Is my father, a doctor, equipped to face COVID-19 in Bangladesh? — Bangladesh’s public health response in the spotlight.
Couching inside, miles away from my motherland, with a computer screen frequently relaying mostly grim news to me has given me a lot to think about. My contemplation mostly revolves around the well-being of my family and questions wondering the reinstatement of normalcy; When will this sequel to ‘The Contagion’ end?; When will this travel ban be lifted and when can I see my family again?; Will my father, a 63-year-old man who is a doctor and also a patient of various complications, survive through this? Are they providing him with the required PPE (Personal Protective Equipment), kits and a facilitated public health response to face this in the frontlines?
I have been dealing with this anxiety by checking in several times with my parents, and when I am not doing so, I am googling ‘Coronavirus updates in Bangladesh’. The results look quite puzzling. Bangladesh has recorded only 48 confirmed cases so far, with 5 deaths. That number does not look too bad when you compare it to other countries. However, this number worried me when I looked at the average fatality ratio index. Bangladesh’s ratio stands tall at 10% compared to the general average ratio of 5% around the world. This figure worried me further when I realized that Bangladesh on average has one of the youngest populations in the world. Our ratio is neck and neck with Italy, a country with one of the oldest population groups on average. Why is such a young population getting affected by COVID-19 so aggressively?
Bangladesh is by far one of the most densely populated places on Earth, with Dhaka being the beehive for that population. Ensuring an adequate public health response, where quarantine protocols are being followed duly has various social, political and financial barriers. The majority of the population lives off of subsistent daily earnings where they amass an average earning of around $20 a week. Quarantine is something they cannot afford, which is why their survivability depends on going out and working despite the various manifestations of the virus. Such a population group requires organized community housing during this period of time to provide necessities such as shelters, food and medicine for the lower class.
Despite the population density, Bangladesh only has one public health centre with the required kits to serve a population of 163 million. To put this matter further into perspective, Bangladesh has only one public healthcare worker serving 6,798 people. Bangladesh also boasts a plethora of remittance workers working in Europe, who returned home and have not followed the strict quarantine protocol. This makes me wonder as to how many blanketed cases are possibly roaming around in my motherland, unknowingly infecting people in their day-to-day lives. Therefore, not only are people unknowingly spreading the virus, but there is not enough healthcare artillery to locate where the cases are and where future transmission might take place.
I believe the first wave of transmission has already taken place, all of which could have been avoided using a swift public health response upon the wake of the virus in other countries. The public health goal now should not only be about ensuring the maintenance of quarantine protocols but also should be about assuring basic necessities for the underprivileged (consists of a large proportion of the population). Nevertheless, ensuring such a multi-sectoral health response with the existing resources in chaotic Bangladesh will be nothing short of a miracle.
Yesterday, my father told me ‘If Bangladesh tackles this pandemic successfully, then it will be one for the history books. If not, then this pandemic can turn out to be a complete massacre’. I believe that is true and the first and foremost public health response should be to ensure that doctors like my father are provided with kits, ventilators and PPE. In a pandemic, I believe doctors without their equipment are equivalent to soldiers fighting a war without weapons. Don't get me wrong, it honestly makes me very proud to claim that my father is someone in the frontlines fighting for the existence of humanity. However, I don’t feel comfortable seeing him join a brawl where the chances of victory are so bleak.