Bangladesh COVID-19 tests hampered by scarcity of medical technologists

As the coronavirus pandemic rages on across the world, health experts have been quick to stress the importance of adequate testing for the disease in shaping a country's containment strategy.

In Bangladesh, however, the efforts to test samples for potential COVID-19 cases have been hamstrung by a marked shortage of medical technologists.

With the number of coronavirus cases and deaths spiralling in recent weeks, the Public Service Commission, at the behest of the health ministry, began the process of recruiting 2,000 doctors and more than 5,000 nurses to combat the crisis on the frontlines.

But the absence of medical technologists in the health ministry's requisition request is a cause for concern among experts.

Regular sample collection and testing is key to preventing a further outbreak of the coronavirus, according to Mustak Hossain, former chief scientific officer of IEDCR.

But the process cannot be conducted effectively without more medical technologists, said Mustak.

“It’s good that the government decided to recruit more doctors and nurses, but we need more medical technologists as well."

"We are asking for an increase in the number of tests, but who will collect the samples if there aren't enough medical technologists? This is not a task for amateurs.”

The technologists, on the other hand, claimed they are already overburdened by the work they have in hand due to a manpower shortage.

As a result, Bangladesh is still lagging in terms of sample testing compared to its neighbouring countries.

According to the World Health Organization's directives, in the battle against the coronavirus, for every doctor, there should at least be three nurses and five medical technologists. But the scenario in Bangladesh does not match up to the WHO standard.

Currently, 25,615 doctors are working under the Directorate General of Health Services, according to government data. The WHO standard would require technologists to take up 128,075 posts in the national healthcare system.

But the DGHS has only allocated 7,920 posts for medical technologists with only 5,184 currently on its roster, equating to a ratio of 0.32 medical technologists for every 10,000 people in the country.

A total of 1,417 lab technologists, who collect samples and conduct tests, are currently working despite 2,182 posts available.

Medical technologists were drafted in from different districts to serve in hospitals in Dhaka as the coronavirus outbreak worsened, according to officials of the health ministry. But this has harmed the sample collection process in the other districts.

Many people from different districts, including Narayanganj, have complained about a lack of response on the coronavirus hotlines despite their repeated calls.

Gazipur, which is a hotspot for the infection, has 17 medical technologists. This includes four in Shaheed Tajuddin Ahmad Medical College and seven in the hospital.

Each Upazila health complex has at least one medical technologist. In Tongi, a 250-bed hospital has a single technologist.

The hospital has been more or less able to manage the workload but the staff in the Upazila health complexes are struggling to cope up.

A technologist in an Upazila health complex, asking to remain anonymous, described his ordeal during the crisis. "I have to collect around 35 samples a day so I had to get two assistants to help me with the preliminary tasks such as noting down names and addresses of patients," he said.

“I feel exhausted from collecting so many samples every day. Gazipur has a big number of patients but we can’t collect the samples from all of them.”

Dilip Kumar Das, a medical technologist in Narsingdi's Palash, shared his predicament after the first cases of COVID-19 were detected in the Upazila.

"I have to collect samples and trace contacts of infected people. Initially, we were two technologists working in the Upazila but my colleague was subsequently called up to a hospital in Dhaka," he said.

“Now I'm having to go door to door to collect all the samples which I then have to take to the hospital. I am entangled in it.”

Other Upazilas in Narsingdi are in a similar bind.

A medical technologist working in a laboratory in Dhaka lauded the government's initiative to add more doctors and nurses to the frontlines while rueing the omission of technicians in the latest recruitment drive.

“According to the WHO, at least 10,000 technologists should be appointed against every 2,000 doctors. Unfortunately, we are nowhere near that ratio,” said the technologist, asking not to be named.

At present, 30,067 medical technologists are working in the country, according to the Bangladesh Medical Technologists Association (BMTA).

"Technologists are working very hard even at the risk of their lives under the current circumstances. Doctors and nurses have been quarantined after coronavirus cases were reported in hospitals but that has not been the case with technologists," said BMTA President Almas Ali Khan.

“This is because there would be no-one to test the samples if the technologists were quarantined.”

But the strain on the testing process can be eased by recruiting a few more technologists, even if they are appointed temporarily, according to Almas.

“Another 20,000 technologists can help us confront the outbreak. This is what we demand now,” he said.

In light of the ongoing crisis, the health directorate has requested the health ministry to recruit 1,200 medical technologists, said DGHS Director Md Belal Hossain.

But Additional Secretary Habibur warned against expecting an overnight influx of technologists in the healthcare system.

“We have to follow a procedure to bring someone into the government payroll. There’s a financial side to it as well. We are mulling over the recruitment of technologists but the process is yet to start,” he told bdnews24.com.

The authorities are making a list of unemployed and trainee medical technologists, according to Habibur.

Other medical workers are also being trained to collect the samples to offset the scarcity of technologists, he said, adding that the process of collecting the samples does not entail too many challenges.

“In many places, the doctors are collecting samples too. We’re also providing training to the health workers to collect samples while keeping themselves protected.”