals.
A health ministry database shows that 47 out of the 64 districts do not have the Intensive Care Unit (ICU) facilities. Besides, a recent study of Directorate General of Health Services (DGHS) revealed a shocking picture of poor ventilation and oxygen supply system in the hospitals.
Both the ICU and oxygen supply system are required to treat critical Covid-19 patients with breathing difficulties. Most of the district hospitals have oxygen cylinders but many of them lack vital equipment that are needed to ensure the supply of oxygen, finds the study.
For example, 90 percent of the hospitals don't have an Arterial Blood Gas (ABG) Analyser which is required to monitor the critical patient's blood situation while 89 percent do not have oxygen concentrators that ensure a smooth and high flow of oxygen.
Besides, 96 percent of the hospitals do not have a mechanical ventilator that works as a breathing machine when a patient cannot breathe.
The study finds 95 percent of the district hospitals do not have BPAP and CPAP and 30 percent of the hospitals do not even have oxygen masks.
BPAP and CPAP are non-invasive ventilation methods used to provide breathing support to the patients with respiratory issues.
Oxygen is delivered through a face mask into the lungs through these machines when patient cannot inhale or exhale alone.
The absence of ICU facility and the essential equipment for oxygen supply means that the critical Covid-19 patients of those districts will have to travel to divisional headquarters to get treatment.
For instance, Bagerhat district hospital doesn't have any ABG machine, oxygen concentrator, cannula and face mask -- which are mandatory to administer all sorts of treatments that involve delivering oxygen to patients.
So, Covid-19 patients of the south-western district will have to travel all the way to Khulna -- the divisional headquarters.
Terminal coronavirus patients in Habiganj may face similar trouble as they would have to travel to Sylhet to receive treatment.
The divisional headquarters have only 16 ICU beds for coronavirus patients in the whole division.
By the same token, patients in Cox's Bazar and Bandarban would have to travel to Chattogram where there are only 24 ICU beds dedicated to coronavirus patients.
The other 10 ICU beds in the division are in Cumilla.
"We have started setting up our central oxygen system and hopeful to complete within a very short time. After that we will purchase the other necessary equipment," said AKM Humayun Kabir, civil surgeon Bagerhat.
The Daily Star has got a similar response from the civil surgeons in Habiganj, Cox's Bazar and Bandarban.
Experts said the rapid growth of the virus has been vividly exposing the real scenario of the existing arrangements, or the lack of it, in the public hospitals.
Contacted, Aminul Hasan, director (hospitals and clinics) of the Directorate General of Health Services (DGHS), said, "We have taken initiatives to purchase oxygen cylinder for district hospitals."
"We have found some lapses and gaps and we are centrally coordinating to fill up those gaps," he added.
"This portrays a grim picture of our health system. We have heard of impressive development in the health sector, but this picture raises questions," said noted physician Iqbal Arslan.
"Since the beginning of the outbreak, we suggested the DGHS keep at least five oxygen concentrators at every hospital to avert crisis. It seems our advice went in vain," he added.
According to a DGHS database, there are a total of 329 ICU beds dedicated to coronavirus patients across the country and 148 of them are in Dhaka city while the rest are in the six divisional headquarters.
Besides, the country has 9,634 isolation beds for coronavirus patients.
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