Unauthorised, uncontrolled

Alamgir Hossain was fixing pieces of elastic thread to surgical masks using a heat pressing device inside a barely hundred square feet room in the Balurmath area of Kamrangirchar.

The way the 35-year-old was going about his job inside that dingy room was anything but hygienic -- he was not wearing any gloves or mask. His wife and their two children, also without any protective gear, were seen putting the finished products inside a sack.

Masks kept falling off from the table onto the grubby floor. Open bundles of masks were scattered around, lying next to used kitchen utensils and other household items, in the cramped room where the family also lives.

Alamgir got a contract to attach the elastic thread to masks from a factory.

"The factory supplied the elastic thread and the mask fabric. I will get Tk 0.20 per mask. I earn Tk 500 every day by doing this," said Alamgir, who started the business after losing his job as an assistant operator at a tailor shop due to the coronavirus pandemic.

Asked about maintaining hygiene, he said, "Why do I have to follow health and safety here? I didn't set up any factory. I just work as a contractor after getting an order from the factory."

Many like him are involved in the production of non-woven surgical masks in Kamrangirchar, Keraniganj, Gazipur, Narayanganj, and Savar areas. In the wake of growing cases of coronavirus patients in winter, the demand for masks is on the rise again.

These masks are supplied to the local market from where wholesale buyers purchase those in bulk at cheap rates, without any packaging.

Later, they sell these masks packed in boxes with no producer's name, trademark, or other means of identification, according to people with knowledge of the booming mask business.

Healthcare experts said such face masks produced by some factories without the authorisation of the Directorate General of Drug Administration (DGDA) and marketed by greedy wholesalers is a cause for concern for public health and safety.

Prof Dr Sultana Shahana Banu, head of the virology department of Dhaka Medical College, said the use of low-quality medical equipment and masks are one of the prime reasons behind the rising number of infected cases in the country.

"Wearing these fake masks, people move around and feel a false sense of security, and that makes them susceptible to the virus."

She said the use of face masks, as an effective gear to prevent community transmission of Covid-19, increased considerably after the government announced a strictly enforced "no mask, no service" policy at public and private offices on November 2.

According to people involved in the business, surgical masks account for nearly 90 percent of the demand while other non-medical fabric masks make up the remaining 10 percent.

Authorised mask producers alleged that unhygienic production of surgical masks has put the sector at stake as the high-quality products of factories maintaining health safety measures cannot compete with the cheap low-quality masks.

"People now only look for cheap masks -- on buses, footpaths, or on the streets. They don't want to know about quality and hygiene," said Mokarram Hossain Sazzad, executive member of the Disposable Mask Association.

He said a surgical face mask was sold at Tk 10 in June-July last year. "Now, people are buying four for Tk 10."

He said the production cost per thousand masks at his factory was around Tk 1,350, but producers of low-quality masks were selling a thousand masks at only Tk 1,100.

"It's a medical product. There is no way to produce it with low-grade non-woven fabric and in an unhygienic environment," said the young businessman, adding that production at his factory has drastically fallen from one lakh to 40,000 per day now.

He claimed that he has obtained an NOC (no objection certificate) from the DGDA for producing surgical face masks.

"But there are at least 50 factories in Kamrangirchar, 20 in Keraniganj, and many others in Narayanganj and Chattogram which are not registered and don't follow any safety measures."

He said the non-woven material for surgical masks was mostly imported from China. Small factories too are now producing these masks in bulk.

MEDICAL VS NON-MEDICAL

Masks used for preventing infection are classified into two types -- medical and non-medical.

Cloth or fabric masks are considered non-medical while all other masks -- from surgical  to respiratory -- are considered medical.

According to the World Health Organisation (WHO), use of a cloth mask in a community setting is enough to stay safe from Covid-19 infection while medical masks are mandatory in a hospital setting, based on the environment.

A surgical mask is a loose-fitting, disposable device that creates a physical barrier between the mouth and nose of the wearer and potential contaminants in the immediate environment, according to the United States Food and Drug Administration (FDA).

A surgical face mask is mainly composed of three layers of non-woven fabric. On the other hand, a cloth mask is made of different weight or gsm (gram per square metre) of fabrics.

The DGDA has set out different specifications and quality control guidelines for both fabric and medical masks.

It laid out the details from materials to be used, to construction, packaging, marking and warnings to be labelled on the boxes of the face masks.

Experts say the quality of a face mask differs considering their efficiency in filtering airborne particles measuring up to 0.3microns, breathability, and fit.

In the marking section, the DGDA guideline said a face mask to be placed on the market should have information on 13 points clearly written in English and Bangla on the package -- including the producer's name, trademark, address, batch number, filtration efficiency, and wearing and disposable instructions.

Prof Be-Nazir Ahmed, former director (disease control) of the Directorate General of Health Services (DGHS), said a surgical mask is single-use. Its disposal is another problem as it is difficult for common people to correctly dispose of it.

"General people should wear a three-layer fine cotton mask, not the surgical mask. It can be used repeatedly."

He said locally made surgical masks may not protect the wearer if quality is not ensured. "It can even spread the disease rather than containing it," he added.

GROUND REALITY

Low-quality masks produced in unhygienic places are now being sold everywhere on the streets.

In Babubazar, the largest wholesale mask market in the country, masks are being sold in an open place without packaging. There are at least 150 wholesalers in the market, from where masks go out to every corner of the country.

The wholesale buyers buy packets and boxes separately without any details of the manufacturer to sell in retail as seen by a reporter of this newspaper during a visit  last week.

Traders said there are at least 10 types of masks of varying prices and quality being sold at Babubazar.

Other than two types which are imported, the rest are locally made. The masks available are non-woven surgical masks, melt blown fabric masks, Ninja masks, woven, knit and sweater fabric masks.

The traders also claimed they sell high-quality imported respiratory masks like the KN95 and N95.

Azad Rahman, who has been involved in the business in Babubazar since March, said he sells 1,00,000 masks every day.

Most of them -- around 90 percent, he estimated -- are surgical masks, adding that it was cheaper compared to other face masks.

"There is very limited profit. I bought masks for Tk 1,150 per thousand and sold it for Tk 1,200. If I give a packet, it would cost another Tk 3.50 per 50 pieces," Azad said.

It's tough to maintain health measures here on the footpath, he added.

NO DGDA AUTHORISATION

DGDA officials said they have given permission (NOC) to 23 companies across the country to produce surgical masks.

"We gave permission to local manufacturers after checking their quality control is maintained. The guidelines have been uploaded on the DGDA website. However, many factories are doing this illegally," Ayub Hossain, director of DGDA, told this newspaper.

He said they are often conducting drives and taking action against illegal mask producers and traders to control the risk of low-quality and sub-standard medical products in local markets.

"Surgical masks -- as a protective gear -- are easy to use and they are produced in large quantities. But we are authorising surgical masks [only] for medical purposes," he said.

"As a regulatory authority, we are just issuing permission [for production]. We have no use-specific guideline; those who are working on [public] health issues can suggest it," Ayub added.

Mohammad Shamsuddin, a deputy director at DGDA, said they have fined three companies in November for producing and marketing unauthorised face masks.