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COVID-19: Bangladesh’s Health system suffocated by lack of oxygen

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Oxygen is one of the most essential factors in the treatment of coronavirus, and yet this very basic element is short in supply. As the pandemic spreads across Bangladesh, the crisis of hospitals, hospital beds, ventilators and other medical requirements becomes more acute. Added to this predicament is the shortage of oxygen supply.

This crisis has silently crept up on the country and now oxygen costing Tk 29 cannot be procured for even Tk 26,000. Oxygen producers and sellers have revealed this shortage of supply.

Linde Bangladesh Limited has the capacity to commercially produce and sell 100 tonnes of oxygen daily. It supplies this gas to steel, food, packaging and beverage industries as well as to the health sector.

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On an individual level, Linde has both a rental system as well as sales. Under the rental system, a cylinder is rented out for only Tk 29. A refundable deposit of Tk 26,000 is to be made and each refill of the cylinder costs Tk 100. However, with the escalating demand for oxygen due to the coronavirus outbreak, the rental service has almost come to a halt. Only in dire emergencies are cylinders given on rent, and not more than one cylinder at a time.

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Linde is having a hard time with its sales too. Under its sales system, a full set cylinder is sold for Tk 26,815. But with a shortage of cylinders, this service has dwindled too. An official of the company revealed that each cylinder with a 1.5 cubic meter capacity can supply a patient with oxygen for 11 hours. However, if the patient’s condition is serious, the oxygen can finish in 6 or 7 hours.  The Tk 100 refill is often not available due to the high demand during the pandemic.

The German company Linde acquired Bangladesh Oxygen Limited and then BOL became Linde Bangladesh. On its website Linde Bangladesh states it has 15,000 cylinders to total. Sources within the company say that there are more cylinders, but the demand is much higher. They will not be able to supply full set cylinders before 15 June.

This is a crisis on both an individual and a hospital level. There are 9 hospitals so far selected for coronavirus treatment in Dhaka. All these hospital require oxygen for the coronavirus patients.

An official of Linde Bangladesh has said that there is no shortfall in the production of oxygen. The problem lies in the infrastructure. When asked if the infrastructure was inadequate, he replied that was a matter for the government and the hospital authorities to determine.

In the meantime, Abul Khair Steel Mills produces 260 tonnes of oxygen daily for industrial purposes. The entire amount is used in the industry. However, the company has signed an agreement with the government’s department of health and will supply oxygen to meet the increased demand created due to the coronavirus outbreak. A helpline has been started up for oxygen supply. On 12 May the company provided 10 oxygen cylinders to the Bangladesh Institute of Tropical and Infectious Diseases in Faujdarhat, Chattogram.

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Then on 13 May the company provided 10 cylinders, each of 1.4 cubic metres capacity, and on 14 May, 20 cylinders of the same capacity, to various places in Chattogram. An official of Abul Khair Steel Mills said that they planned to provide oxygen to all hospitals around the country where coronavirus cases were being treated. It will initially provide 200 cylinders and also refill all the empty cylinders in the hospitals.

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Founder and trustee of Gonoshashthya Kendra Dr Zafrullah Chowdhury has said that this shortage of oxygen during the coronavirus pandemic was an extreme failing of the country’s health system. He said when everybody was making a noise about the shortage of ventilators, from the very start he had emphasised the need to first ensure an adequate supply of oxygen. He said that the hospitals had such weak infrastructures, that is was not surprising that there was a short supply of oxygen.

This pioneer of the people’s health movement went on to say that only a certain number of coronavirus patients required to be put on the ventilator. But a much larger number of patients who were in general wards, not ICU, also needed to be administered oxygen. They had breathing difficulties which were exacerbated by fear. But the inadequate supply of oxygen simply increased the risks.

Public health expert Dr Nasir Uddin said this was simply a blatant lack of preparation. He said that in December it was obvious that an epidemic was approaching. There were warnings from all over. But the health department failed to take timely leadership. Persons coming from abroad were allowed to go about freely. Frontline professionals were not trained. Their protection wasn’t ensured. And there are the infrastructural weaknesses too, as proven by the shortage of oxygen. The big hospitals could have been fitted with large oxygen tanks for a central supply system. Smaller cylinders could have been imported. “We will have to pay the price for this negligence,” he said.