Millennial Medics: Young Doctors at the Forefront of COVID-19 Care in Bangladesh

As the COVID-19 pandemic has placed increased pressure on health systems, newly graduated young doctors around the world have stepped up and shouldered responsibility beyond their years and experience to provide care to people in need. This is particularly true in countries with fragile and under-resourced health systems like Bangladesh.

Dr. Masura and Dr. Rony are young doctors who completed their medical training in Bangladesh in 2019. Within months, both started work in the COVID-19 Isolation and Treatment Center (ITC) supported by Community Partners International (CPI) at Sadar District Hospital in Cox’s Bazar.

​The ITC serves patients with moderate to severe COVID-19 from the surrounding Bangladeshi communities and Rohingya refugee camps. The 52-bed facility, which is the only one of its kind for Bangladeshi nationals in Cox’s Bazar, receives patients referred from the hospital’s Emergency Department and provides a range of diagnostics and care, including X-rays, laboratory tests, oxygen, regular monitoring of vital signs and symptoms, medication to treat symptoms, and referral to the Intensive Care Unit for critical cases.

As key members of the CPI-supported medical team at the facility, Dr. Masura and Dr. Rony work three shifts daily. With infections rising in Bangladesh, the team has shown remarkable resilience to hold the line and bring lifesaving COVID-19 care during the pandemic.

Since opening in March, the ITC has served nearly 1,188 patients with an average bed occupancy rate of 80%. More than 900 of these patients were considered at high risk of developing severe health complications due to underlying health conditions. The ITC is divided into two zones – one for patients with possible COVID-19 symptoms who have not yet been tested and a second for patients who have returned positive tests.

It is a challenging place to work. Space constraints make in-patient care difficult, with insufficient physical distancing when the facility is busy. Medical staff have experienced severe oxygen and oxygen delivery system shortages across the Bangladesh health system. They have also experienced shortages of other equipment, such as blood pressure cuffs and oxygen saturation monitors.

Due to personnel constraints, it can be difficult for the ITC medical staff to contact experienced doctors for guidance. While there is a messaging system in place, it is only sometimes possible for the staff to access advice late at night when a patient’s condition worsens suddenly. This puts strain on relatively inexperienced doctors like Dr. Masura and Dr. Rony.
The CPI-supported ITC team has helped strengthen Sadar District Hospital’s capacity to provide free care to COVID-19 patients with multiple types of clinical comorbidities and to deal with complex clinical cases. CPI is supporting the cost of providing medicines and medical equipment for COVID-19 care and funding laboratory services for patients who cannot afford these costs.

With the ITC running close to capacity, there is concern that a surge in COVID-19 cases could overwhelm Sadar District Hospital, mainly if there is a significant outbreak among the Rohingya refugee communities living nearby.

To help mitigate this risk, CPI is supporting the construction of a new rooftop facility at Sadar Hospital to provide additional COVID-19 isolation and treatment facilities. The new 43-bed facility will open in December 2020, increasing the hospital’s bed capacity for moderate to severe COVID-19 cases to 123.
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Dr. Masura and Dr. Rony were kind enough to spare time from their busy schedules to talk about their work at the ITC and their hopes for the future:

Why did you decide to serve at the COVID-19 Isolation and Treatment Center (ITC)?

Dr. Masura: “It is my duty and responsibility as a physician to serve during this pandemic.”
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Dr. Rony: “As a physician, I must join the fight against this pandemic. I can share my knowledge and gather new experiences to prepare myself better for a future pandemic.”

Did you have any concerns when you first started work at the ITC?

Dr. Masura: “I was a little concerned about the possibility of catching COVID-19. This is a daily risk that we all take. I was also worried that the ITC might be overwhelmed with sick patients and that I would have to treat them without having the equipment needed to provide adequate care.”
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Dr. Rony: “I was a little nervous initially, but I’m getting more confident each day. I was also worried that the ward might be overwhelmed with patients. We face challenges, such as a shortage of oxygen and insufficient personnel, but so far, we’ve been able to cope.”
Bazar, Bangladesh. (Md. Dipu/CPI)

Has it been challenging to juggle your home life with your work at the ITC?

Dr. Masura: “Yes. My friends and family are concerned about contact with me. I am also concerned about contact with them due to my work with COVID-19-positive patients. I have to be very cautious.”

Dr. Rony: “Sometimes, yes. My wife went back to our hometown to be safer. I couldn’t join my family to celebrate Eid-ul-Adha in July because of the risk of infection.

What are the biggest challenges that you face day-to-day working at the ITC?

Dr. Masura: “We sometimes run short of PPE. This is a problem faced by health workers worldwide, so as Bangladesh is a low-resource country, it doesn’t surprise me. Due to space limitations, we don’t always have access to space to remove and dispose of our PPE safely.”

Dr. Rony: “Sometimes the center gets busy, and it’s hard to cope. As this is a new disease, we must make decisions without as much information and guidance as we’d like.”

What are the most satisfying aspects of your work at the ITC?

Dr. Masura: “It is amazing when people recover and thank me for caring for them. I feel that I have achieved something good here.”

Dr. Rony: “The mortality rate on the ward is low, which is an encouraging sign because many patients have underlying conditions that make them especially vulnerable to COVID-19. The laboratory supports us in making accurate diagnoses and designing treatment plans. We’ve been able to juggle our resources so far to ensure we can treat everyone who needs our help, so I feel a sense of achievement for what we do here.”

What important lessons have you learned during your time working at the ITC?

Dr. Masura: “To stop the spread of COVID-19, people must follow infection prevention guidelines. Everyone must wear masks, avoid crowds, practice hand hygiene, and maintain physical distance as much as possible.”

Dr. Rony: “I think patient counseling is so important. When people come to the ITC, they are often afraid. We need to spend time reassuring them and making them feel comfortable.”

How did you feel when you heard that potentially effective vaccines were on the horizon?

Dr. Masura: “It was overwhelming to learn that the world would be blessed with rays of hope after all the hardship we have faced. I have been unable to see family and friends for months, so I look forward to reconnecting with them once the pandemic ends.”

Dr. Rony: “I felt a sense of relief. It is a great achievement for medical science. I am excited to see the results once the vaccine is widely distributed.”

Has this experience changed you?

Dr. Rony: “Yes, I am more confident now in some aspects of epidemiology than I was before. I’d like to write a paper about my experience dealing with the pandemic here in Bangladesh in collaboration with my friends who are working at other COVID-19 isolation and treatment centers around the country.”

What are your plans once the COVID-19 pandemic is over?

Dr. Rony: “This experience has made me more interested in microbiology and virology. I’m considering taking up postgraduate studies focused on these subjects.”

What lessons do you think Bangladesh and the world can learn from the response to the pandemic?

Dr. Rony: “I think we need to focus more on infection prevention and control measures here in Bangladesh and to stabilize the health system through investment in more human resources, better equipment, improved training, and operational support. Globally, all countries need to cooperate closely with the WHO and the UN to ensure we are better prepared for the next pandemic. We need to carry out more research to inform future pandemic response.”