There are more than 14,000 community clinics across the country. These clinics were originally set up to provide healthcare services and distribute essential medicines free of cost to people at the grassroots level. Normally, medicines were supplied to each clinic every three months. But for more than the past nine months, the government has not provided adequate medicine to these clinics. Even though some clinics did receive supplies, the quantity was far below the actual demand. As a result, patients visiting these clinics are not getting the medicines they need. This has put low-income people, who largely depend on these clinics, in a difficult situation.
Abdullah Al Noman, a resident of Khojapur in Ward 29 of Rajshahi city, has been suffering from fever for the past three days. He went to his local community clinic for primary treatment. While he did receive medical advice there, he did not get any medicine. There are a total of 2,088 community clinics in the Rajshahi division alone. These clinics usually provide around 21 types of medicines including paracetamol, histacin, antacids, pantoprazole, folic acid, vitamin B-complex tablets, saline, and contraceptives. However, complaints have been raised that for the past six months, patients have not been receiving medicines at these clinics, only healthcare advice.
In Durgapur upazila of Rajshahi district, there are 19 community clinics. Each of these clinics serves nearly 70 people daily. Hafiza Khatun, a health officer there, said that the clinics have not received any medicine for the past six months. The same situation exists in the community clinics of Pabna district under this division. The Marmi Community Center at Dashuria Union in Iswardi has been without medicine since March.
Speaking on the matter, Dr. Md Habibur Rahman, Director of Rajshahi Health Division, said, “There is no shortage of medicine or problem in supply anywhere in Rajshahi division. Some problems did arise due to a strike a few days ago. The clinics remained closed for a while. But now every clinic has an adequate supply of medicine, and patients are receiving them.”
The community clinics in Khulna division are facing the same problem. Investigations reveal that in the coastal upazila of Koyra, there are 32 community clinics. More than 45,000 people regularly receive services from these centers. For the past eight months, medicine supply to the upazila’s community clinics has been halted. These clinics had become a trusted place for people because they provided free healthcare and medicine to the poor. Now, the medicine shortage has left those who depend on these clinics in a dire situation.
According to the Upazila Health and Family Planning Office, a total of 23 types of medicines have not been supplied for eight months. Supply has been suspended since January. There is also no supply of iron, calcium, or folic acid tablets. As a result, pregnant women and adolescents are being deprived of essential healthcare.
Another district under Khulna division, Jashore, has 283 community clinics at the rural level. These clinics have also been without medicine supply for eight months. The CHCPs in charge of these clinics said that previously, medicine used to arrive every three months. Now, no clinic is receiving any medicine.
Fayaz Ahmed Faisal, Upazila Health and Family Planning Officer of Monirampur in Jashore district, said, “Community clinics have been facing a shortage of medicines for quite some time. In April, we were able to provide some medicines. Since then, no medicines have arrived. It is not possible to provide the desired healthcare until medicine supply resumes.”
In Rangpur division, there are a total of 1,895 community clinics across eight districts. Rangpur district alone has 311 community clinics. Dr. Mst Shammi Akhter, officer in charge of the community clinics in Rangpur Sadar Upazila and the Upazila Health and Family Planning Officer, said, “There are a total of 47 community clinics in Rangpur Sadar Upazila. For ten months, no medicines were supplied. However, last week, all medicines were delivered.”
Regarding the reason for the lack of medicines, she said, “After the fall of the previous Awami League government, various complications arose. The salaries and allowances of those working in community clinics were also halted. However, before the last Eid, everyone received their salaries and allowances.”
Regarding the matter, Dr. Md Gausul Azim Chowdhury, the newly appointed Divisional Director (health) of Rangpur, said, “While there may be a shortage of one or two medicines in some community clinics, it is not true that medicine supply has been absent for a long time.”
According to the latest update from the Chattogram Divisional Health Directorate, there are a total of 2,740 community clinics across the 11 districts of Chattogram division. Of these, 2,709 are operational.
Health workers at community clinics in various unions of Chattogram told Bonik Barta that around 32 types of medicines, including antibiotics, were previously supplied to the clinics. Now, the supply of antibiotics has been stopped, and only 22 types of medicines are being supplied. Among the 22 types of medicines supplied monthly to community clinics, the notable ones are paracetamol tablets (3,000 pieces), paracetamol syrup (60 bottles), histacin tablets (1,500 pieces), histacin syrup (24 bottles), salbutamol syrup (24 bottles), oral saline (400 packets), amoxicillin capsules and syrup, antacid tablets, calcium, vitamin A and B capsules, zinc tablets, and contraceptive pills.
Nizam Uddin Mohammad Fahad, the Officer in Charge of Popadia Community Clinic in Boalkhali Upazila, Chattogram, told Bonik Barta, “Since August 5 last year, the medicine allocation for community clinics has decreased. We couldn’t provide medicines to those who came for treatment. Some medicines were supplied in limited quantities through the Civil Surgeon’s office. Although this is much less than the demand. However, last week we were informed that medicines are arriving at the Upazila Health Complex. Regular supply will resume from Saturday.”
Dr. Sheikh Fazle Rabbi, Director of Chattogram Divisional Health Directorate, told Bonik Barta, “Medicine supply to community clinics in Chattogram was never completely stopped. The community hospitals were part of a project. Although the clinics did not receive 100 percent of their required medicines through the Civil Surgeon’s office, no one was sent away empty-handed. After the previous government fell, those who used to supply medicines stopped. The interim government has supplied medicines through new contracts. A small amount of medicine has already started reaching the upazilas. The lack of medicine has disrupted healthcare at the community clinics for the marginal population. However, vaccination programs are running regularly.”
He also said that under the operation plan, letters have been sent to the community health workers (CHWs) of the community clinics regarding their medicine requirements. It will take about a month for the supply to increase. This shortage has been ongoing for a long time due to the interruption in supply. The Director said the medicine shortage is expected to be resolved by September.
On this matter, Dr. Asif Mahmud, Director (Field Administration) of the Community Clinic Health Service Trust under the Health Services Division, told Bonik Barta, “Our medicine supply contract expired in June last year. After that, it was not possible to renew this project because the country was in an unstable situation. Supplying medicines requires going through a lengthy process. Completing that process takes a lot of time. However, the problem has now been resolved. Medicine supply resumed under a new contract from July. But it is not possible to supply medicines to all clinics simultaneously. That is why it takes some time to reach certain areas. We hope this problem will be resolved in a few days.”
Meanwhile, Professor Dr. Md Abu Jafor, Director General of the Directorate General of Health Services, said that medicines have already been supplied to 105 upazilas. He told Bonik Barta, “Purchase orders worth a total of BDT 1.19 billion have been issued to EDCL (Essential Drugs Company Limited). A total of 49,200 cartons of medicines will be supplied. As of yesterday, 10,600 cartons of medicines have reached 105 upazilas.”
(The report was prepared with assistance from Bonik Barta’s correspondents in Jashore, Chattogram, Khulna, Rangpur, and Rajshahi.)