Reshuffle slows Covid-19 response

As the government brings changes at the DGHS top end to improve the image of the health sector, tension among officials is apparently causing sluggishness in Covid-19 response and hampering daily activities of the directorate.

Many DGHS officials said some high-ups at the directorate were obsessed with "what was going to happen", "where they would be positioned", and were not completely focused on the job in hand.

Director General of the DGHS Prof Abul Kalam Azad resigned on Tuesday following a blame game between the DGHS and the ministry over signing a deal with Regent Hospital. He mentioned deteriorating health as reason for quitting.

The health ministry yesterday appointed Abul Bashar Mohammad Khurshid Alam, a professor of Dhaka Medical College Hospital, as the new DG of DGHS.

Yesterday, the health ministry also named Farid Hossain Miah, the current programme manager of National Tuberculosis Control Programme of DGHS, as the new director (hospitals and clinics) of the Directorate General of Health Service (DGHS).

He replaced Aminul Hasan, who was made Officer on Special Duty (OSD), on Wednesday.

According to insiders, there would be more changes in the DGHS soon and at least two more directors were likely to be shown the door within days.

"Obviously there is a deep but silent worry among different line directors. So, all activities have come to a halt here," a top official involved in Covid-19 containment activities told The Daily Star seeking anonymity.

The lack of work getting done at the directorate has become all too apparent.

DAILY TESTS DECLINE

Since the beginning, different expert committees, including the National Technical Advisory Committee (NTAC), have been consistently asking for increased number of daily tests.

On June 26, the highest 18,498 samples were tested.

Since then, the number of daily tests has been declining.

On Sunday, the number declined to 10,625 -- the lowest in July -- while yesterday's number was 12,398.

This is happening when around 80 Covid-19 testing laboratories have the capacity to test 25,000 samples a day, according to the DGHS officials.

"Every day the positivity rate is increasing. In this situation, we need more tests," Prof Ridwanur Rahman, an infectious disease specialist told The Daily Star.

Officials there have cited manpower shortage, imposition of a fee for the test, and people's unwillingness to get tested as reasons for the poor number of daily tests.

There has, however, been no visible step by the DGHS to rectify these problems. Some people were appointed but not the required number.

HIGH-FLOW NASAL CANNULA

In a meeting with the NTAC on June 10, the then additional secretary of health service division Habibur Rahman assured that high-flow nasal cannula, a device to ensure adequate oxygen supply to patients, would be set up at more than 30 Covid-19 hospitals within the following two weeks.

This life-saving equipment has not been set up at any hospital even though almost a month and a half have gone by.

"They [ministry and the DGHS] could not set up high-flow nasal cannula and central oxygen supply system in all hospitals yet. This is a managerial gap. Many deaths could have been prevented," Prof Nazrul Islam, member of the NTAC, told The Daily Star.

SOP ON ZONE-BASED LOCKDOWN

According to a top DGHS official, after more than a month-long work, the final copy of the Standard Operation Procedure (SOP) of zone-based lockdown was submitted to the director general of DGHS last Saturday.

The SOP was scheduled to be published and put into effect within days.

However, this has also been halted after Prof Azad resigned.

Multiple government organisations including, PMO's a2i project, the local government ministry, health ministry, and the DGHS were involved in zone-based lockdown plan.

"Whatever happens, the first and foremost necessity is to continue with the Covid-19 activity in a full swing. The government high-ups should take action immediately, otherwise we have to suffer a lot," Prof Nazrul Islam said.

He expressed "dissatisfaction" over the inertia and anomalies in the health sector.

"It [health system] is like a machine; the activities are the result of coordination between the ministry and the health directorate. When there is a lack of this, the health system become fragile. And the current situation is the result of it," said Prof Nazrul, who served as the vice-chancellor of Bangabandhu Sheikh Mujib Medical University (BSMMU).

Experts, however, said the ministry high-ups, who were allegedly involved in recent scams, must also be held accountable to bring qualitative changes.

"It is urgent to assign skilled, efficient and honest people everywhere, especially in administrative posts," said Prof ABM Abdullah, noted medicine specialist.