Exposed to virus risk
Shafiqul Islam Rony is more worried than ever.
The health assistant at Mougram community clinic in Pabna feels unprotected every time he goes to work amid a wave of Covid-19 cases in the country.
On an average, he comes in contact with 40 to 50 patients a day. The number of people at the clinic has gone up since most other local healthcare institutions are turning away patients to avoid coronavirus transmission.
The man in his mid-30s is also frequently visiting the homes of those who returned from abroad to collect information from them.
He is doing all these without having adequate protective gears. Only on 16 April, he received a set of personal protective equipment (PPE) from the district civil surgeon's office.
"Though I don't have enough safety gears, I have to go to patients every day. Even the mask and hand gloves I'm using are bought with my own money. I have my family and children. They are extremely worried," he said.
Shafiqul's anxiety is shared by thousands of other healthcare providers at community clinics across the country. These health workers are providing services in rural Bangladesh despite being equipped with insufficient protective gears, which makes them and their families exposed to the deadly virus.
The country has 13,850 community clinics under the Community-based Healthcare Project. Some are, however, closed due to a shortage of manpower and other issues, according to officials.
Each clinic has a community healthcare provider (CHCP), a health assistant under the Directorate General of Health Services, and a family welfare assistant (FWA) under the Directorate General of Family Planning.
Together, they provide a wide range of services to people related to increasing immunity and promoting health and community mobilisation.
Soon after the government enforced the countrywide shutdown late last month to stem the coronavirus outbreak, these clinics started witnessing a sharp rise in patients. It happened after many hospitals, other clinics, and private doctors in the rural areas refused treating patients out of fear, according to reports from our correspondents in several districts.
Recently, health workers at the community clinics wrote twice to the project office for providing them with adequate protective materials, but they were yet to get any response.
In the meantime, the government decided to use them to collect samples from suspected Covid-19 patients as coronavirus cases continue to soar, hitting 4,689 with 131 deaths until yesterday. The health workers are expected to be given one-day training in this regard.
"A letter has been issued and it says we have to collect samples from suspected patients after the one-day training. But without sufficient protective gears, things will be quite risky for us and our families," said Suraiya Aktar, a community healthcare provider at Sabgram Chak Alam community clinic in Bogura Sadar upazila.
'WE'RE IN GRAVE RISK'
Healthcare providers at different community clinics said most of the patients they were dealing with suffer from seasonal fever, cough, and cold.
They are providing services from 8:00am to 1:00pm. Also, whenever they find any patients with further complications, they refer them to the upazila health complexes.
In many cases, patients appear at clinics without even wearing any mask. So, the health workers need to deal with them maintaining a safe distance.
"Earlier, we used to get 10 to 12 patients a day, but 53 people turned up yesterday. Sometimes the number rises to 70 to 80," said a community healthcare provider (CHCP) in Barishal's Gournadi upazila on Tuesday, wishing not to be named.
The situation is almost similar in all 25 clinics in the upazila.
"We are asked to keep our clinics open, but we are not given enough safety tools to protect ourselves," said the CHCP.
He said each of them received two masks and two pairs of hand gloves a week ago and two sets of PPEs five days ago, but the quality of the PPE was not up to the mark as "those were made from shopping bags".
"Most of the people who come to us are already panicked. Yet some of them don't use masks. We feel a bit nervous as we sometimes need to touch them to check their blood pressure," said Suraiya of the clinic in Bogura.
Umme Kulsum, another healthcare provider, of Shakharia Tilerpara community clinic in Gournadi, said, "We still didn't get any PPE. We've bought masks, hand sanitisers, and gloves on our own. We also maintain social distancing while providing treatment to people."
Shahidul Islam, convener of Bangladesh Community Healthcare Providers Association, said, "Each of the CHCP is dealing with almost 50 patients every day without wearing proper protective gears. We are in grave risk."
Two of their colleagues already got infected, and the number could rise if their safety was not properly ensured, he told The Daily Star.
Shahidul said upazila health complexes in many areas provided them with only two pairs of one-time gloves and two masks and two sets of PPEs, which were "basically similar to raincoats".
But in many areas, the clinics didn't even get those, he said.
"We have written twice to our project office for adequate safety measures, but to not avail."
'ENSURE OUR SAFETY'
Some 267 health assistants are working in nine upazilas of Pabna.
"These health workers are giving medicine, injections to patients and even visiting their homes, but their safety is being compromised," said Fazlul Haque, president of Pabna district unit of Health Assistant Association.
Echoing the view, HM Arifur Rahman, general secretary of Community Healthcare Providers Association in Patuakhali, said, "We are compelled to risk our lives as we have to do our job without adequate safety gears."
Similar is the picture in 176 community clinics in Patuakhali.
Also in Tangail, each of the healthcare providers in four upazilas got one-time PPE, a pair of gloves, a mask, and a bottle of hand sanitiser around two weeks ago. But clinics in the remaining eight upazilas got only masks and hand sanitisers.
"I have not used the PPE yet as it cannot be reused," said Reza Khan, a CHCP at Chinmura Mosinda Community Clinic in Kalihati upazila.
"We are always ready to provide services during crisis time, but what about our safety? We request the government to ensure that first. We also demand that it provide financial support to any of us who would die while performing duties."
Contacted, Sahadeb Chandra Rajbongshi, the line director of community clinics, said CHCPs would not directly treat any Covid-19 patients.
"We have already supplied gloves, [three-layer] masks and soaps or hand sanitisers to all the community clinics," he said.
[Our correspondents from Pabna, Bogura, Barishal, Tangail, and Patuakhali also contributed to this report]
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