When every breath is no longer a luxury

“My child was having seizures. My mind was not working. I couldn’t figure out what to do,” remembered Sharmin Siddiki about her previous night.

As Sharmin talked, her three-year-old child, Fatima, was drifting into sleep. Amid the rhythmic sounds of the UNICEF-supported oxygen equipment, Fatima’s eyes closed. Her mouth and nose rested under the green translucent oxygen mask.

With the support of UNICEF and partners, no longer was the three-year-old gasping for air.    

Seizure, pneumonia, and interrupted oxygen

In the dead of night the day before, Fatima had a seizure. During a moment of despair, Sharmin thought that her only child would not make it till dawn. Holding the feverish girl in her lap, Sharmin left the house and waved for a rickshaw to rush to Mugda Medical College Hospital.

As soon as she made it to the hospital, Fatima had the next seizure. As it turned out, she had pneumonia - one of the leading causes of death for children under five in Bangladesh. While treatable, pneumonia and many other respiratory diseases, remain fatal for children in health facilities not equipped with adequate oxygen equipment.  

“By the time I can bring an oxygen cylinder, it might already be too late,” remembered Efteara Begum, a nurse supervisor at UNICEF-supported Mugda Medical College Hospital. “But we have overcome this challenge. We no longer have to do this now.”

During COVID-19, breathing was a luxury

For years, Efteara had taken care of sick children like Fatima and saw firsthand the heart-wrenching impact of lacking oxygen care. Many patients and newborns needed uninterrupted oxygen but had to take turns using oxygen cylinders, which also couldn’t meet the needs of all patients. And when oxygen therapy was available, there were potential fire hazards caused by oxygen infrastructure and equipment.

This reality was not only happening once in Efteara’s hospital; it still was in many places in Bangladesh. During the COVID-19 pandemic, oxygen shortages were especially revealed, pressuring the country’s already overburdened health system.

Prompted by the oxygen crisis during the pandemic, a UNICEF-supported assessment in 2020 found that a staggering 70 percent of health facilities in Bangladesh did not have adequate oxygen infrastructure in the maternal, pediatric, and newborn units. Around 88 per cent of doctors were not trained to safely use oxygen equipment. And none of the Upazila Health Complexes (health facilities in rural areas) had oxygen manifold systems.1

Without oxygen, sick children like Fatima couldn’t survive.

Fatima’s recuperation

To Sharmin’s relief, Fatima was immediately moved to a bed equipped with a UNICEF-supported centrally supplied oxygen outlet, which delivered oxygen directly to each patient.

Medical staff and nurses like Efteara no longer had to move oxygen cylinders from bed to bed. Instead, patients could easily receive uninterrupted oxygen from their beds.

“My daughter received oxygen support immediately. Here, they connected the oxygen,” said Sharmin, pointing to the oxygen outlet above Fatima’s bed. “After an hour, my child was doing better thanks to oxygen support and her fever came down. This oxygen treatment saved my child. It is a blessing that this service is available here. I did not need to rush my sick child from one location to another, searching for oxygen treatment.”

Planting seeds for a better future

During the COVID-19 pandemic, thanks to the contribution of donors, UNICEF supported the Government of Bangladesh to strengthen oxygen infrastructure and equipment throughout the country.

“What we didn’t have in the beginning was a vision of what an oxygen system looks like. And this initiative has helped us to discuss this and develop a system of oxygen that is suitable for Bangladesh,’’ emphasized Maya Vandenent, Chief of Health, UNICEF Bangladesh. “We have taken this crisis of the pandemic as an opportunity to build stronger health systems in Bangladesh.”

Beyond Mugda Medical College Hospital, in 2022-2023, oxygen manifold rooms and central oxygen pipelines were constructed and installed in 60 Upazila Health Complexes. Across the Special Care Newborn Units in 30 hospitals, liquid medical oxygen plants[2] were also built and maintained, health facilities renovated, and gas pipelines for oxygen management installed. More than 300 healthcare staff received training to efficiently use and maintain oxygen equipment, and over 1,000 health care staff and managers learned about fire safety procedures. Efteara was among them.

“The central oxygen system has made the treatment easier and accessible for everyone,” said Efteara. “The fire safety trainings not only help me in my workplace, but also help me at home. I will also teach my colleagues and family members on how to manage a fire without getting panicked.”

Most importantly, the initiative had resulted in a national medical oxygen plan to ensure long-term access to oxygen for the most vulnerable children in Bangladesh.

For every child like Fatima, quality oxygen care

Since 2021, thousands of children in Bangladesh like Fatima have benefited from the UNICEF-supported initiative.

UNICEF will continue to support the Government of Bangladesh to strengthen its health system and improve the quality of care for newborns and children, ensuring that every child like Fatima can survive and thrive to their full potential. 

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1 Oxygen manifold system is a critical component in healthcare facilities where a centralized and reliable source of medical oxygen is essential. It provides and distributes oxygen to various patient care areas and equipment throughout a healthcare facility.

2 A liquid medical oxygen plant is a facility that produces liquid oxygen. The facility or plant uses a separation process to liquefy atmospheric air and separates oxygen from other gases. 

UNICEF wishes to express sincere gratitude to the World Bank, the Bill and Melinda Gates Foundation, the Government of Canada, the Government of Norway, UKAID and USAID, for their continued support and immense contribution to the health and well-being of children and newborns in Bangladesh.