From Mohammad Jahidul Hasan, M.Pharm., clinical pharmacist, Square Hospitals, Dhaka, Bangladesh.
Bangladesh confirmed its first COVID-19 case on March 8 and its first COVID-19 death on March 18. On March 26, a countrywide lockdown came into force and its noisy cities became eerily silent. Since then, Bangladesh's poor and extremely poor have started to face new challenges with new government policies because they cannot now work and have no funds to support themselves.
Bangladesh is one of the most densely populated countries in the world and, according to a national database, 1.1 million people live in 3,400 slums in the capital, Dhaka, mostly rickshaw pullers, day laborers, factory workers and transgender people.
Before the COVID-19 attack, Bangladesh's health system was already struggling with the increasing burden of disease, the low quality of health care coverage and an inadequate national budget for health.
Out-of-pocket payments for health care for Bangladeshis are among the highest worldwide, while according to World Bank data only 15% of Bangladeshi people earn more than $5.9 per day. The U.S. and China have 29 and 42 hospital beds for 10,000 people, whereas in Bangladesh the number is only eight. There are only five doctors for the same number of people in Bangladesh.
In Bangladesh, where 90% of workers are in informal sectors and health insurance is absent, this COVID-19 shutdown places the people in these slums and low to middle income families at serious financial, mental and social risk.
Within Bangladesh is an especially vulnerable group: the more than one million Rohingya refugees who have fled Myanmar. They suffer from many disadvantages in the camps: highly congested accommodation, lack of social distancing, lack of awareness about the effects of COVID-19, insufficient access to lifesaving medicines, lack of advanced health care facilities and limited access to personal hygiene products.
The severity of COVID-19 is adversely affecting the lives of the Bangladeshi people, exacerbating their existing crisis and putting the lives of Rohingya refugees at greater danger. Local governments and humanitarian organizations should focus on these vulnerable groups of people to help them face this pandemic threat and to support them in regaining their physical and mental health along with their socioeconomic status.
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