Around 1,000 farmers thronged Alampur Baliapara ground in Kushtia Sadar upazila, the largest cattle market in the district, with their animals on Saturday without maintaining social distancing though the coronavirus cases are spiking in the country.
Visiting the weekly market, the UNB correspondent found huge crowds at the cattle market with few wearing facemasks.
According to locals, there are about 12 markets of sacrificial animals in the district where the wholesale merchants gather to collect cattle and take those to other parts of the country.
This year the scenario was quite different as there was neither any individual buyer nor any merchant from other districts to buy sacrificial animals from the Kushtia market.
Disappointed, many farmers had to go back home with their animals at the end of the day.
Golam Mostafa, officer-in-charge of Kushtia Model Police Station, said many people gathered at the market. “It’s really hard to maintain proper physical distancing in a market like this,” said the OC adding, “We’re trying our best to keep people safe. “
According to sources at the upazila administration, around 30 people are getting infected with coronavirus in the upazila on average every day while the number of infected people was recorded 36 on Monday last.
Read More: 27 cattle markets to be set up in city
They said around a thousand people have been infected with the deadly virus while 19 died in the upazila so far.
At this critical stage of coronavirus infection, locals alleged, allowing such a market to be set up here is really a matter of concern.
But the cattle traders are more concerned about the sale of their sacrificial animals than the Covid-19 safety restrictions as they fear whether they will be able to get back the money they invested in cattle rearing.
Meanwhile, Local Government and Rural Development (LGRD) Minister Md Tajul Islam on July 13 urged people to use online platforms for selling and buying animals to contain the spread of the virus.
He discouraged people to gather at sacrificial animal markets amid the coronavirus pandemic.
Health experts have expressed apprehension that Covid-19 infection rate may take an upward trend sharply after the upcoming Eid-ul-Azha as several crore people will directly get engaged in sacrificing over one crore animals across the country.
To check the transmission of the coronavirus, they urged the government to promote a system where the animals are sold, bought and slaughtered, and the meat is distributed under a single system in a particular area like union, village or ward for reducing engagement of people.
Alongside the promotion of online cattle markets, the experts stressed the need for following health guidelines while buying and selling animals in traditional markets, slaughtering them and distribution of their meat.
A highly respected physician and professor of medicine at Bangladesh Medical College (BMC) has been using a combination of two cheap, easily available drugs to treat patients suffering from COVID-19 with great success in reducing the viral load and restricting the severity of disease.
Apparently 98 percent of Covid-19 patients get cured with the combined use of anti-parasitic drug Ivermectin and antibiotic Doxycycline within 4-14 days, said Dr Tarek Alam, the renowned doctor who has been leading a team of BMC physicians in a study during the course of treating patients at the hospital attached to BMC.
They recently reported tremendous success with the two-drug combination treatment against the virus during its study that started on April 15 last.
“What we’ve found is that it’s better to use the two drugs as soon as possible after a person is tested positive or symptom is seen,” Dr Alam said in a virtual interview with UNB.
“We used the drugs within 5-6 days on all patients (and almost all got cured). Actually it needs to conduct further study whether these (drugs) will be effective in case of use after the time,” he said, adding that so far the drugs have been used on “some 400-500 Covid patients” since April.
But only “4-5 patients” having diabetes and heart problems or who delayed in getting the treatment needed to go to Intensive Care Unit (ICU). And two patients died despite being administered with Remdesivir and plasma therapy. “Our 98 percent patients got cured,” he went on.
Dr Tarek Alam.File Photo
That may not sound like much against a virus that in Bangladesh is struggling to kill 2 percent of the patients it infects, but here is the nuance: when Dr Alam says ‘cured’, he means cured on the drugs alone, and without needing ICU support. If the numbers reported from his study were to hold, that would present a dramatic reduction in the pressure being placed on health systems.
Worldwide, the percentage of patients needing ICU support of course varies from country to country, across health systems, and even among regions within countries. In Italy during the early part of the outbreak up to 12% of all positive cases required ICU admission, a startling figure that may be traced to its older population. In New York on the other hand, hospital sources estimated 1 in 5 of the total hospitalisations (itself around 20%) needed ICU support at some point, so that would mean around 4%. In China, a study of the first 44,000 patients showed 5% needed critical care.
If that 4-5% number could be reduced to 2 percent, that would free up at least twice the number of ICU beds available. Or seen another way, require half the number of ICU beds as they did, or less. If his numbers hold.
Hidden wonders of a ‘lice-killer’
It becomes pertinent to ask how Dr Alam happened to arrive at the prescription that eventually was taken up for a clinical trial by ICDDR, B, that is now ongoing. Particularly given how even some in the scientific community were dismissive of its potential.
One is reminded of a virologist attached to a national institute of repute, who literally exited the panel of a tv program reporting the earliest results from Dr Alam’s team with the implication that discussing any therapeutic outside antivirals was a waste of time.
If the virologist had hung around, what he could’ve learnt from Dr Alam (who eventually managed to connect to the program), the professor of medicine, may have transformed his view of a drug that most Bangladeshis know from adolescence as a lice-killer.
In fact, Ivermectin “proposes many potentials effects to treat a range of diseases, with its antimicrobial, antiviral, and anti-cancer properties as a wonder drug,” according to a paper published just last month in The Journal of Antibiotics.
Also last month, the journal Antiviral Research reported the findings of the first in vitro (in cell culture) study that showed Ivermectin inhibits the replication of SARS-CoV-2, the causative agent of COVID-19.
“Ivermectin, an FDA-approved anti-parasitic previously shown to have broad-spectrum anti-viral activity in vitro, is an inhibitor of the causative virus (SARS-CoV-2), with a single addition to Vero-hSLAM cells 2 hours post infection with SARS-CoV-2 able to effect ~5000-fold reduction in viral RNA at 48 hours,” the authors report, the potency corresponding with the effect on the viral load reported by Dr Alam’s team from PCR test results on their patients.
The viral load is a measure of virus particles present in an infected person. With most viruses, higher viral loads are associated with worse outcomes.
Dr Alam, also Head of the BMC Medicine Department, said his team had primarily applied the two drugs on 60 patients during their observation before they came to the media. “All the 60 patients were tested for Covid-19 negative within 4-14 days. They did not need admission in hospital or go to ICU,” he said.
Noting that the two drugs have been available for many years at cheap prices in Bangladesh, Dr Alam asked the people not to use the medicines arbitrarily, or without a prescription from a physician.
He said many people have taken the combination by now, prescribed by doctors who spoke to Dr Alam observed its effectiveness. “But none should intake these medicines unless she or he is tested positive for Covid-19 or without prescription of a physician,” he added.
The noted medicine professor said it is better for the patients to go to hospital before the condition deteriorates seriously and not waste time in taking treatment at home. The use of antiviral drugs is not enough to get cured of this disease in many cases and many more medicines are needed, he added.
He suggested the elderly patients or other patients having comorbidities like diabetes or hypertension must be admitted into hospital without fear or delay, as the doctors and nurses now know what needs to be done in such cases.
“There is no accommodation problem (for Covid-19 patients) in the hospitals. All doctors now know what they should do in case of Covid-19 patients,” he said, adding that the government has managed enough hospital beds and oxygen by and large.
Dr Alam said his team started the study on its own, and now seek permission from the regulatory Bangladesh Medical and Research Council (BMRC) for the clinical trials in this regard. The ICDDR, B trial is expected to conclude next month.
To end, it may not surprise you anymore to learn that in 2015, Irish scientist Dr William C. Campbell of Merck Laboratories and Japanese researcher Satoshi Omura were awarded the Nobel Prize in Medicine for the discovery of Ivermectin. It is strongly held that they would have shared it with a third scientist, indeed the head of the research team at Merck that developed the drug, had he not passed away (the Nobel Prize is never given posthumously). That man was Bangladeshi scientist Dr Mohammad A. Aziz.
Temporary teachers and employees of schools under jute mills are staring at a bleak future after the government decided to shut state-owned jute mills in Khulna region.
Jute mill workers have been assured of cash and savings certificates and MPO registration of permanent teachers of the schools there has been no word on what will happen to 60 temporary teachers and 10 employees.
Sources say there are five secondary schools under Crescent, Platinum, Star, Eastern and JJI mills in Khulna region.
The salaries and activities of the teachers of these schools were given from the income of the jute mills. After their closure, there are doubts about continuing operations of the schools.
The state minister for jute has assured the MPO registration of the permanent teachers of these schools.
Teachers say there are about 60 regular teachers in the schools while 60 more teachers and 10 staff work on temporary basis. Many of them worked for 15-20 years but were not made permanent.
Raja Khan, an assistant teacher at the state-owned Star Jute Mill High School, said he has been working on temporary basis since January 25, 2012. His job is yet to be regularised.
“I don't know what our fate is as the mill is closed,” he said with frustration.
Shirina Khanam, a teacher at Platinum Jute Mill Secondary School, said she has been teaching since September 2000 but has not been made permanent. She said they hearing that they will be left out of the MPO scheme.
The teachers have requested the Prime Minister to regularise their jobs.
Abul Kalam Azad, project head of Star Jute Mill, said a list of permanent teachers has been sought from Bangladesh Jute Mill Corporation (BJMC). They also wrote about the temporary teachers.
"It's up to BJMC now," he said.
Meanwhile, a memorandum has been sent to the Prime Minister through Khulna Deputy Commissioner on July 15 demanding that the jobs of the temporary employees be regularised.
According to the memorandum, 40 temporary teachers and staff are working in the state-owned Crescent, Platinum and Star Jute Mill schools in Khulna. They have been working for 10-15 years.
They said their families would suffer much if they lose their jobs now. So, they requested the Prime Minister to include them in the MPO scheme.
The traditional Basundia jackfruit haat in Jashore from where thousands of jackfruits go to different districts every season now looks almost deserted for lack of buyers and the blame goes to Covid-19 pandemic and cyclone Amphan.
Just ahead of the jackfruit season, cyclone Amphan hit the region hard and destroyed crops and trees, including that of jackfruit, resulting in short supply of jackfruits to the haat this time, they said.
Besides, they added, fewer buyers visit the market due to transport crisis caused by the coronavirus pandemic, causing frustration among the jackfruit growers.
Mizanur Rahman Khan, a local businessman, said they have heard from their grandparents that this preferred market is hundreds of years old.
Traders from far from Barisal, Patuakhali, Madaripur and other places in the south used to come here to buy jackfruits and ship those in big trawlers, he said. Jackfruits used to be transported by roads to different districts, too.
Apart from Jashore, jackfruit traders from Narail, Khulna, Jhenaidah and Magura used to bring jackfruits to this market.
“Now things have changed. As the jackfruit supply has declined, the market is no longer a popular destination,” he said.
Besides, the trader alleged, many traders do not want to come to the market due to harassment by extortionists.
Kabir Khan, another businessman, said 50-80 truckloads of jackfruits used to be transported to different parts of the country from this haat every day, but this time only 8-10 trucks are carrying the delicious summer fruit.
In addition to transportation problem, there are administrative restrictions too, said local traders adding that the local administration is obstructing people from gathering at the haat as part of social distancing rules to prevent the spread of coronavirus.
In many cases, they said, law enforcers are using force to remove buyers and sellers which discourages them to visit the market.
According to the District Agriculture Office, there are jackfruit trees on about 1,000 hectares of land and there has been plentiful yields of the fruit this time in Sadar, Chougachha, Jhikargachha upazilas.
According to farmers, they are not getting the fair price this time as they are unable to go outside the district with their produce due to the coronavirus situation.
Azizur Rahman of Petvara village in Chougachha upazila said he has counted heavy losses this year due to the abnormal situation created by corona and cyclone Amphan.
Local jackfruit farmers said they suffered a double blow this time as traders neither bought jackfruits from their orchards nor the market.
Akhtaruzzaman, Deputy Director of the Department of Agricultural Extension (DAE), said both Amphan and Covid-19 have caused huge damages to the agricultural sector in the region and elsewhere in the country and that is why the farmers are in trouble.
A recent study revealed that about 85 percent leprosy disabled people in Bangladesh have been suffering from psychological problems besides many other disease-related complications.
The sufferings of the excluded and stigmatised community have intensified manifolds during the Covid-19 pandemic.
Most of this vulnerable community has been literally left behind from pandemic response programmes as well as deprived of proper information related to hygiene and other health issues during this crisis.
A study titled 'The Quality of Life (QOL) and Mental Health Status (MHS) of People Affected by Leprosy and People with Leprosy Disability in Bangladesh’ brought the tragic scenario to the fore.
The cross-sectional study was conducted between August 2019 and May 2020 in Dhaka, Moulvibazar, Meherpur, Kustia, Chuadanga and Thakurgaon.
The researchers reached 94 respondents, diagnosed with leprosy, 80 percent of them were without disability while 20 percent of them suffered from leprosy disability.
The research supported by The Leprosy Mission International, Bangladesh, (TLMIB) was authored by Hosne Ara Hoque of Advancing Leprosy and Disadvantaged Peoples’ Opportunities Society (ALO) while INTERACTION Chief Executive Serajud Dahar Khan played an advisory role.
According to the World Health Organization (WHO), actions needed in 22 priority countries including Bangladesh as people affected by leprosy continue to suffer discrimination and lack of access to medical care.
Leprosy itself is a highly stigmatised and disgraceful term in society while disability from the disease is the other concern that victimises the patient drastically, said the study.
Study findings showed that over mental health screening, 69 percent of the people affected by leprosy go through psychological difficulties. It is observed that 85 percent of the leprosy disabled people and 65 percent of the general leprosy patients were in poor psychological condition.
Leprosy disable people lack Quality of Life
According to the study, the overall Quality of Life (QoL) of the people with leprosy disability was much worse than respondents without disability.
Altogether 40 percent of leprosy-disabled persons said they were living a poor QoL while 20 percent had very poor QoL.
However, 52 percent of leprosy-affected people without a disability were found with a marginal level of QoL.
Altogether 31 percent of the leprosy-disabled persons said they were dissatisfied with their health condition, while 10 percent said they are very dissatisfied.
However, 40 percent of leprosy-affected people without disability had marginal level satisfaction.
Leprosy disability and insomnia
The marginalised and endangered community goes through another lifelong crisis which is insomnia.
Altogether 30 percent of people with leprosy disability face more difficulty in sleeping while 20 of them were in lower cut-off levels.
However, 51 percent of the leprosy-affected people without disability had moderate level satisfaction in regard to sleep.
Negative feelings and dissatisfaction
Altogether 55 percent of people with leprosy disability said they were very dissatisfied with daily living while 44 percent without disability said they were neither satisfied nor dissatisfied.
According to the satisfaction level of enjoying life, the study revealed that both leprosy affected people with and without a disability do not enjoy life at all.
A total of 41 percent with and 45 percent without disability manifested similar experiences.
However, 16 percent of people without and 10 percent with disability expressed their satisfaction at very much level.
Almost 50 percent of the people with disabilities felt negative feelings quite often.
Perception on self-esteem, value of life
The study shows that the vulnerable community has a very negative perception on self-esteem and value of life.
The major 60 percent of people with leprosy disabilities expressed that they feel that life is totally meaningless while 44 percent without disability think that there is some hope in life.
Some 10 percent of the people with disabilities expressed that they were leading a moderately meaningful life, while 25 percent of people without a disability have the same experience.
Poor financial life
The research findings revealed that the majority of leprosy-infected with disability go through severe financial crises.
A total of 60 percent of the people with disabilities had too little money to meet their basic needs while 20 percent were found in extremely destitute situations, the study showed.
However, 24 percent of leprosy-affected people without a disability are financially in good condition to meet their basic needs.
Dissatisfaction over access to health services
The leprosy-disabled people were found dissatisfied regarding their access to health services and this has gone to a marginal level during Covid-19 pandemic.
Altogether 40 percent of the leprosy-disable persons expressed dissatisfaction while 18 percent showed extreme levels of dissatisfaction as they have little access to health services.
Meanwhile, some 14 percent of the respondents without a disability were very satisfied.
The researchers recommended some actions on emergency for the people affected by leprosy with and without a disability.
The study suggests a pragmatic intervention to be deployed to properly address the psycho-social impairment for people with leprosy-disability.
The experts also underscored the need for enhanced socio-psychosocial support for improving the quality of life for both the groups who are highly stigmatised in society and live ‘disgraceful’ life.
The study assessed that the mental health and quality of life are major concerns for the people affected with leprosy-disability.
Asked about the crisis of leprosy-affected people with and without disability, Jiptha Boiragee, program support coordinator, TLMIB, “They’re going through unspeakable adversity during this Covid-19 pandemic.”
“The sufferings of leprosy disabled persons have increased many folds and they are going through another brunt of social stigma during this pandemic,” he said.
Underscoring the response to these vulnerable groups, Boiragee said “Both of these groups deserve emergency aid on humanitarian ground and they will need special attention in the post-pandemic period.”
These people require counseling and mental assistance to overcome the disaster and at least find hope of living despite all these happenings in life, Boiragee added.
Similar study results, recommendations
Earlier in 2007, Atsuro Tsutsumi, Takashi Izutsu, Md Akramul Islam, A N Maksuda, Hiroshi Kato among other experts conducted a study titled “The quality of life, mental health, and perceived stigma of leprosy patients in Bangladesh.”
A total of 189 leprosy patients and 200 without leprosy were selected from Dhaka for the study.
According to that study, the patient group's depressive status was significantly more severe than that of the comparison group.
The authors underscored an urgent need for interventions sensitive to the effects of perceived stigma, gender, and medical conditions to improve the QOL and mental health of Bangladeshi leprosy patients.
What is leprosy?
According to the World Health Organization (WHO), Leprosy, also known as Hansen’s disease, is a chronic infectious disease caused by Mycobacterium leprae (a relative of TB).
This disease primarily affects the skin, the peripheral nerves, mucosal surfaces of the upper respiratory tract and the eyes. The first signs of leprosy are patches of skin that look paler than normal or sometimes nodules on the skin.
It is known to occur at all ages ranging from early infancy to very old age.
WHO as well as organizations like TLMI provide confirmation that leprosy is curable and treatment in the early stages can prevent disability.
Leprosy in Bangladesh
According to the National Leprosy Elimination Program (NLEP) yearly for 2019, altogether 2,26,711 leprosy cases were detected in Bangladesh in between 1985 and 2019 but after receiving MTD treatment 2,18,538 of them made recovery from the disease during this period.
NLEP data shows 26,479 people detected with disabilities caused by Leprosy in between 1985 and 2015 in the country.
The data also reveals that around 4,000 patients were detected per year in Bangladesh over the last few years, with this figure standing at 3,638 in 2019.
Among the newly detected cases, 252 people were found with leprosy disability in 2019, NLEP data shows.
In India, 127,334 new leprosy cases were detected from 2016 to 2017, and 4.6 percent of them had Grade 2 disability at the time of diagnosis.
The World Health Organization (WHO) shows that a total of 20,8619 new cases of leprosy were reported in 2018 from 127 countries.
According to the United Nations (UN), "The level of serious disability is alarming and completely unnecessary.”
“Too many people with leprosy remain trapped in a never-ending cycle of discrimination and disability,” it said.