The article was published in Daily Star and Dhaka tribune authored by Dr. Md. Tariqul Islam, Director-Hospital, SAJIDA Foundation

By end of February 2020, it was very clear that the pandemic will hit the country
hard. SAJIDA’s programs immediately shifted gears to align their activities with national efforts to combat COVID-19. Preparations started to convert SAJIDA’s 50-bed Hospital at Narayanganj into a dedicated COVID-19 hospital under an MoU signed with Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare, Government of Bangladesh on 21st March 2020.

Preparation for patient surge

With experts predicting that many facilities in the healthcare system will be overwhelmed with COVID-19 cases, SAJIDA Foundation undertook a gap analysis and operationalized a plan to provide completely free of cost healthcare service to people in need.

Enhancing infrastructure capacity – SAJIDA with support from Renata Ltd. invested over BDT 2.5 crore /BDT 25 million in March 2020, to enhance available equipment and facilities to serve COVID-19 patients. A four-bed intensive care unit, ventilator, dialysis machine, and 46 bed general ward was setup in the 15,000 square feet premise.

Enhancing technical expertise of frontline healthcare professionals – To ensure uninterrupted service, the hospital deployed 102 staff including 18 doctors, 21 nurses, 5 medical technologists, electro medical engineers, support staff, management staff and an expert team for operating ICU and Dialysis units. 75 staff members received training from DGHS before deployment.

SAJIDA additionally introduced a quality control team consisting of healthcare workers and a microbiologist to ensure highest standards of safety. Strict disinfection protocols and procedures have been put in place to avoid transmission of infection across the board.

Redesigning hospital layout – The hospital management built a triage tent as a safeguarding measure to screen suspected patients. Additionally, structural changes were made within the hospital for creating separate walkways for suspected patients and healthcare workers. Remote observation room with video cameras has also been setup next to the ICU unit to enable regular monitoring of COVID-19 patients.

Protecting frontline healthcare workers

As coronavirus cases surged, the nation’s healthcare workers faced tremendous risk. Healthcare workers served patients round the clock with little knowledge on how to tackle this crisis. Considering the risks involved, the management introduced a set of initiatives to ensure a conducive working environment including generous expenditure in procurement of PPE and arranging other safety measures for the hospital staff.

In some cities around the world, healthcare workers are earning standing ovations for the long, life-risking hours they are putting in. Unfortunately, in Bangladesh most have been facing discrimination and even attacks. SAJIDA Foundation took steps to protect its healthcare workers from such harassment and arranged accommodation, daily necessities, and transportation facilities.

SAJIDA organizes weekly training for all hospital staff. Local clinical experts and consultants are participating through remote tools and providing in-depth analysis on relevant case studies to ensure that hospital staff are up to date regarding COVID-19 treatment protocols.

“Ensuring safety and security of our frontline healthcare staff has been among our top priorities. We are being extremely cautious within the hospital, but we have to be responsible outside as well” – Dr. Md. Tariqul Islam, Director, Health, SAJIDA Foundation.

Current care and treatment of patients

The hospital has been providing services free of cost to all COVID-19 patients since March 2020. BDT 15.54 crore / BDT 155.4 million has been spent from SAJIDA Foundation’s own funds, corporate support, and individual contribution to cover the treatment cost of COVID-19 patient and operating cost of the hospital.
.It is to be noted that SAJIDA did not take any funds from the Government of Bangladesh to cover operating and patient treatment cost. The treatment package covers the cost of medicine, oxygen, diagnostic test, bed/cabin rent, ICU, dialysis, ambulance, food etc. To enhance a patient’s overall wellbeing, hospital management appointed nutritionists to ensure that the diet is tailored to a patient’s need.

“My mother was having breathing problem, but she could not express it properly. We had gone to the most renowned medicine doctors, private hospitals, and Government Hospital of Chandpur District. None could give the support we needed for our mother. Our relative from Narayanganj who was very confident about the service at SAJIDA Hospital recommended us to take her there. We saw a glimmer of hope and instantly took her there. She was admitted in the ICU for a week. The doctors and nurses there have given their 100% continuously. Our family is forever indebted to SAJIDA Hospital for helping my mother’s recover.” – Bishajit Saha, son of Borna Shaha.

During a patient’s stay, the hospital’s doctors and nurses regularly provide health update to the patient’s family members through daily phone calls. SAJIDA’s hospital staff regularly follow-up with patients over phone even after they have been discharged to ensure wellbeing.

SAJIDA has also introduced a remote consultation helpline, ‘Doctor 24X7’ which is manned by a pool of nine registered doctors around the clock. 4,069 consultations have been provided through this service. An online symptom checker supported by a Facebook chatbot was developed and introduced in collaboration with Renata Pharmaceutical and Appinion Bd Limited. The service has been accessed by 10,711 individuals in the last seven months.

Patient inflow pattern

SAJIDA Narayanganj Hospital has treated patients from all over Bangladesh: eight divisions and 39 districts. Technical expertise and quality of patient care have been the key drivers for patients to seek service at SAJIDA Hospital, Narayanganj.

Working with responsible partners to further enhance hospital services

SAJIDA Foundation has been working with national and international partners including Standard Chartered Bank, Community Bank, Kazi Farms, CVC Finance, Epyllion Group, Unilever, Bill & Melinda Gates Foundation, MetLife Foundation, Give2Asia and numerous other supporters to further enhance hospital infrastructure and extend high-quality care for patients.

Through these partnerships, SAJIDA upgraded 44 general ward bed into semi-critical units: 37 beds with a dedicated oxygen concentrator, cardiac monitors, Bi-PAP machines and 7 beds with central oxygen line along with other equipment.

Way Forward

Preparedness is the key to addressing any health crisis. Globally, countries are reopening their economy and experiencing a second wave of COVID-19 transmission. With a view to tackle a second potential surge, SAJIDA plans to operationalise the following in conjunction with its existing initiatives:

Shifting COVID-19 treatment facility from Narayanganj to Keraniganj: Upon expiry of the MOU on December 31, 2020, the SAJIDA Hospital, Narayanganj will stop admission of patients and close its services on January 15, 2021. From January 16, 2021, SAJIDA will start shifting its COVID-19 facility (HR, equipment) from Narayanganj to its 100-bed hospital in Keraniganj to continue treating COVID-19 patients and to comply with a GOB circular which requires hospitals with 50+ bed capacity to be equipped with a COVID treatment unit. The COVID treatment unit at SAJIDA Hospital, Keraniganj will have 22 semi-critical beds and a 6-bed ICU.

Diagnostic facility jointly with Renata: SAJIDA in collaboration with Renata is setting up a diagnostic and COVID-19 testing center in Gazipur. Potential clients will be able to avail services either by visiting the facility or through home collection teams which will be deployed by SAJIDA.

Smart card-based healthcare service program: SAJIDA is successfully implementing a smart card-based health voucher schemes in partnership with Feni & Chandpur Municipality Corporation. The scheme enables low-income, vulnerable households to access free primary healthcare including medicine, nutrition, and family planning services through a network of empanelled doctors, clinics, hospitals, and diagnostic service facility. SAJIDA will expand this programme in other parts of the country.

Telemedicine program: A telemedicine platform can be an effective channel to enable consultation with specialised doctors from anywhere in Bangladesh. SAJIDA has developed a telemedicine platform in partnership with Appinion Bd Limited. The platform will be piloted with pharmacists, visiting doctors, SAJIDA hospitals, and other existing networks to serve healthcare seekers across the country.

Capacity building of secondary and tertiary care service providers: Analysing secondary data and patient inflow pattern at SAJIDA hospital, it is evident that accessing quality healthcare services in peri urban and rural areas is challenging. Going forwards, SAJIDA will aim to address technical, infrastructure and capacity gaps of these healthcare service providers by leveraging its own healthcare professionals who have vast experience in secondary & tertiary care and frontline experience in addressing the COVID-19 crisis.

SAJIDA’s healthcare professionals will also play a key role in setting up ‘smart health clinics’ which will employ the latest technology and medicine to serve clients in peri urban and rural communities.