Widespread irregularities and corruption in the government adopted initiatives in tackling COVID19-led challenges have deeply affected the healthcare system of Bangladesh, thus contributing to a growing crisis of public confidence in the wake of likely 2nd wave of spread, a recent study by Transparency International Bangladesh has found.
According to the study titled Governance Challenges in Tackling Corona Virus (Part II), follow-up research of a study previously released, the crisis has not only exposed the deep-rooted corruption in the health sector but also new scopes for corruption have been created circling the crisis at the same time. Besides, the study observed that low virus detection through controlling policy and mechanisms is being touted as a political achievement – portraying it as "pandemic control." Although Corona Virus transmission has recently been decreasing to some extent in Bangladesh, it continues to be a big health hazard. The numbers partly reduced mainly due to Govt. imposed restraining policy of limiting the number of detection tests.
Since the detection of the first COVID-19 patient in Bangladesh on 8 March 2020, the country currently ranks 20th globally in terms of the total number of affected. The study also identified ongoing corruption-friendly tendencies during the pandemic, i.e. theft from relief and incentive programmes depriving the actual beneficiaries, hiding irregularities, corruption and mismanagement by restricting disclosure of information; taking bureaucratic decisions ignoring specialist opinions in tackling challenges, etc. According to the study, there are no testing facilities in 35 districts of the country yet. So far, 113 labs across the country have been designated for the virus test, but 38 of them have not run any tests since 2 August.
The study findings were shared in a virtual press conference by TI Bangladesh on 10 November 2020. The anti-graft watchdog also placed 15-points recommendations to tackle the crisis and strengthen good governance, stressing on a coordinated action plan in combating the likely 2nd wave of the pandemic.
In the Press conference, it was revealed that TIB carried out this study as a second phase of the research work that was conducted to identify challenges of good governance in various activities undertaken by the government during the first three months of Corona Virus spread released on 15 June 2020. This 2nd part of the study is being conducted as a follow-up to monitor the progress of various indicators of governance in the post-June 15 period up to 31 October 2020.
In the press conference, TIB Executive Director Dr. Iftekharuzzaman, Adviser-Executive Management Professor Dr. Sumaiya Khair and Director-Research & Policy (R&P) Mohammad Rafiqul Hassan were present. TIB Director-Outreach and Communication (O&C) Sheikh Manjur-E-Alam conducted the virtual event. Deputy Programme Manager (DPM)-R&P Md. Julkarnayeen presented the study findings at the event, accompanied by research supervisor Senior Programme Manager-R&P Shahzada M Akram. Other researchers of the study team were DPM Mohammad Nure Alam, DPM Morsheda Akter, Programme Manager (PM) Taslima Akter and PM Manzoor-E-Khoda of R&P.
Researchers conducted the study using mixed methods with three types of survey on healthcare services and social safety net programmes, polling 3131 people, including health service recipients, beneficiaries of social safety Net programmes and health service providers. The data was collected between June 16 and October 31, 2020.
According to the study, health workers in most hospitals did not get PPE with WHO standards. Although the government claims that there is no crisis of isolated bed and ICU beds for COVID patients, the survey shows that 5.4, 32.4, and 30.2 per cent of the service recipients across different divisions of the country did not get oxygen cylinder, ventilator support and ICU beds respectively. In addition, 9.9 per cent of the healthcare service recipients received false reports from the laboratory, and 8.7 per cent of the patients died because they did not receive healthcare on time in the health centres. Medical personnel at most health facilities were not provided with the safety equipment as per World Health Organization (WHO) standards. Ordinary surgical masks were provided instead of N-95 or KN-95 masks to 48.6% of hospitals. Furthermore, all of the hospitals had vacant positions for doctors, while 89.1 per cent had empty positions for nurses.
The study found that a few syndicates were controlling all procurements in the health sector — allegedly involving some health ministry officials, DGHS, Central Medical Storage Depot, Anti-Corruption Commission, and some senior officials of different hospitals.
Citing research findings, Dr. Iftekharuzzaman said, “There have been massive deficiencies in every governance indicator for the government adopted initiatives at both national and local level in tackling Corona Virus. Most of those deficiencies and violations are man-made. Taking advantage of both the Corona crisis and the crisis that put the health sector under pressure, corrupt individuals, influential people and beneficiaries of corruption have joined in the grand festival of corruption. As a result, widespread corruption has taken place and is still ongoing. So far, we have only seen some officials transferred or made OSD [Officer on Special Duty] after serious allegations of corruption were brought against them. Although the ACC has been active to some extent, it seems as if they have been roaming within their self-set boundaries. As a result, the so-called godfathers of corruption have remained out of reach. Only a few people in the front row have been dragged out."
Due to corruption and irregularities, the survey has identified that 12% of the beneficiaries of cash aid and 10% of Open Market Sales (OMS) cards were victimised while getting listed. An average of Tk220 was paid as a bribe to be listed for government relief, and in the case of cash incentives, 56% of recipients were victims of irregularities and corruption. 18.9 per cent had to pay a bribe to get on the list, while 36.1 per cent had to request an influential local figure to refer them for the list. About three lakh beneficiaries have been named more than once for aid. Three thousand government employees and 7,000 pensioners were included on the relief list. In addition, over 100 people said they had to prove their political identity to get on the list. Of the people involved in corruption, the local MP, chairman, member, councillor or mayor were found to be involved in an overwhelming majority of the cases.
The study also observed that no public employee had received the government-announced compensation so far except the first doctor who died from Covid-19. A tendency to serve personal interests through irregularities in relief and incentive programs persists, depriving the affected families at the field level. The report has further observed that the expansion of private testing facilities and urban-centric government-run laboratories exposed the fees for tests, depriving poor people and putting them at risk of harassment and corruption.
According to the study, most of the committees formed by the government to deal with the Covid-19 situation in Bangladesh are now ineffective. “When corruption in the health sector has widely been discussed and emerged as one of the most important issues at the national level, the Parliamentary Standing Committee on Health did not even hold a meeting during this period,” said Dr. Zaman. Expressing concerns over govt. adopted restraining policy that led to controlling relevant initiatives and information during the crisis, Dr. Zaman said, “As a result, data has been regulated, tests have been regulated, and public access to health care has decreased. The government was more active in controlling the disclosure of information than controlling corruption. Which is very worrying and in conflict with our constitution.”
"Despite warnings from the top echelons of the government about the likely second wave of transmission in winter, we do not see any specific policy or strategy to deal with the second wave of infection without some scattered announcements,” concluded Dr. Zaman.
The study came up with 15 recommendation points, including health sector procurement in e-Government procurement (e-GP); the expansion of testing facilities in all districts, formulation of specific plans with proper coordination of experts for tackling the probable second wave of Corona Virus transmission; adequate management of medical waste with additional training; extension of free sample testing facilities to all districts; coordination among implementing agencies; ensuring free flow of information including media on public procurement abolishing restrictions on disclosure of information; the utilisation of private hospital services through specific plans; the implementation of expert committee recommendations, and the proper implementation of incentives packages.