A massive expansion of intensive care infrastructure in Bangladesh following the Covid-19 pandemic has failed to translate into lifesaving services, with most of the country’s installed intensive care unit beds lying unused mainly for manpower shortage even as critically ill patients continue to die waiting for such care.

The crisis has become starkly visible amid the ongoing measles outbreak, which has reportedly killed at least 156 children and infected over 17,024 others since March 15, exposing deep systemic weaknesses and raising serious questions about health sector planning and accountability.

According to official data from the Directorate General of Health Services, Bangladesh now has 1,372 ICU beds at 72 public healthcare facilities and 1,054 CCU beds at 51 facilities — almost three times the pre-Covid figure of 498 ICU beds which were far lower than the standard requirement.

Health officials and hospital authorities say that over half of these ICU beds remain out of service due to an acute shortage of manpower, lack of maintenance, and technical failures — rendering expensive equipment idle while patients queue for critical care.

Health minister Sardar Md Sakhawat Husain on Monday told New Age that they had taken measures to inaugurate 13 ICU facilities by next week.

The facilities total over 100 beds.

However, DGHS hospital wing director Abu Hussain Md Moinul Ahsan did not share if any information on unused ICU was available.

Hospital officials said that the crisis stemmed from a fundamental flaw — expanding infrastructure without ensuring the requisite operational capacity.

In March alone, at least 229 patients — including 91 children — died at Rajshahi Medical College Hospital while waiting for ICU beds, as the hospital struggled to cope with a surge in critically ill patients, many suffering from complications related to measles and pneumonia.

Data from Rajshahi division show that out of the 94 ICU beds installed under a pandemic-era project, only around 50 are currently operational. The remaining beds lie idle in district hospitals due to lack of doctors, nurses, and technicians.

At RMCH, which serves a vast population in northern Bangladesh, the demand for services consistently outstrips the supply. In March, 386 children were placed on ICU waiting lists, 91 of whom died before receiving care. Among adult patients,  dozens met similar fates while waiting.

Examples of unused ICU facilities abound across the country.

At the Infectious Diseases Hospital at Mohakhali in the capital, a 10-bed ICU unit has remained unused for years due to manpower shortage. The facility was only made operational after a child died recently without access to ICU care, on an emergency directive from the health minister.

In Bhola, a six-bed ICU unit installed at the district hospital in 2020 has not been used for a single day. Hospital superintendent Taiabur Rahman said that many of the machines had meanwhile gone out of order after years of neglect.

In Tangail, a 10-bed ICU launched in 2020 at the district hospital ceased operations in February 2025. The equipment has remained unused for over a year despite repeated requests to authorities for staffing support.

In Munshiganj, a 10-bed ICU facility remains unopened, with equipment unboxed due to lack of manpower.

Even in specialised hospitals in Dhaka, gaps persist. At the National Institute of Cardiovascular Diseases, at least five ICU beds are currently non-functional.

Hospital director Abdul Wadud Chowdhury said that all operational ICU beds remain occupied year-round, leaving many patients waiting.

Much of the ICU expansion was carried out under the World Bank-funded ‘Emergency Response and Pandemic Preparedness’ project, launched in April 2020 with an allocation of $100 million.

Under the project, the government installed ICUs in 10 medical college hospitals and 13 district hospitals.

However, health officials acknowledge that while equipment and infrastructure were delivered, adequate manpower was not ensured.

‘The facilities were launched virtually, but many did not have the staff required to run them,’ said a DGHS official.

Temporary staffing support was provided at some hospitals during the project period, but once the project concluded in June 2025, services in many facilities were suspended due to the withdrawal of manpower and operational funds.

Officials also admitted that even ICU units established before the pandemic were suffering from poor maintenance and lack of technical support, leading to gradual deterioration.

Public health experts say that the crisis reflects deeper structural weaknesses in Bangladesh’s healthcare system.

Professor Syed Abdul Hamid of the Institute of Health Economics at the University of Dhaka said that while the shortage of ICU facilities remained significant, the management crisis was even worse.

‘How can facilities be installed without a proper operational plan?’ he said, pointing to the acute shortage of trained personnel as the primary bottleneck.

Former president of the Bangladesh Medical Association, Rashid-e-Mahbub, stressed the need for long-term workforce planning.

‘The government must develop a system to produce need-based skilled manpower. Otherwise, these expensive machines will become useless,’ he said.

Bangladesh’s ICU capacity remains far below international benchmarks.

Global guidelines typically recommend at least three to 10 ICU beds per 1,00,000 population. Even at the lowest threshold, Bangladesh would require more than 5,000 ICU beds for its population of around 17.5 crore — far exceeding the current capacity.

Yet, experts say, the real crisis is not just the number of beds, but their usability.

For patients and their families, the consequences of this systemic failure are immediate and painful.

The ongoing measles outbreak has intensified the demand for paediatric ICU care, pushing an already strained system to its limits.

RMCH doctors said that most paediatric ICU beds were now occupied by measles patients, forcing authorities to increase capacity from 12 to 18 beds by reallocating resources — still far short of the demand.

Meanwhile, in districts without functional ICU facilities, patients continue to be referred to distant hospitals, often resulting in loss of critical time.

The public hospitals provide ICU services in cheap rates, which in private facilities sometimes take 20 times that cost, making it unbearable for many patients.

Despite the nationwide expansion, ICU services remain heavily concentrated in the capital.

An analysis of DGHS data shows that 736 of the 1,372 ICU beds — more than half — are located in just 22 healthcare facilities in Dhaka, leaving many districts without any functional ICU in public hospitals.

This disparity forces critically ill patients to travel long distances to urban centres, often only to face uncertainties and long waiting lists.