Ten patients were waiting in a very small room in South Fatehpur Community Clinic in Hathazari upazila in Chattogram. None of them had a mask. They did not pay heed to maintaining social distancing rules. In another room, Nasima Akhter, a community health care provider, was examining patients without using personal protective equipment (PPE).
Along with this clinic, almost 2,000 health professionals in 525 community clinics in Chattogram are risking their lives by working without PPE while treating patients amid the Covid-19 outbreak. Every day, as many as 7,000-8,000 patients – with a sore throat, cold, fever, and cough – visit these clinics, however, no PPE has been sent for the healthcare workers.
As more than 170 health workers have already tested Covid-19 positive in the country, these doctors and other professionals fear both healthcare workers and patients will contract Covid-19.
Nasima Akhter said, "The masks provided by the government are of low quality. They have one layer whereas they should have three layers. We have not received any PPE. Local patients are also not aware. When we ensure social distancing, they complain we do not provide good treatment."
"Everyday health professionals test positive but we have to work to save our jobs," she added.
According to the Bangladesh Doctors' Foundation, 250 health professionals – 170 doctors and 80 nurses – have tested positive for Covid-19, so far, in the country. Yet, their safety has not been ensured.
Though other hospitals have fewer patients due to Covid-19, the number of patients with fever, cold and cough has increased recently at these clinics. Many patients come to these clinics after receiving no treatment at hospitals or private chambers.
Selim Uddin, a staff member of Chattogram University, received treatment at a clinic in Methol union. He said he did not see any safety measures used there. Not all patients washed their hands, and it was risky to go to the clinic.
Hathazari upazila health and family planning officer Dr Abu Mohammad Imtiaz said, "There are 35 community clinics in Hathazari. We have received only 60 PPEs for the upazila. No PPE has been sent for community clinic health workers."
Many returnee expatriates in the rural areas in the district roam around, violating home quarantine rules and posing a threat of spreading Covid-19. In the district, many people in Satkania, Sitakund, Patiya, and Mirsharai have been tested positive.
No PPE has been sent to any of the 40 community clinics in Satkania though 11 patients have already been tested positive.
Satkania upazila health and family planning officer Dr Abdul Mazid Osmani said, "Satkania is under lockdown. Community clinics are treating patients. Healthcare workers have been given masks and gloves but no PPE. We have received 100 PPEs so far but these can be used only once. As soon as we get PPE for community clinics, we will distribute it."
Many have expressed their dissatisfaction over PPE not being provided to healthcare workers. Janasastha Odhikar Rokkha Committee secretary Dr Susanto Barua said, "Most of the people come to community clinics at present as doctors do not see patients and people cannot go to hospitals due to the lockdown. So, PPE is essential for health workers in the clinics."
"Rural people are less aware [about Covid-19] and pose more of a threat of infection to the healthcare workers. We can build hospitals quickly but not nurses and doctors. So, their safety must be ensured," he added.
According to the Chattogram civil surgeon's office, 10,655 PPEs have been distributed and 23,000 PPEs are in stock.
Civil surgeon Dr Sheikh Fazle Rabbi said, "We have not yet received any PPE for community healthcare workers. We have already sent our requisition for PPE and when we receive it, we will distribute it."
So far, 39 patients have tested Covid-19 positive, of them five died. Chattogram General Hospital and Bangladesh Institute of Tropical and Infectious Disease are treating Covid-19 patients.