We are now witnessing a global crisis, the COVID-19 pandemic. Millions of people may get critically ill, of whom many may die. According to the World Health Organization, as of 23 April 2020, there were over two and a half million confirmed cases of COVID-19 globally and 172,241 people had died from the disease. In Bangladesh, there were 3,772 confirmed cases and 120 deaths.
The government of Bangladesh has taken positive steps during this crisis. In this situation, social distancing is a must. Some districts in the country have been locked down. Narayanganj district is one of them.
In Narayanganj City Corporation, the ‘Compassionate Narayanganj’ project is providing palliative care to people suffering from life limiting and life-threatening diseases. However, the lockdown measures imposed by the government, while essential to stopping the spread of COVID-19 infection, have presented serious challenges to providing palliative care to those who need it.
Older people, and people with pre-existing medical conditions are more likely to become severely ill with the virus. This means that, in addition to having their home care interrupted by lockdown measures, the people with palliative care needs are at greater risk from COVID-19.
To combat this situation, the Compassionate Narayanganj team is taking novel steps to provide palliative care as before, but in different ways.
Before the lockdown started, we distributed total of 40 special food packs containing food, soap, protective equipment and leaflets to our patients. We also distributed 210 normal food packs and leaflets to the local community people of Narayanganj City Corporation.
Now that we are in lockdown, providing home care is quite impossible for us. But we haven’t stopped our services. We are utilizing social media such as Facebook and technology like WhatsApp effectively.
We have opened a Facebook Messenger group for all the staff of the Compassionate Narayanganj project. We are sharing our thoughts regarding patient care, and exchanging information through this group. The Project Manager shares his experiences, receives updates from staff, coordinates the various activities or assigns specific tasks.
We have started a project WhatsApp group specifically for discussion related to patient care. The doctor and nurse play a key role in this group. The Palliative Care Assistants (PCAs) each talk to five patients daily through mobile phones and record the entire matter in the follow-up sheets.
After that, they take a snap of the sheets and post it in the WhatsApp group. After reviewing the sheets, the doctor and nurse then take the decision as to which patients need a follow up conversation.
Sometimes, the PCAs also request the doctor and nurse to call the selected patients on an emergency basis as needed. It’s a continuous process. Needless to say, mobile phones are playing the biggest role here regarding the continuation of our patient care service.
One of our PCAs named Liza Akter said: “As a Palliative Care Assistant, I would like to say that I am very proud to be able to stand by our patients during this epidemic. If I was in a general profession like other people, I would have to spend this lockdown period at home. But as a PCA, I am not just sitting at home, but I can stand beside the people suffering from life limiting diseases and continue to serve them.”
One of our patients named Md. Shahjahan (Age: 59) said: “Nowadays, your service is not just a phone call; it is a beacon of hope for us. I have no one here (at home); you are talking to me and receiving news from me like my relatives. Receiving phone call from you actually gives me a lot of courage. I believe, you will stand by us in this crisis period like before.”
Fatema Begum, the caregiver of one of our patients, said: “He (patient) is feeling much better now. I think he would have died very early if he hadn’t received your services. Many thanks for continuing your services in this way. We are very happy to have you on these days of crisis. Stay safe. If you are not safe, who will take care of us in future?”
“Compassionate Narayanganj” is a pilot project funded by UK Aid Direct. It is a collaboration between Bangabandhu Sheikh Mujib Medical University (BSMMU), the Worldwide Hospice and Palliative Care Alliance (WHPCA) and the Narayanganj City Corporation (NCC) to ensure the availability of palliative care services in the community.