The COVID-19 pandemic has brought unprecedented challenges for eye care providers in Bangladesh. Eye health workers are also risking their lives to care for patients as they are in close contact with patients during consultation, screening or treatment service. But Deep Eye Care Foundation has taken it up as an opportunity to rebuild & adopt themselves to step forward for the new era of COVID-19. To ensure the eye care services are continued, DECF did not close their activities for a single day except holidays. DECF continues its services, catering to only emergency cases both medical & surgical at the time of lockdown and after lockdown starts to serve all OPD patients with a conscious effort to keep the regular services functioning. Generally, before the lockdown, the hospital served an average of 700 patients per day in the general OPD. At present there are about 250-300 patients per day in the OPD. Although the health of our patients and staffs is our biggest priority. We have put in place a number of precautionary measures while providing our highest standard of ophthalmic care in the safest possible way.
Ample of precautionary measures:
- To develop awareness on COVID-19 among the hospital staffs as well as the patients printed posters and festoons with COVID 19 message is being displayed at the hospital premises.
- Restrict the unnecessary movement of the patients’ attendees. It is preferred that patients enter alone to the hospital. If a support person is needed, this is restricted to one person.
- Separate Setting arrangement of the attendees outside of the hospital building.
- To stop the crowding in the waiting area, an additional registration desk has been set up temporarily.
- In order to ensure clean hygiene of patients and staff, a temporary hand wash area has been built in front of the hospital entrance. All patients and staff are required to wash their hands before entering the hospital.
- Bleaching powder soaked carpet is put in front of the entry gate.
- Face mask is mandatory for every person entering hospital building. We are also providing face mask free for the patients who come without mask or if the mask is not clean.
- Body temperature is being checked using a Thermal Scanner before entering hospital.
- Maintaining social distancing of at least 1 meter wherever practical.
- All setting chairs are spread out or maintaining gap between chairs
- All ophthalmic equipment used including the slit lamp, fundus camera, B-scan machine in the OPD area are cleaned after every patients examination and investigation.
- Alcohol disinfectants are used to clean surfaces and equipment in consulting rooms and in clinical and administrative areas. Attending doctors, nurses and OAs are using face shields and protective wear, for example, using adapted theatre gowns as personal protective equipment (PPE) when attending patients. Hospital is providing gloves, gowns, and hand sanitizer for the staffs.
- Signing a special declaration Form by the patient regarding COVID Hospital transmission risk and hiding of information hazard.
- All routine elective eye surgeries have been postponed until the situation is normal. All outreach programs remain suspended till now.
OPD Performance report during COVID-19 lockdown: (April-May-June, 2020)
OPD Patient Flow comparison with previous 3 months:
| New & Review Patient flows: | Male & Female Wise Patient flows: | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Age group wise Patient flows: | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
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District wise Patient flow during Lockdown Period:
| District wise Surgery Patient | April | May | June | Total | % |
| Rangpur (within 35 km) | 25 | 68 | 164 | 257 | 58% |
| Rest of the districts | 20 | 33 | 133 | 186 | 42% |
| Totla | 45 | 101 | 297 | 443 | 100.0% |
Common Diseases found during lockdown for the month of April, May, June 2020:
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Refraction done among total Patient during lockdown period:
| Number of total Patient=11717 | April | May | June | Total | % |
| Refraction | 672 | 1404 | 3281 | 5357 | 46% |
Surgery done by the Doctors during Lockdown period:
| Name of the Doctors | April | May | June | Total | % |
| Dr. Khairul Islam | 30 | 75 | 206 | 311 | 70% |
| Dr. Abdur Rab | 8 | 6 | 22 | 36 | 8% |
| Dr. Kamrujjaman | 3 | 16 | 27 | 46 | 10% |
| Dr. Maidul Islam | 2 | 4 | 8 | 14 | 3% |
| Dr. Sumsujjaman | 2 | 0 | 31 | 33 | 7% |
| Dr. Rokhsan Afroje Shoma | 0 | 0 | 3 | 3 | 1% |
| Total | 45 | 101 | 297 | 443 | 100% |
District wise Surgery patient during Lockdown Period:
| District wise Surgery Patient | April | May | June | Total | % |
| Rangpur (within 35 km) | 25 | 68 | 164 | 257 | 58% |
| Rest of the districts | 20 | 33 | 133 | 186 | 42% |
| 45 | 101 | 297 | 443 | 100.0% |
Financial Report:
Income status before lockdown & during the lockdown
Productive use of non-clinical human resources:
Engaging Outreach team productively was a challenge during the initial days as they are accustomed with outreach activities. So, Outreach Organizers & Counsellors were involved in exploring all the surgery files of camp patients of last 12 months and start communication over phone to inquire their health status & eye condition during COVID-19 outbreak. They also gave advice & raised awareness on COVID-19 among the camp patients. By this rapport building over phone, they also gathered the feedback & willingness to do second eye surgery, who have cataract in their another eye. Drivers & other supporting stuffs were involved in gardening to grow green leafy vegetables for hospital canteen as well as to sell at low price to the hospital staffs. They also introduced hydroponic system in the garden.
Data Analysis & Research:
As project & training related activities were less than usual time, so staffs & trainees related to this group were involved in retrospective analysis of hospital data. Some research papers can be published from these studies in the coming days.
Conclusion:
Human is adaptive to circumstances by born, hence they are thought to be the super being. COVID-19 was never imagined to jeopardize our daily life style, economy in such way, but we the human being didn’t let it to go unchallenged. Bringing changes in our thinking process we designed our efforts as if our highest capacity utilization do not go un productive. Though we are still far away to achieve the previous state again, but we hope that we shall overcome someday.