It is very natural that the state of the public health facilities would come under public scrutiny from time to time, as millions of patients visit those every year seeking treatment.
The results of such scrutiny in most cases are found to be highly disappointing. Most public hospitals, large or small, and health complexes are problem-ridden and problems are of varied nature. Public hospitals in divisional and district headquarters have been experiencing a serious dearth of senior and specialised physicians and medical equipment/machines. The situation is altogether different in public hospitals in Dhaka where there is an oversupply of all types of doctors. This is because most government physicians, including the seniors, are unwilling to go to places outside Dhaka and try their best to avoid transfers to districts. Connections, political or otherwise, and greasing of palms are employed to remain in Dhaka.
What is, however, a common ailment of public hospitals, be those in Dhaka or outside, is poor maintenance of medical equipment, both diagnostic and therapeutic. The lack of care very often leads to the breakdown of such equipment and consequent sufferings of patients most of whom cannot afford treatment or diagnostic tests at private facilities.
A national vernacular daily other day ran a story on its front page highlighting, what it described, the ailment of hospital equipment. A recent inspection report, prepared jointly by the health ministry and the directorate general of health services (DGHS), has found 438 medical equipment/machines belonging to 13 public medical college hospitals and five specialised hospitals inoperative. The equipment/machines include costly ones like MRI and CT scanners.
There are also many instances where hospital authorities have not even opened crates containing new medical equipment for years. A case in point is the failure to unbox a new linear accelerator, also referred to as LINAC, a machine that aims radiation at cancer tumours with pinpoint accuracy, by the Khulna Medical College and Hospital authorities during the past 11 years. None knows for sure whether the machine is still operational or not. The machine reportedly could not be put to use for a lack of a bunker. The hospital authorities hold the health ministry responsible for that.
Many medical sets of equipment/machines worth billions of taka have remained out of order for lack of repair or proper maintenance at public hospitals. The hospitals concerned often notify the authorities concerned and seek funds for repair and maintenance, but that is hardly made available. Allegations of irregularities in the procurement of goods and services by public hospitals surface very often. What is more troubling is that the suppliers of medical equipment demand an exorbitant amount for doing the repair job.
While visiting a government hospital one can personally witness how poor patients suffer day after day due to acute shortage of equipment used for diagnostic and treatment purposes. For instance, the government cancer hospital has only six radiotherapy machines and the breakdown of one or two is a common happening. With this small number of machines, it has been very difficult for the hospital to treat hundreds of patients coming to this hospital daily from every corner of the country. The situation is so difficult that patients get their schedule of radiotherapy even after six months though they need it urgently. Many patients die even before their first therapy session. Patients throng this hospital for treatment because a complete course of radiotherapy costs between Tk15,000 and Tk 22,000 here while the same costs more than Tk200,000 in a private health facility.
Thus, the failure of government hospitals to serve patients opens up opportunities for private health facilities. Allegations have it that some unscrupulous doctors and technicians at government hospitals join hands to create a situation where patients have no option other than going to private hospitals and clinics of the intriguing doctors’ choice.
The health ministry is aware, at least a part, of the problems relating to medical equipment/machines in government hospitals. It should go deep into those in order to find a permanent solution and ensure medical treatment for poor patients as good as possible.