As the number of infections and fatalities from the novel Coronavirus (2019-nCoV) continue to rise, there is panic around the world, including in Bangladesh, a country that has become more and more closely intertwined with China. According to the World Bank, the Bangladesh government’s spend on the health sector has been 2-2.6% between 2000 and 2016, and has been declining since 2012. This is less than half of what the experts suggest is needed.

In 2015 Bangladesh was one of 62 (out of 195) countries to meet the target of cutting child mortality levels by two thirds. It still meant that “an estimated 236.3 million children under age 5 died between 1990 and 2015.”

This progress in one of the most densely populated countries in the world is threatened by many things, not the least of which is how climate change impacts are driving disease and displacement. The dense urban slums in capital Dhaka are especially vulnerable.

Added to this, Bangladesh now hosts an estimated one million Rohingya refugees from Myanmar, most of them in the refugee camps near Cox’s Bazaar.

The crowding in these camps close to the border with both India and Myanmar, means that there is a possibility of diseases spreading fast across populations and regions. The poverty and distress of the refugees leave them more vulnerable to disease as well.

All these factors combine to make Bangladesh a potential driver of new diseases, such as the novel Coronavirus (2019-nCoV).

Talking to thethirdpole.net, Lelin Chowdhury, a medical specialist working at a hospital in Dhaka, said, “A good number of people are crossing these three borders and even sometimes carrying some smuggled items on a regular basis.”

Chowdhury, who is also the joint general secretary of Poribesh Bacho Andolan (POBA, an NGO focussed on environment and human health) noted that many international visitors, donors, fundraisers, and media personnel visit the camps regularly. This opened up many  possibilities for the spread of diseases.

However, Meerjadi Sabrina Flora, Director of the Institute of Epidemiology Disease Control (IEDCR), claimed that the government has taken all precautions to prevent such diseases.

“Already we have closed all the pockets of border areas and communications like sea ports, land ports with our neighbouring countries. We also deployed a medical team in each border area,” she said.

The challenge of the slums

This prompt action by the government may protect the refugees, but the challenge of urban slums has no quick or easy remedy. According to the “Census of Slum Areas and Floating Population” conducted by the Bangladesh Bureau of Statistics in 2014, there were over 5,000 slums in Dhaka, where about four million people lived. High population densities, chronic malnutrition and inadequate access to health services cause various health problems to the slum residents.

“Their immune system is not as robust as [those of] a healthy man from a non-slum background,” said Chowdhury Tasneem Hasin, a nutritionist with United Hospital Ltd.

Referring to the current situation, she noted that the city slums have very poor sanitation, which make them fertile breeding grounds for disease vectors.

“I am really very concerned about the health issue of this community. We are advising them to wash their hands repeatedly with soap and water so that they will not be affected by diseases. But in reality they do not have sufficient water,” Tasneem said.

Given this reality, there have been various expressions of worry about the arrival of 312 students and family members from China’s Wuhan province. Eight of them are currently admitted in the Kurmitola hospital, the rest quarantined at Ashkona Hajj Camp.

Returning these people to Bangladesh, where health systems were already weak, and quarantines difficult to maintain, may not have been a wise step. Furthermore, talking to thethirdpole.net on the condition of anonymity, officials of the Biman Bangladesh Airlines said that the pilots who carried these people were not quarantined.

AZM Anas, economic editor at Dhaka’s Financial Express newspaper, said that the health system of Bangladesh is pitifully ill equipped to handle a potentially dangerous outbreak which could turn into an epidemic. Even if a coronavirus drug is available in future, would Bangladesh be able to afford it, he asked. “When countries like the United States and Italy declare state of emergency, can we afford to drag our feet? I’m not saying we should follow the same the US and Italy did, but we need to snap air connection with China without any further delay.”

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