Titu Nakti is relieved that his 11-month-old son, Tamzid, is finally going home to Madaripur after a week-long battle with measles at a Dhaka hospital. Yet, a newly acquired debt casts a shadow over the relief.
Titu, a battery-run rickshaw van driver in his mid 30s, said he had to borrow Tk 25,000 from his neighbour just to cover his son’s medical expenses, leaving him saddled with a monthly interest payment of Tk 2,500. Locked out of the formal system, Titu is paying a punishing 120 percent annual interest rate, compared to the 14 percent he might have secured from a traditional bank.
“It’s a huge relief that my son is recovering, but I’m really worried about repaying the money I borrowed,” Titu said at the DNCC Dedicated Covid Hospital in Mohakhali, recently converted to treat measles patients.
Titu’s struggle reflects how a nationwide outbreak is pushing vulnerable families into their absolute limits.
Around 58,500 confirmed and suspected measles cases and 424 deaths linked to the disease, including nine yesterday, have been reported.
If the outbreak continues, it could add to the various financial challenges people are already facing, said Prof Shafiun Nahin Shimul, director of the Institute of Health Economics at Dhaka University.
Interviews with a dozen parents over the past three days at the DNCC hospital and the Infectious Diseases Hospital (IDH) in Dhaka revealed a recurring pattern: families travelling to the capital after local facilities fail to handle severe complications.
For poor households, the health emergency quickly turns into financial trouble.
Many of the children have had diseases prior to measles that cost these families their savings.
After contracting measles, many parents had to turn to neighbours or informal lenders to pay for ambulance fares, medicines, and food in Dhaka.
According to what the families told this paper, treatment costs range from Tk 20,000 to Tk 40,000 at government hospitals. For those needing ICU support at private hospitals, the cost is in lakhs.
The burden is twofold for low-income families. They are not only spending heavily on treatment but also failing to earn while caring for sick children.
Tamzid developed a fever on May 1, only days after recovering from pneumonia and a three-day stay at Madaripur Sadar Hospital. When his condition worsened the next day, he was readmitted.
The family later consulted a doctor acquaintance and rushed him to a private hospital in Khulna, but doctors there refused admission, saying his condition was too critical. Desperate, the family travelled to Dhaka and finally secured a bed at the DNCC hospital on May 6.
“I had to pay Tk 16,500 for the ambulance alone,” Titu said, adding that he had already spent around Tk 14,000 during the two hospital stays in Madaripur.
The DNCC hospital, which was treating 443 measles patients yesterday, including around 100 children in Tamzid’s ward, supplies most medicines. But other expenses keep mounting. Titu estimates the family spent another Tk 6,000 on food, transport, and supplementary medicines in Dhaka.
“In the last month, I could not run my auto-van as I was busy taking my child from one hospital to another,” he said.
At IDH, Farzana Akther sat near a third-floor staircase, watching her five-month-old daughter, Sadika Noor Safa, sleep on a mattress. Farzana was waiting for her husband to return with a nasogastric tube to feed the baby.
Their savings had already been exhausted.
The child had recovered from chickenpox only 10 days earlier. Doctors at Shreenagar Upazila Health Complex referred them to Dhaka at the time. The family had then spent around Tk 35,000, including Tk 14,000 for the ambulance, for a nine-day stay at IDH.
Farzana’s husband works as a day labourer.
When the baby developed fever and measles on May 5, a lack of ICU support at the local upazila health complex forced the family back to Dhaka again.
Out of money and having already relied heavily on their parents and in-laws, Farzana had to part with a quiet, personal treasure.
“I sold my wedding nose pin for Tk 2,000 to help bring my daughter to Dhaka as quickly as possible,” she said.
During this second trip alone, the family has already spent about Tk 13,000 on transport, food, and supplementary medicines.
At the DNCC hospital, Mohammad Alauddin, an auto-rickshaw driver from Barishal now living in Hazaribagh, waited for test results for his 14-month-old son, who contracted measles and diarrhoea three days ago.
Alauddin himself has been unable to work since fracturing his right arm in an accident over a month ago.
After spending Tk 7,000 at the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), he was told he needed surgery. Unable to afford the Tk 35,000 allegedly demanded by hospital brokers, he turned instead to a quack, paying Tk 8,000 upfront with another Tk 7,000 due later.
Now, his three-member family survives only because of his four sisters covering their rent and daily expenses.
“I don’t know how I will bear these costs when we are already depending on my sisters to survive,” Alauddin said.
Like Alauddin and Farzana, Titu is now planning how to survive financially after leaving the hospital. He hopes to secure a loan from a local NGO at a lower interest rate so he can repay informal lenders and begin reducing his debt burden.
Prof Shimul said the outbreak has hit poor and slum communities hardest because measles vaccine coverage remains relatively low in those areas.
He added that higher rates of child marriage among low-income groups often lead to low-birth-weight babies and poor nutritional conditions, making children more vulnerable to infection.
Public health expert Mushtuq Husain said the crisis is fuelled by the living conditions of the poor.
Malnutrition and overcrowded environments create fertile ground for infections, putting low-income children at the highest risk, he said.
Fear of massive medical bills also causes many parents to delay seeking hospital care until conditions become critical.
“By the time they are forced to take their children to the hospital, treatment costs rise because of the severity of the illness, and in many cases, the children cannot be saved,” Mushtuq said.
He argued that medical treatment alone cannot break this cycle.
Mushtuq called for urgent structural support mechanisms for poor communities, including community-based isolation centres in slum areas, where the government and society can step in to share the burden before a family’s financial fear costs a child their life.
