Why is Saline so elusive?

Jashore 250-Bed General Hospital has not provided injectable saline to patients in any ward, such as medicine, gynaecology, cholera, and surgery, for the past two months.

As a result, patients have to buy it from outside at several times higher prices.

The upazila health complexes in the district have also faced a shortage of injectable saline supplies.

If saline is available in one or two pharmacies in the city, the price soars to Tk250-300, which is significantly higher than its regular rate of Tk95. This sharp increase in price has caused immense suffering for patients and their relatives.

Apart from Jashore, a crisis of injectable saline exists in many other districts and upazilas, including Sylhet, Cumilla, Khulna, Bogura, and Savar.

While the intensity of the crisis is lower at government hospitals, there is an acute shortage of saline in private hospitals and pharmacies, compelling patients to purchase saline at significantly higher prices.

Due to the dengue outbreak, other patients are also being affected by the shortage of injectable saline across the country.

Nazrul Islam, a 60-year-old resident of Fatehpur union in Jashore Sadar, underwent surgery at the district's general hospital on Tuesday.

Biggest saline producer runs at 25% capacity for 'capital crunch' 

Lucky Khatun, his wife, said after being admitted to the hospital two days ago, her husband required eight bags of saline every day.

"The hospital did not provide any saline. Saline had to be bought from pharmacies in front of the hospital at double or triple the price," she shared with The Business Standard.

The crisis comes at a time when at least 15 more dengue patients have died, and 2944 were hospitalised across the country in the last 24 hours till Wednesday morning.

Of the new cases, 823 were reported in Dhaka city, while 2121 were in various parts of the country.

Brigadier General Dr Mahbubur Rahman Bhuiyan, director at Sylhet MAG Osmani Medical College Hospital, told TBS, "Because of the low dengue outbreak in Sylhet, the demand for saline has not increased much here. But the crisis across the country has also affected Sylhet. We are not getting saline as per demand."

Stating that the supply of saline has halved compared to earlier, he said, "We have to manage somehow. We're supposed to get some saline on Saturday. It will somewhat mitigate the crisis."

Liton Chand, proprietor of Sita Pharmacy in Rikabi Bazar area of Sylhet, said that there has been a shortage of saline there for a month.

Saline shortage prevails in private hospitals, pharmacies

Stating that there is no saline in his pharmacy, he said that some companies, including Libra, Opsonin, and Orion, supply saline. But they have not been able to supply as per demand for a month.

Although there is no shortage of saline in Cumilla, there have been complaints about high prices. Saline is being sold at two-to-three times more than the fixed rate of Tk87. People have to pay up to Tk87 for each bag.

Nazma Akhtar, a resident of Cumilla city, said that my eight-year-old daughter needs saline because of fever and weakness. "I went to all the nearby pharmacies that are selling saline at higher prices. I was then forced to buy saline at triple the price," she added.

Although there is no shortage of saline in the government hospital of Savar Upazila on the outskirts of the capital, private hospitals, clinics, and medical service providers say that only large institutions continue to treat patients by collecting saline in various ways, while relatively smaller ones are struggling to serve patients.

Village doctors in different localities of Savar say that they are struggling to provide nebuliser support to patients with respiratory problems in emergency cases due to the saline crisis.

Ashulia Pharmacy Development Association President Zahirul Islam Liton told TBS that their association has 3,000 members who are all involved in the pharmacy business. 

He said that no one has been getting injectable saline for the past 1.5-2 months.

"I myself was infected with dengue last month and was hospitalised for six days. The hospital did not have saline, so I had to arrange DNS saline for myself from outside with great difficulty. Except for a small number of people who have leftover stock, no one else has any saline," he added.

Khulna Medical College hospital's pharmacy department reported that their normal saline stock was depleted last Saturday. On that day, they urgently requested a normal saline supply from Essential Drugs Company. Previously, on 15 June, the state-owned company had supplied the hospital with 1,500 units of 500 ml of DNS.

Dr Niaz Mustafi Chowdhury, deputy director of Khulna Medical College Hospital, stated that currently, no hospital has a supply of normal saline.

"We have repeatedly reached out to the government pharmaceutical company, both in writing and via phone. If we can obtain saline, we will be able to administer it to patients," he added.

There is a shortage of saline in almost all the pharmacies in Bogura city. Many unscrupulous pharmacies in hospital areas are taking advantage of the opportunity to sell saline for more money.

The process of importing 7 lakh bags of saline is underway to deal with the saline crisis, said Ashraf Hossain, director at the Directorate General of Drug Administration.

He said six saline companies were producing saline in three shifts, including holidays.

"If the companies continue to produce saline in this way and the market is not manipulated, there might be no crisis of saline. Eight teams at our head office are monitoring the market. If any consumer gives us a cash memo for buying saline at an extra cost, then we will take action against that pharmacy," he added.

TBS correspondents Monowar Ahmed from Jashore, Debashish Debu from Sylhet, Khorshed Alam from Bogura, Noman Mahmud from Savar and Awal Sheikh from Khulna have contributed to the report.