‘I haven’t been able to work for over 15 days. I lost my job while caring for my daughter,’ said Sojib Barman, sitting beside his nine-month-old child in the measles isolation ward of Shaheed Suhrawardy Medical College Hospital in Dhaka.
A mobile servicing technician from Kishoreganj. Sojib has already spent nearly BDT 80,000 on treatment, financed through loans and the sale of household belongings.
Sojib, his wife and his mother have been staying in the hospital for nine days to care for the child.
‘This is the fourth hospital where my daughter has been admitted. We first went to an upazila health complex, then a district hospital, and later a private hospital. Now she is receiving better treatment, but money has become a major problem. Most of the medicines are given free here, but some must be bought outside, and medical tests are expensive. Food and transport costs are also a heavy burden’, he said.
Sojib’s experience highlights a growing financial crisis confronting families of measles patients as the disease spreads across Bangladesh. Extended hospital stays, loss of income, and rising out-of-pocket expenses are pushing many into debt, even in government facilities where treatment is officially free.
In hospitals across Dhaka and other government hospitals, similar stories are unfolding.
A joint assessment by the Bangladesh Red Crescent Society (BDRCS) and the International Federation of Red Cross and Red Crescent Societies (IFRC) across 12 government hospitals and medical collages found that measles is triggering a significant economic stress among low-income families. Assessment data shows that 100 per cent of the surveyed families required cash assistance.
According to the Directorate General of Health Services (DGHS), from 15 April till now, measles suspected cases crossed 100,000. Bangladesh recorded nearly 84,000 hospital admissions linked to measles, with deaths exceeding 700, including confirmed and suspected cases.
At Dhaka North City Corporation (DNCC) Dedicated COVID-19 Hospital, Khaled Hasan,32, a measles affected patient lies weak in bed, uncertain about his job at a small biryani restaurant in Thakurgaon.
‘I am not sure if I will get my job back,’ Khaled said. ‘I took one week’s leave, and it’s already been nine days. Doctors haven’t told me how long I must stay. A colleague said a replacement has already been hired temporarily.’
A weekly wage worker, Khaled has had no income since he was admitted.
His wife and their three-year-old son, who share the same hospital bed, said the family is running out of money.
‘I just borrowed BDT 10,000 from my parents yesterday.’ she said while feeding her child a banana and bread.
‘So far, we have spent more than BDT 50,000. We first received treatment in Thakurgaon before coming to Dhaka. A large amount was spent there with tests, medicine and ambulance transport. In Dhaka, most expenses are for daily living.’
Debt and Informal Economy at the Centre of the Crisis
Across hospitals, caregivers or patients are losing income, borrowing money, and struggling through prolonged hospital stays. In many cases, entire families are displaced into hospitals, turning treatment wards into temporary shelters for families.
BDRCS with the support of IFRC already reached more than 1,500 measles affected families and continuing- covering Dhaka, Mymensingh, Barguna, Chattogram, Rangpur, Naogaon, and Cox’s Bazar - aimed to support 2,400 measles affected vulnerable families with BDT 10,000 each through financial service provider.
The assessment found that 87 per cent of families had taken loans to cover treatment costs, while 47 per cent had exhausted their savings.
The vast majority - 93 per cent - depend on informal work, earning between BDT 6,000 and BDT 15,000 a month.
'In almost every family we visited in hospitals, at least one income earner had stopped working to care for a child,' said Faysal Ahmed of BDRCS National Disaster Response Team (NDRT).
'Some families have come to Dhaka on borrowed money and are struggling even to afford food and medical tests, he added.
Al-Amin Hossain, a transport painter worker from Barishal, has been staying at Suhrawardy Hospital with his 13-month-old son.
‘I had no work and no income in the past month. Everything was managed through loans. Even buying food was difficult until I received BDT 10,000 from the Red Crescent, which I will use for my son’s treatment and daily needs’, he said.
Private Hospital Care and Rising Treatment Costs
For many families, the search for treatment itself drives up costs.
Ayaz, a nine-month-old child diagnosed with measles, was treated at two private hospitals in Dhaka. His uncle, Mumtahin Sifat, said the family was initially advised to admit the child to a neonatal intensive care unit (NICU).
‘At the first hospital we were told NICU care was needed, but his condition did not improve. A second hospital later said it was unnecessary.
The child recovered after six days, but costs for medicines, doctors’ fee and hospital stays exceeded BDT 150,000.
Migrant Families Also Under Pressure
The financial shock extends beyond informal workers to migrant families who rely on overseas income.
At Suhrawardy Medical College Hospital, Hazera Khatun; came to Dhaka for the first time with her 11-month-old daughter and mother-in-law. Her daughter was placed in an oxygen hood, battling both measles and pneumonia.
Perched on the edge of the bed to give her child more room, she said her husband works in the Middle East, but his income has become uncertain recently.
‘He has not received his salary this week. The last time he sent money, he had to borrow it from a friend,’ Hazera said. ‘Right now, I am almost out of money.’
A similar situation is faced by returning migrant worker Tanjir Ahmed, who spent nearly a decade working in Saudi Arabia and Dubai.
‘I came back with BDT 1 million in savings. But BDT 700,000 was already spent on my sister’s heart surgery,’ he said. ‘Then both my sons became ill with measles.’
Repeated hospital visits, tests, and transport costs quickly drained his remaining savings.
‘Food, transport, and test costs are much higher than the actual treatment cost,’ he said.
Tanjir has now borrowed BDT 50,000 from colleagues in Saudi Arabia and says his financial recovery has been severely set back.
‘I will have to start again from zero,’ he said.
Out-of-Pocket Costs Drive Financial Strain
While treatments in government hospitals are provided at minimal cost, families report that most expenses come from medical tests and medicines unavailable at facilities.
Out-of-pocket expenses – on food, transport, accommodation - often exceed direct treatment. For patients with complications like pneumonia, costs rise due to additional medicine.
Along with 100 per cent of families need cash assistance; IFRC–BDRCS data also shows 34 per cent needed help with medicines, 22 per cent required water, sanitation, and hygiene support, and 19 per cent needed food assistance.
Authorities and experts respond
‘All government hospitals have adequate supplies of medicines required for measles treatment,’ said Dr. Abu Hossain Md. Mainul Ahsan, Director (Hospitals and Clinics), DGHS. He added that additional supplies are dispatched promptly when based on the request of the hospitals.
He noted that six hospitals (Mugda Medical College Hospital, Shaheed Suhrawardy Medical College Hospital, DNCC Covid-19 Dedicated Hospital, Shishu Hospital Infectious Diseases Hospital and Manikganj Sadar Hospital) have been designated as dedicated measles treatment centers, while all public hospitals are authorized to treat patients under national guidelines.
Experts, however, warn that the measles surge is exposing deeper structural weaknesses.
‘A large proportion of measles patients come from low-income and lower-middle-income families. Many are borrowing at interest, pushing them into debt traps,’ said Dr. Syed Abdul Hamid, Professor at the Institute of Health Economics, University of Dhaka.
He warned that families may be forced to sell assets or discontinue treatment due to financial pressure, while lack of information about where to seek care increases costs.
‘The government wants to spend 5 per cent of GDP on the health sector. A portion could be allocated to a National Health Fund to help cover treatment costs during future outbreaks such as measles,” he said.
He added that the social and psychological consequences are severe, particularly when families lose children while carrying heavy debt burdens.
Dr. Hamid also recommended establishing a National Health Fund, creating a dedicated referral system and information centre for measles treatment, and strengthening Upazila Health Complexes and District Hospitals to reduce the financial burden on families.
Back in the isolation ward at Shaheed Suhrawardy Medical College Hospital, Sojib Barman does not know when his daughter will be discharged, or when he will find work again. For now, he sits beside her bed, the same way he has for nine days, waiting, not just for her recovery, but for a way back from the debt that followed it.
***The post is authored by Shameul Islam Shovon, Senior Communications Officer, at the International Federation of Red Cross and Red Crescent Societies (IFRC).