MANTRAYA ANALYSIS#46: 20 JUNE 2020
‘War’ with the Pandemic: Bangladesh Grapples with Uncertainties
Bibhu Prasad Routray
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Abstract
Bangladeshi society, economy, and the health sector are being overwhelmed by the Covid-19 pandemic. The ‘lockdown’ strategy that was employed for two months has been abandoned after it failed to flatten the curve. Now the government hopes to achieve an 8.5 percent GDP growth by gradually opening up the economy. To contain the surging number of infections, Bangladesh needs to quickly mobilize considerable external assistance. In its absence, it could well face a major humanitarian crisis.
(People queue outside a Corona Virus testing centre in Dhaka in May 2017, Photo Courtesy: Reuters)
Introduction
“This is a kind of war”, said Prime Minister Sheikh Hasina in the national parliament on 14 June, on the challenges of fighting the Covid-19 pandemic and keeping the wheels of the nation’s economy running.[1] But at best, it’s a war bereft of a clear strategy against an invisible enemy. While Bangladesh is certainly not alone to have faltered and changed its goalposts several times, it seems to have reached an absolute state of desperation. With the total number of infections surging each passing day, the country could be staring at a major humanitarian crisis in the months to come.
Surging Numbers
The first case of infection was reported on 8 March. While the number of infections remained low in the initial days, mostly due to the lack of testing, it has continued to increase significantly across the country, including among the Rohingya refugee population. By 19 June, the total country-wide infections had shot up to 105535 cases with 1388 deaths. Bangladesh is 10th in the global list of worst corona virus affected countries. Over 6718 personnel of the Bangladesh police including 1828 deployed in Dhaka have been infected and 18 have died. A visiting Chinese team of experts revealed that such high rate of infection was due to the fact that the police personnel did not zip up their PPEs properly and were exposed to the virus. Among the dead also are 34 doctors and several high-profile politicians including the state minister for religious affairs Sheikh Mohammad Abdullah and former Health Minister and Awami League Presidium Member Mohammed Nasim.
Health Facilities under Stress
Bangladesh spends less than three percent of its GDP on healthcare. Decades of neglect of the health sector, has resulted in a largely non-existent capacity to handle pandemic of the present variety. The country has one of the lowest ratios of hospital beds to patients in the world. According to the World Bank, with only four beds per 10,000 population and HRH (physicians, nurses and midwives) density of 5.8, Bangladesh’s capacity to provide quality healthcare is one of the worst.
The government has allocated Taka 292 billion in the budget for financial year 2020-21 towards the health services and health education sector. Additionally, Taka 100 billion has been set aside to meet emergency requirements arising out of the pandemic in the country. This, at best, is a delayed reactive move.
Bangladesh’s testing rate for infection has remained abysmally low. According to an estimate in April, the country was testing about 2000 samples per day in 17 labs around the country. By May this had increased to about 5500, with the Health Minister promising to set up additional 16 labs. By mid-June, the testing had increased to 16,000 in 57 labs, which is still short of the 20,000 target the government had set. A part of the reason is the reliance on only PCR testing method, as the government has refused to deploy the Rapid Antigen test.
There has been a serious shortage of ICU beds. According to the Directorate General of Health Services(DGHS), by late March, there were 508 ICU beds in government hospitals and 737 ICU beds in private hospitals. By early June, 225 ICU beds had been added to the government hospitals taking the total to 733. Even this is highly inadequate. For instance, the Dhaka Medical College Hospital has only 14 ICU beds dedicated for Covid-19 patients or those showing the symptoms. The demand is for at least 100.
The total number of ventilators in the country is around 550. Due to acute shortage of doctors and trained healthcare professionals, patients are either being turned away from hospitals or are being housed in makeshift facilities without safety measures. In one such incident, Vernon Anthony Paul, a veteran pilot of Bangladesh Air Force was burnt to death in a Covid-19 isolation unit that was erected on the badminton court of a private hospital in Dhaka. For a population of more than 160 million, this could turn into a nightmarish situation. The only way Bangladesh could have dealt with the situation was to keep the number of infections low. However, that has not happened.
The Lockdown Experience
‘Lockdown’ has been the most common strategy to battle the virus across the globe. In Bangladesh, the lockdown was first imposed on 26 March, when the number of reported infections was only 44. It was extended several times till 28 May, when the government brought the strategy to an end. Interestingly, on 28 May, the total number of infections has shot up to 40,321 infections with 559 deaths. 24 hours before the decision to end the lockdown was taken, 2029 persons were tested positive. Public transport and public and private offices resumed on a limited scale from 31 May. Domestic flights resumed operations and banks opened all their branches with restrictions from 1 June and 31 May respectively. The decision was criticized by some members of the government’s own eight-member heath expert panel that ‘withdrawal of the shutdown would increase the risk of further spread, and country is heading in a terrible direction’.
The surge in the number of the infections is a clear pointer to the fact that Dhaka’s management of the complete lockdown was unsuccessful. Ingress and egress of people into several cities of the country including national capital Dhaka had continued, especially during the Eid celebrations. The export-oriented factories had partially resumed operations in April. The health panel had recommended that the government imposes a curfew before and after the Eid celebrations to contain infections. The advice was ignored, leading a member to say, “What can we do if the government doesn’t pay heed to our advice?”
At one level, Dhaka’s decision to end the lockdown when the number of infections was surging was baffling. On the other, it was a clear sign of desperation by the government, like many of its counterparts in the South Asian region and the world, who are apprehensive of the negative impact of a prolonged lockdown on the state of economy.
Impact on the Economy
The Pandemic has had an enormous damaging impact on Bangladesh’s garment sector. The country is the second largest garment exporter in the world after China. Bulk of its orders are for European and American markets. Those orders have simply vanished as the virus wept through Europe and the US. Shutting down of factories and cancellation of orders has put nearly four million jobs at risk.
The World Bank has predicted that Bangladesh’s GDP is likely to slump to 1.6 percent in the current fiscal year. The Asian Development Bank (ADB), on the other hand, has predicted that Bangladesh’s GDP ‘is expected to grow by 4.5 per cent in fiscal year 2020 and 7.5 per cent in fiscal year 2021’. The government of Bangladesh, however, has set a target of 8.2 percent GDP growth rate for the fiscal year 2020-21. By all means, the goal is not only ambitious, but almost impossible to achieve.
On 29 May, the International Monetary Fund approved US$732 million emergency assistance for Bangladesh under the Rapid Credit Facility and the Rapid Financing Instrument, to address the urgent balance-of-payments and fiscal needs. A week earlier, the Asian Infrastructure Investment Bank (AIIB) had approved a US$250 million loan, co-financed by the ADB to support Bangladesh’s budget to help the country’s most vulnerable. Weaker domestic demand and a sharp decline in exports and remittances, have put enormous stress on the country’s economy. In the short term, it has resulted in massive unemployment. In the medium and long term, the country’s poverty reduction achievements are bound to come under stress. The rate of poverty may in fact double to 40.9 percent. A study conducted by a group of Bangladeshi NGOs revealed that ‘every three out of five people in the country are at high risk of facing economic and health vulnerabilities’[2].
External Assistance
In the first week of April, as the number of infections reached 218, Chinese Foreign Minister Wang Yi called up his Bangladeshi counterpart AK Abdul Momen and the two leaders discussed the situation in the wake of the virus. Prior to this, China had sent a batch of medical supplies to Bangladesh. On Mr. Momen’s request, on 8 June, a team of ten Chinese medical experts comprising specialists in public health, infectious diseases, intensive care, and respiratory diseases reached Dhaka from Haikou, south China’s Hainan Province, to work in Bangladesh for 15 days and exchange experiences with their local counterparts and provide guidance for medics on the prevention, control, diagnosis and treatment of Covid-19.
Between March and May, India provided three consignments of medical supplies consisting of 30,000 surgical masks and 15,000 caps, 50,000 sterile surgical latex gloves and 1,00,000 Hydroxychloroquine medicine tablets and 30,000 COVID-19 test kits to Bangladesh. On 25 May, Indian Prime Minister Narendra Modi had a telephone conversation with Sheikh Hasina and discussed the pandemic situation among others. On the question whether Bangladesh is benefiting from the rivalry between India and China, Deputy Foreign Minister Shahriar Alam has said despite the “politics” between India and China, Bangladesh was open to help that it needed from both.[3]
The country’s actual requirement, however, far exceeds what it has received. According to preliminary estimates, Bangladesh needs at least US$250 million for clinical equipment, testing, and contact tracing, just to respond to the initial impact. This amount has to be mobilized with external support.
The Next Global Hotspot?
Managing social distancing was never going to be easy in a densely populated country like Bangladesh. Worse still, the lack of health infrastructure and a lackadaisical policy have made the situation unmanageable. Testing for infections still remains low and may not reach the target of 20,000 with rising infections all across the country. It is being predicted that the country could emerge as a global hotspot of Covid-19 infection. To prevent such a scenario, clear domestic policies will have to formulated. Bangladesh needs to mobilize a significant amount of external financial as well as logistical assistance. At a time, when large number of countries are vying for such assistance, will Bangladesh succeed in its attempt remains a big question. And how would the country’s economy manage the burden of mounting debt after the pandemic passes, is another.
End Notes
[1] “Protecting people, keeping economy moving is ‘war’”, Daily Star, 15 June 2020, https://www.thedailystar.net/frontpage/news/protecting-people-keeping-economy-moving-war-1914537. Accessed on 15 June 2020.
[2] “Coronavirus: Economy down, poverty up in Bangladesh”, Dow Jones, 10 June 2020, https://www.dw.com/en/coronavirus-economy-down-poverty-up-in-bangladesh/a-53759686. Accessed on 16 June 2020.
[3] Suhasini Haidar, “Aid offers from India, China galore”, The Hindu, 14 June 2020, https://www.thehindu.com/news/national/aid-offers-from-india-china-galore/article31828030.ece. Accessed on 15 June 2020.
(Dr. Bibhu Prasad Routray is Director of Mantraya. This analysis has been published under the ‘Fragility, Conflict and Peace Building’ and ‘China in South Asia’ projects. Project intern Dhanyaswaroopa Deb contributed to the analysis. All Mantraya publications are peer reviewed.)
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