Pandemic and the state of cancer care in Bangladesh

Ten months have passed since COVID-19 was detected in Bangladesh. What challenges have you faced at United Hospital and how have you addressed the needs of your patients, especially cancer patients?

We were plagued with uncertainty when COVID-19 was first detected in Bangladesh. At United Hospital, we were still able to grasp onto things and respond quickly. Starting from ensuring the supply chain and resource mobilisation to educating ourselves and organising a central committee, everything was done to ensure the total safety and care of patients. We really wanted to ensure overall knowledge enhancement through engagement with international bodies such as United Nations Development Programme (UNDP) and World Health Organization (WHO).

Cancer patients already have a compromised immune system due to nature of the disease and also because of the side effects of the treatments. So, we took it upon ourselves to prioritise raising awareness among them. In the past ten months, we have performed almost 20,000 radiation therapies, around 800 positron emission tomography-computed tomography (PET-CT) scans, 5,500 oncology consultations, and nearly 500 oncology patients were reached through telemedicine.

In the backdrop of the COVID-19 crisis, was there hesitation and/or fear among cancer patients or their caregivers? How did you address their concerns?

From quite early on, we had two completely segregated zones for COVID-19 patients and non-COVID-19 patients. The sixth and seventh floors were converted to negative pressure zones. All of that was achieved in only a few weeks, at an expense of several million dollars. Many of our patients who usually go abroad to seek treatment, had to come to us due to travel bans. We made sure that they were provided with the level of service they would expect overseas.

In our country, the casualty rate among caregivers was higher in the early days of COVID-19. Thus there was some justifiable apprehension. Since we have been maintaining separate units at our hospital, it felt like we were running two parallel hospitals. Our senior consultants kept themselves updated and helped the central committee organise various programmes. Our hospital management was also significantly productive.

We ensured that our caregivers were given treatment free-of-cost. Wearing personal protective equipment (PPE) and working long hours must have been difficult for our doctors and nurses. However, they duly carried out their duties and I thank all of them for their service. We ensured that our caregivers were compensated in a timely manner, despite the financial crunch.

Do you think that the fear of COVID-19 has delayed cancer diagnosis and treatment? How would you address the pandemic going forward?

Unlike other patients who could delay their elective treatment, diagnosed cancer patients could not opt to do the same. We had to ensure that cancer patients not infected with COVID-19 were tended to in an entirely different zone due to their compromised immunity.

When it comes to cancer patients who were not diagnosed, it is very likely that the diagnosis may have been delayed due to the fear of catching COVID-19 at hospitals. Being under proper screening and adaptation of preventive measures usually ensure diagnosis of cancer at earlier stages.

We had a two-time cancer survivor recover from COVID-19 at the age of 80. We took every step necessary to ensure the wellbeing of our patients.

Has there been any recent upgrade to cancer care therapy in your hospital that you would like to mention?

We are a tertiary care hospital, and our cancer centre is of the utmost priority. In Bangladesh, cancer is mainly diagnosed through histopathology. However, for appropriate diagnosis, PET-CT scan is necessary. Our ingredient for PET-CT, fluorodeoxyglucose (FDG), is produced by the cyclotron machine. This machine is only available here at United Hospital in Bangladesh. Installed back in 2011, almost 100 crore taka was invested into this. Each equipment and machine required for PET-CT scan and radiotherapy costs 14 to 17 crore taka for maintenance every year. Even this year, we invested an additional half a million dollars to ensure proper planning, recording, and storing of the data of all the services provided to our patients.

Cancer treatment is very specialised and protocol-based. A cancer patient requires mental healthcare as well. For World Cancer Day this year, our message is "Cancer screening and awareness; let it start from the family."

Tell us about United Hospital's plans and goals for the near and distant future.

United Group is highly committed to healthcare. In the next three years, three more hospitals will be run by the United Group, which will equate to 1,700 available beds. For our medical college in Madani Avenue, we are constructing a 500-bed hospital. We will also build a 100-seat medical college and 500-bed hospital in Chattogram. The former will be the first project under Public Private Partnership (PPP) Authority in Bangladesh, in the healthcare sector. We are constructing a 200-bed hospital in Jamalpur, our Chairman's home district. United Trust is funding this hospital and it will be run through cross subsidisation.

When it comes to plans for the distant future, we want to be the best hospital, and not in terms of profitability or revenue. We want the same service to be provided to our patients that we would provide for our immediate families consistently. Our country is populous and mass-treating patients in hospitals is not a feasible solution to our collective health problems. We want to raise awareness and advise people to lead a healthier lifestyle. Despite all this, if medical attention is still needed, we will ensure the support required.

In a way, COVID-19 has been a blessing in disguise because it has highlighted our shortcomings. The pace at which the physicians caught up despite COVID-19 gives us hope that a developed healthcare system is possible in the country.

Do you have any message for cancer patients and oncology professionals of the country on World Cancer Day?

In most cases, the cancer patients who had higher comorbidity could not survive COVID-19. Thus, cancer patients and their families cannot compromise their hygiene. I would also urge them to remain hopeful, happy, and always under proper treatment. A cancer patient is the best teacher for ten other cancer patients. We regularly organise programmes with cancer patients and the strength they exude blows our minds. Thus, I really hope they take on this responsibility willingly.

I am no oncology professional, but I humbly believe that we need to be united in our efforts to develop the sector. We need to prepare good clinicians and technologists and expand our institutes to meet the needs of our patients.

The interview was taken by Aysha Zaheen of The Daily Star.