Poor treatment, saline shortage add to dengue patients’ woes outside Dhaka

Infograph: TBS

The number of dengue patients outside the capital is rising but the treatment facilities at hospitals and access to medicine, including injectable salines and platelets, remain inadequate.

In many districts, patients are suffering due to a shortage of beds and staff at hospitals. Besides, centrifugal machines — a device that spins the blood to separate red blood cells, platelets and plasma — are not present in many hospitals outside Dhaka, forcing patients towards Dhaka for medical treatment.

According to the Directorate General of Health Services (DGHS) data, 21 dengue patients have died and 3,015 were hospitalised across the country in the 24 hours till Wednesday morning.

Of the new deaths, 10 occurred in Dhaka hospitals and 11 in hospitals outside Dhaka. Of the new cases, 857 were reported from Dhaka and 2,158 were from various parts of the country.

A total of 10,263 dengue patients, including 3,819 in Dhaka, are now receiving treatment at hospitals across the country, DGHS data shows.

The number of dengue cases and deaths is increasing in Faridpur, with 38 people dying of dengue in the last two months. Even two months ago, no dengue death was reported from the district.

At present, 821 dengue patients are receiving treatment in various hospitals in Faridpur. However, treatment facilities have not improved at the same rate as the rise in fresh cases.

Visiting firsthand, The Business Standard correspondent found that bed shortage in Faridpur hospitals is acute. Many patients are being treated on the floor of the balconies and corridors.

Along with that, there is an extreme shortage of injectable saline heavily used in the treatment of dengue patients. In addition to this, the demand for platelets has increased several times but the supply is very low as per demand.

As in Faridpur, the number of dengue patients is increasing in Bagerhat and physicians are struggling to provide proper services. The number of dengue patients admitted to the Bagerhat 250-bed district hospital is 302. Other hospitals are also having more dengue patients than the number of beds they have.

Nazrul Islam, who was treated in the dengue ward of Bagerhat 250-bed district hospital, told The Business Standard, "The hospital is very untidy. There is no light in the bathroom and no tap water. I am an impoverished man and therefore I came to the government hospital. But if I stay in such an unclean place, I will get even sicker."

Another patient named Iqbal Hossain said, "I got admitted to the dengue ward at first but could not stand the foul smell and decided to move to the balcony floor."

Bagerhat 250-bed hospital's Supervisor Dr Asim Kumar Samaddar said, "We are seeing a surge in patients recently, including dengue patients. Although our medicine supply is normal, we are struggling to serve patients due to a shortage of manpower. That is why patients could not get their desired service."

Lakshmipur is one of the districts at high risk of dengue outside Dhaka. In addition to dengue, diarrhoea patients have also surged in the district. An acute shortage of saline in private hospitals and pharmacies in Lakshmipur was also observed by the TBS correspondent.

Ankur Chandra Debnath, owner of Bandhu Pharmacy in Lakshmipur, told The Business Standard, "Today, I had to turn away some 20 patients seeking salines. There is a demand for at least 50 bags of saline per day but the companies are not giving us the product as per demand. I have received only two bags of saline in the last 14 days."

The situation is similar in Barishal division. A majority of the hospitals there do not have centrifugal machines for separating blood platelets.

A machine is available in Sher-e-Bangla Medical College Hospital but there is no technician to operate it. However, patients from various district and upazila hospitals of the division are sent to Sher-e Bangla Medical for advanced treatment. Critical dengue patients have to come to Dhaka to get platelets.

On 17 September, the DGHS instructed civil surgeons across the country not to send dengue patients to Dhaka from upazila hospitals. However, patients are compelled to come to Dhaka, flouting the directive.

The situation in the capital is also dire. On Wednesday, some 68 people were admitted to Mugda Hospital due to dengue. Of them, 24 came from outside Dhaka.

Dr Niatuzzaman, acting director of the hospital, told TBS, "Around 25% of dengue patients in our hospital, many of whom are in critical condition, are coming from outside Dhaka, especially from Narayanganj, Lakshmipur, Brahmanbaria, Cumilla, Chandpur, Narail and Khulna districts."

Colonel AKM Zahirul Hossain Khan, Acting Director of DNCC Hospital, also said the same thing. "Most patients from outside Dhaka are coming to the hospital in critical condition," he said.

Public Health Expert Dr M Mushtuq Hossain told TBS, "Dengue tests should be available for all at community clinics and primary health care centres. If a dengue test is made easy for people like the Covid test was, then patients will be at ease after a diagnosis and take precautions from the start. That way, the situation will be much less complicated."

"Due to a lack of dengue testing facilities outside Dhaka, patients are coming to Dhaka in very critical conditions. This is overwhelming the Dhaka hospitals as well as increasing the risk of death," Mushtuq Hossain said, adding that hospitals should also monitor whether treatment is being provided according to the guidelines.

Professor Dr Ahmedul Kabir, Additional Director General of the DGHS, said, "Saline is being imported and the areas where there is still a crisis, the problem will soon be over. In addition, the guidelines given for dengue have reached marginal levels."

"All civil surgeons have been directed to set up Rapid Response Teams in every hospital. The team will provide instant care to patients who are in critical condition as well as monitor patients' condition so that they are not sent to Dhaka," Ahmedul Kabir added.

TBS correspondents Ali Akbar Tutul from Bagerhat, Sanjib Das from Faridpur, and Sana Ullah Sanu from Lakshmipur have contributed to the report.