Salma Akter Sharmin: Amid a nationwide measles outbreak, concerns are mounting over continued transmission inside hospitals and homes, as shortages of beds and inadequate isolation facilities are forcing infected and uninfected children to share wards, leading to new infections. Health experts say measles, caused by a highly contagious virus, can infect 12 to 18 unvaccinated people through a single infected case.

According to the Directorate General of Health Services (DGHS), one death from measles was reported in the last 24 hours, while four more suspected deaths were recorded during the same period. A total of 1,170 new suspected cases were identified in the last 24 hours.

From March 15 to April 23 (8:00am), suspected cases have reached 28,334, of which 4,059 have been confirmed as measles. So far, 18,845 patients have been hospitalized with suspected and confirmed infections, while 15,728 have recovered and been discharged. Since the outbreak began, 39 confirmed deaths and 194 suspected deaths have been reported.

Data from Dhaka North City Corporation (DNCC) Hospital shows that 426 patients received outpatient care in the last 24 hours, while 100 were admitted. A total of 436 patients are currently undergoing treatment at the facility. One death was reported in the last 24 hours, bringing the total number of deaths at the hospital to 12. So far, 2,107 patients have been admitted there.

Hospitals, including the Infectious Diseases Hospital in Mohakhali and other public and private facilities, are currently facing severe bed shortages. As a result, patients with highly contagious diseases such as measles and chickenpox are being treated in shared wards, contributing to hospital-based transmission, with new infections emerging among already admitted children.

A similar case has been reported in Chapainawabganj, where a one-and-a-half-year-old girl, Tahmina, was initially admitted with fever and later diagnosed with pneumonia. Her family said she developed measles symptoms after being exposed to infected patients in the same ward. Her condition deteriorated, and she was referred to Rajshahi Medical College Hospital and later to Dhaka Shishu Hospital. However, due to a lack of available beds, she is currently receiving treatment at DNCC Hospital.

Public health expert and vaccine specialist Dr. Md. Tajul Islam Bari said measles patients must be strictly isolated. “Whether in hospital or at home, isolation is mandatory. If patient numbers are high, additional beds or even temporary arrangements such as tents should be used,” he said, adding that failure to isolate patients accelerates transmission.

Doctors at DNCC Hospital said transmission from one patient to another within healthcare facilities is known as cross-infection. They added that infections are also spreading rapidly within families, creating what they described as a chain of transmission.

Dr. Shreebas Pal, consultant at the Infectious Diseases Hospital in Mohakhali, said measles, chickenpox, and mumps are all highly contagious diseases. Due to heavy patient loads, maintaining proper isolation is often not possible, leading to rapid spread of infection. He added that around 10 percent of patients admitted for other conditions are found to have contracted measles during treatment.

In response to the worsening situation, the Health Services Division has instructed all public hospitals to increase bed capacity. In a directive issued on Thursday (April 23), signed by Dr. Abu Hossain Md. Moinul Ahsan, Director (Hospitals and Clinics) of the DGHS, hospitals were instructed not to turn away any measles or suspected measles patients due to lack of beds. Instead, hospitals have been directed to arrange additional beds or alternative facilities where necessary.

DHAKA – Ten more people have died of suspected measles in the country in the last 24 hours, according to the control center of the Directorate General of Health Services (DGHS). In a press release today, it said that in the last 24 hours, 1,248 new suspected measles patients have been identified across the country and 189 laboratory-confirmed patients have been found.

According to the release, from March 15 to April 8, the total number of confirmed measles patients was 1,599 and the number of suspected measles cases was 11,133. DGHS has so far confirmed a total of 21 deaths as measles-related and 138 people have died of suspected measles during the same period, it added.

During this period, the highest number of suspected measles cases was reported in Dhaka Division, where 4,667 people were infected. Of these, 991 people were confirmed to have measles.

The DGHS is continuously monitoring the situation and is regularly collecting and analyzing information through the Integrated Control Center. In addition to ensuring necessary medical care for patients, the people have been advised to remain vigilant.

For many in Bangladesh, the country’s strained health system is not an abstract policy issue but a daily reality measured in long waits, rising bills, and difficult choices between treatment and survival. The COVID-19 pandemic exposed these weaknesses sharply, yet little has changed since. Shortages of doctors and nurses, low budget allocation, mismanagement, and soaring treatment and medicine costs continue to weigh heavily on patients and families.

Experts say the system lacks a comprehensive master plan and remains overly centralized, leaving rural and district-level facilities under-resourced and overcrowded. Decentralization, they argue, is key to making healthcare accessible to ordinary people.

In Bangladesh, health sector allocation remains below 1% of GDP, with most of it spent on salaries and allowances. Although the World Health Organization recommends at least 5%, that benchmark has not been achieved. During the interim government period, the sector saw little visible progress. The BNP’s election manifesto included a pledge to allocate 5% of GDP to health, though experts say implementation will be difficult.

Health Secretary Kamruzzaman Chowdhury said the government plans to spend 5% of GDP on the sector, focusing on infrastructure development and modernization to improve services and build a healthier nation. The Health Sector Reform Commission has recommended allocating at least 15% of the national budget to health. However, only 5.3% has been allocated in the 2025–26 fiscal year.

Public health expert Dr. Lelin Chowdhury said that although the allocation is low, even the existing resources are not being effectively utilized. He said the health ministry and its directorates lack the capacity to manage funds efficiently and need restructuring, though no initiative is visible.

For patients, the imbalance between demand and available healthcare providers is most visible at hospitals and clinics. Bangladesh has only 0.83 doctors per 1,000 people, with around 90,000 practicing physicians. Nursing shortages are even more severe: against a need of 310,500 nurses, only 56,734 are currently employed—just 28% of the requirement.

This shortage means longer waiting times, hurried consultations, and overworked medical staff. In many rural and upazila-level facilities, patients often find no choice but to travel to private hospitals or delay treatment altogether.

Each doctor ends up seeing far more patients than recommended, while limited nursing support affects patient care and recovery. The situation contributes to declining service quality and growing frustration among patients. The government has announced plans to recruit doctors, nurses, and technicians in phases. Health Minister Sardar Md. Sakhawat Hossain said the shortages will be addressed gradually through large-scale hiring.

Dr Lelin Chowdhury noted that the country has about 172,000 hospital beds, with roughly 100,000 in the private sector and 72,000 in the public sector. He said oversight capacity is limited, particularly in monitoring private facilities, and there is no dedicated system to ensure quality standards. He added that serving a population of 180 million requires a comprehensive plan and better distribution of services.

For many families, the biggest burden is not just access to care but the cost of it. A study by the Health Economics Unit shows that individuals bear the majority of healthcare expenses. In 2018, 2019, and 2020, out-of-pocket spending accounted for 64%, 66%, and 69% of total health expenditure, respectively, while government spending remained much lower.

More than 8.6 million people fall below the poverty line each year due to medical expenses, with medicines alone accounting for 64.6% of total spending.

A 2020 study found that individuals bear 68.5% of total healthcare costs themselves. A Bangladesh Institute of Development Studies (BIDS) report published in July 2024 showed that out of every Tk100 spent on healthcare, patients pay Tk73—54.40% on medicines, 27.52% on diagnostics, 10.31% on doctors, and 7.77% on transportation.

Latest estimates from the World Health Organization and the World Bank indicate that 44% of households face financial hardship due to healthcare costs. Public health expert Professor Dr Be-Nazir Ahmed said many people are forced to forgo treatment, deplete savings, take on debt, or sell assets to afford care. “The burden falls most heavily on the poor,” he noted.

Lelin Chowdhury said tertiary care services remain concentrated in Dhaka and major cities, leaving district-level populations underserved. He stressed that decentralization is necessary to reduce pressure on urban hospitals and improve access to advanced care closer to home.

The Health Sector Reform Commission, formed by the 2024-2026 interim government, submitted 32 recommendations aimed at short- and medium-term improvements, including structural reforms, digital health systems, increased funding, universal health coverage, protection of healthcare workers, and better medicine management.

Commission chief Dr. A.K. Azad Khan said the responsibility of the commission was to recommend reforms, while implementation lies with the government. Public health expert Dr. Mushtaq Hossain said the recommendations have largely not been acted upon. He added that even a monitoring committee was not formed to oversee reforms, and little attention has been given by the current government as well.

For patients and families navigating this system, the gap between policy discussions and everyday realities remains stark—reflected in overcrowded wards, rising bills, and the ongoing question of who will truly take responsibility for a health sector under strain.

DHAKA  – Prime Minister Tarique Rahman today visited his political adviser and BNP Standing Committee Member Mirza Abbas Uddin Ahmed, who is currently undergoing treatment at Evercare Hospital in the city.

“The premier reached the hospital at 2:20 pm. He spent some time beside Mirza Abbas’s bed and inquired about his overall health condition,” Prime Minister’s Press Secretary Saleh Shibly told BSS this afternoon.

During the visit, he said, the Prime Minister instructed the concerned authorities to take swift measures for Mirza Abbas’s treatment in Singapore. Afroza Abbas, wife of Mirza Abbas and President of the Jatiyatabadi Mohila Dal, and concerned physicians were present during the visit.

Earlier in the day, the BNP said that an air ambulance from Evercare Hospital would carry Mirza Abbas to Singapore at 6:00 pm today for advanced treatment. He is expected to be admitted to the Department of Neuroscience at the National University Hospital in Singapore.

Mirza Abbas fell ill suddenly on Wednesday evening while drinking water during iftar and lost consciousness. As his condition did not improve, he was admitted to Evercare Hospital late that night. Afroza Abbas sought prayers from the people of the country for her husband’s speedy recovery.