Quandaries of Health System during Covid-19 Pandemic

Pranab Kumar Panday

26th August, 2020 12:08:54 printer

Quandaries of Health System during Covid-19 Pandemic


The COVID-19 pandemic has exposed the terrible state of the world's health system. Even the developed countries have been struggling to provide sufficient health services to their patients due to the shortage of ICU beds, doctors, nurses, health professionals, equipment and the increasing number of patients. The improved economic situation has helped the government of developed countries to manage the overall crisis in a better way through spending additional finances required to build sufficient infrastructure. However, it is difficult for governments in developing countries to provide their people with adequate health care. This warped state of the health in Bangladesh has generated debates and discussions from different corners of the society, seeking more intervention by the government to make a marked improvement to the structure of the health sector.

From the onset of the diagnosis of the first COVID-19 patient on the 8th of March 2020 in Bangladesh, there have been a lot of discussions about the capacity of the health ministry of the government to tackle the adverse public health and economic consequences of the pandemic. The inadequate infrastructure required to deal with COVID-19 patents coupled with mismanagement of the higher officials of the health ministry created a position of awkward concern to the government, while the Prime Minister made every effort to save the people.

The main intention of this write-up is to share one of my personal experiences that I gained recently while dealing with one of my relatives who first have had serve heart attack followed by heart failure and COVID-19 positive. The insight I have gained over the last 15 days has changed my view of the country's overall health system. I had spent quite a significant time of my life in three continents for higher education. I have had the opportunity to settle overseas. Yet, I came back from every place completing my higher degree within the stipulated time for the love and affection to my country. The recent experience has made me think whether I did the right thing or not?

One of my relatives recently had a serious heart attack and had to stay for a few days in the hospital. Due to the erroneous treatment of the doctor, he had heart failure after the attack which was not noticed by the doctors in the hospital. Once he was seriously suffering from breathing problem, I consulted a heart specialist though telemedicine service who confirmed that he had pulmonary edema, mostly due to congestive heart failure after carefully examined his X-ray, ECG and blood reports. The pulmonary edema refers to blood flowing through the veins that carry blood into the lungs, as the heart is not able to pump efficiently. As the pressure in these blood vessels increases, fluid is pushed into the air spaces in the lungs causing the patent to have respiration problems.  Once their fault was identified they wanted to refer the patient to another hospital though it was not done due to intervention of the director of the hospital who was a gentle and kind person. The physician was subsequently changed and the medicines corrected. Yet he was released very early from the hospital.

Once he went home, he began to experience breathing problems again and we had to admit him in another private hospital. While admitting him to the hospital I had to seek recommendations from a former minister who is presently an MP as well as higher administrative officials. Though the hospital authority admitted him they were unable to provide him ICU support because he was suspected of being positive for COVID-19. Once again we had to seek recommendations from different corners to conduct his COVID-19 test at the quickest possible time. While he was tested positive he was breathing through high flow nasal oxygen. When the COVID-19 positive test report was issued, the private hospital rushed to release the patent without considering his condition. We tried to admit him in several private hospitals. Unfortunately, none of the hospitals agreed to provide him with ICU support if required. Then, we had to again use different channels to arrange a bed in the government hospital. After eight hours of anxiety, we managed a bed for him in the government hospital. The coordinator of the COVID-19 unit of that hospital was very supportive in the whole process.

Once the patient was admitted to the hospital, he was treated properly. However, the doctors and nurses did not measure the blood pressure of the patent, although it was necessary to use certain medicines. Even none of the doctor checked his chest in the last five days. Even I had to seek support from the coordinator to monitor his blood pressure. I fully understand their anxiety while treating COVID-19 patents. Nevertheless, it is also important that they must treat patients properly being the frontline fighters. Otherwise, they would be accused of breaking their oath that they have taken while being a doctor. Though the patent has been improving, the experience that I have gained in the last 15 days has changed all of my views about the health care system and miseries of patents and their families.

It creates burning at my heart when I think the situation of the majority of the people who do not have any access to administrative power and politicians. It is pathetic to think about the overall administrative procedure of the health care system during the COVID-19. If someone is tested COVID-19 positive he could get some sort of treatment. However, the sufferings of the non-COVID patents are beyond explanation. Most of the senior doctors do not attend their private chambers where a majority of the patents meet them. Even when the senior doctors are attending the hospital patents they are not properly doing physical examinations.

In one of the earlier writings, I praised the doctors as the frontline warriors in the fight against COVID-19. I still respect them as they can only save us during this pandemic. However, at the same time, my recent experience has created immense anguish within me to think about how the country's health system functions. We must acknowledge the fact that our Prime Minister has been working hard to save the people during this pandemic. But, her efforts could not materialize the desired level of success due to mismanagement in the hospitals. Therefore, overwhelming reforms must be introduced to rectify all these flaws in our health system.

The right to avail adequate health care facilities is the human right of an individual. Therefore, it is the responsibility of the government to ensure that every citizen enjoys their health care rights without any hassle. However, at the present movement, the situation of the health care sector is not quite satisfactory as regards to providing health services to the patents. I am sympathetic to the doctors and health professionals as they are also the human being and have warriors for their families. Around the same time, they should also bear in mind that they are working in a noble profession where serving people with their utmost ability is their priority. Considering the risks and vulnerabilities of the health professionals, the government has announced different incentives and risk coverage. Despite the incentives of the government, many of the health professionals do not provide services in compliance with the government's norm. Therefore, the government should immediately take measures to review the overall hospital management and take necessary corrective measures to ensure that citizens could get access to healthcare service equally without any difference. Otherwise, the situation would get aggravated further and it would be difficult for the government to establish discipline in the health sector.

Pranab Kumar Panday, PhD is a  Professor of Public Administration and an Additional Director of the  Institutional Quality Assurance Cell (IQAC) at the University of Rajshahi.