Debt timebomb: poor Bangladeshi households overburdened with debt to pay for dengue treatment

The parents of Arshi brought the 14-month old girl to Dhaka Shishu Hospital from Chuadanga a week ago as she was battling dengue fever. Her treatment began in a regular cabin, then in a paying bed, and eventually in a free general ward as the parents started running out of cash.

They were in real trouble when the doctors advised Arshi, who was identified with a single name, be moved to the intensive care unit.

Her father, Alamgir Hossain, could not afford the ICU expenses.

“My child has blood and heart issues. I buy her six to seven injections daily, and most of the tests are done at the hospital,” he said.

“I've spent at least Tk 45,000 so far. I run a local restaurant and will stay here for a few more days. I don’t understand how to afford these costs.”

Some things like bed rent and certain medicines are provided for free by the hospital, but the parents have to buy most of the things from outside.

Many families like that of Arshi are having a hard time paying medical bills.

Amid inflation, cash-strapped families are borrowing from wherever they can to pay hospital bills for their beloved ones amid a deadly dengue outbreak.

Treatment at private hospitals is too expensive.

Even in government hospitals, some tests and medicines are not available, forcing the low-income people to go outside for these.

Experts advise the government to create an emergency relief fund to help cover these medical expenses.

Six-year-old Adriya Saha was released from the hospital's dengue ward on Thursday.

According to her mother, Ringku Saha, they did not have to pay for the hospital bed, but they needed to purchase most of the medicines from outside.

"We've already spent more than Tk 40,000. Rod's father works in a private company. We used savings from our village and borrowed from relatives to cover the costs."

Yameen, a 6-year-old, who was identified with a single name, was hospitalised at Dr MR Khan Shishu Hospital and Institute of Child Health in Mirpur on Aug 9.

His father, Alamgir Hossain, who works as an assistant to a mason, told bdnews24.com that they were paying a “huge sum” for tests and medicines.

The complete blood count or CBC test costs him Tk 400 daily.

"I bought a bag of platelets for Tk 22,000. The daily bed rent is Tk 1,100, and there are other expenses to account for,” he said.

In total, the cost exceeded Tk 40,000.

“I earn Tk 500 per day. I'm managing these costs by borrowing from others, but I'm not sure how to repay it."

Milton Biswas, a resident of Notun Bazar, has been undergoing treatment for dengue at Delta Hospital in the capital since Aug 8.

His brother, Shujon Biswas, said they were paying Tk 2,400 for the bed.

“It's been seven days already. We'll need one more day here. Every day, we spend Tk 2,500 on other things, including medicines.”

“I provide him [Milton] with seven to eight green coconuts daily. The expenses for dengue treatment are really straining us."

Tania, the daughter of Selina Begum, who came from Lakshmipur to Dhaka North City Corporation’s dengue hospital, said that most medicines are provided by the hospital.

However, some medicines need to be purchased from outside.

"Some patients need special care. If someone is in shock, they might need albumin or plasmasol [a sterile solution]. These are expensive and sometimes not available in our supplies, so they need to be purchased,” said Colonel AKM Johirul Hossain Khan, the director of the hospital.

“Also, if someone has diabetes or high blood pressure, they need separate medicines, which must be bought."

Professor Syed Abdul Hamid and his team from the University of Dhaka's Institute of Health Economics conducted a study on hospital expenses during the 2019 dengue outbreak.

Their findings revealed that the average expense for treating a dengue patient in a government hospital is roughly Tk 11,000.

For patients from outside Dhaka, the cost rises to Tk 20,000.

They categorised private hospital expenses into three tiers.

The average cost for class A hospitals is Tk 200,000.

Class B hospitals have an average cost of approximately Tk 41,000, while class C hospitals fall within the range of Tk 25,000 to Tk 26,000 on average.

Hamid shared with bdnews24.com that they estimated families of the dengue patients across the country spent a total of Tk 4 billion on medical bills that year, when the number of cases crossed 100,000.

This year, he predicts the figure will surpass Tk 10 billion with the number of patients approaching 100,000 steadily in August.

“The poor are suffering the most. They are borrowing from relatives and selling assets. If these are not sufficient, they are begging.”

He said an emergency relief fund was necessary because the hospitals are treating more dengue patients than their capacity.

“A hospital with a 500-bed capacity has 700-800 patients. It means the expenses are overriding the allocations. The patients must buy services like tests from outside.”

[Writing in English by Arshi Fatiha Quazi; editing by Osham-ul-Sufian Talukder]