has happened to the Dhaka Medical College Hospital ?
of our readers who have gone through our correspondents Naimul Huq
and Bindu Saha's piece “Midnight nightmare at DMCH” must have had
great difficulty in removing the graphic images of haemorrhaging patients
not being attended to, severely injured victims waiting for hours
for a doctor to see them, patients with fractured limbs being forced
to walk or being dragged to x-ray machines because there is no trolley
available, etc. We received several phone calls expressing complete
disbelief that such things can actually occur in a hospital. The truth
is that they do and has been for some years now.
remember how efficient, patient friendly and clean Dhaka Medical College
Hospital (DMCH) was. My first acquaintance with this premier hospital
of the country occurred in 1960. This was when, after 13 months of
solitary confinement in Ayub Khan's (the first Martial Law administrator
of Pakistan who came to power through a coup d'etat in 1958) jail,
my father, Abul Mansur Ahmad, was suddenly shifted to DMCH from Dhaka
Central Jail as his condition deteriorated to a critical state. He
needed to stay in the hospital for several weeks. My mother stayed
with him all the time and I accompanied her on most occasions. As
a young boy I used to loiter around the huge 2nd floor corridor of
the hospital, climb its red coloured stairs several dozen times a
day and try to steal into the hospital's only elevator along with
some patient as often as I could. The elevator, which we call a lift
in Bangladesh, was a novelty at a that time and riding it was a very
myself needed to be hospitalised for a few days in the late sixties
and stayed in a ward. My mother-in-law had an operation in '73, which
again gave me a first hand exposure of how good and efficient DMCH
was. My last experience at this great institution was when we took
our sick father for a series of check ups in early 1979 just a few
weeks before he passed away.
then a lot has changed, regrettably mostly for the worse. But the
question is why? We think it is a systematic flaw. The institution
has been forced to lower its standard due to neglect, inappropriate
resource allocation, lack of leadership, and interference by the higher
authority and of course corruption and lack of management skills.
Tk. 30 crore, the Asian Development Bank funded new
Operation Theatre (OT) complex consisting of 12 new operation theatre
was started a few years ago. About six have been completed and others
await completion. A Tk. 15 crore-extension work of the hospital has
also been completed including the creation of VIP rooms, some single
rooms and other related facilities. Some very expensive and essential
machines are also in place that are used for limited hours as technicians
qualified to use them are very limited in number.
is interesting to note is that we see the propensity of going for
big renovation and extension protects while there is a definite lack
of improving the day to day service of the hospital. As our “Midnight
nightmare” story clearly points out, practically nothing has happened
in terms of providing better service to the thousands of patients
on a day to day basis.
the total bed capacity of the DMCH has been doubled, from 600 to 1,200.
However the yearly allocation for MSR (medical and surgical requirement)
remains at Tk. 3.97 crore. There is an OCC (One Stop Crisis Centre)
fund of Tk. 50 lakhs. Though the number of beds has been doubled,
the number of doctors remains at 326, nurses 445, interns 126. Without
a commensurate increase in the professional staff there cannot be
improved service in the DMCH.
is another problem that needs to be immediately addressed; and successive
governments have shied away from it for reasons completely incomprehensible
to us. It is the total taking over of the hospital administration
by the so-called class IV employees of the hospital. These employees
do menial work like cleaning, providing trolleys, serving food, etc.
This group now controls the emergency sections and decides which patients
will get admission and which ones will not. Obviously patients who
want service have to pay them adequately or they will not even be
able to register. There are the private clinics that whisk away patients
from DMCH's doorstep with the help of these class IV employees. Doctors,
nurses and even the hospital administration are afraid to go against
this group for the fear of anything from verbal abuse to physical
assault. Some of them are in league with them for the extra money
that it brings.
story of DMCH is sad. But it does not have to be. We urge upon the
government, especially the health ministry, to take a determined stand
to clean up the DMCH. The first decision should be to set up an autonomous
administrative body under a professional board of directors. The government
can entrust this body with power and reasonable budget and give the
task of running it independently and professionally. If our doctors
and hospital administrators can run private hospitals successfully,
why can't a great institution like the DMCH be run properly? The fact
is that it used to be run better in the past. How was it possible
then? Let us learn from our own past experience, add to it all the
modern day knowledge and apply it. Let us also remember that hospital
management in today's world is a far more complex, challenging and
advanced art than it was before. Let us also get away from the view
that hospital management and medical knowledge is the same thing.
want to see our DMCH reach its old glory, and it can. What is needed
is a determined decision from the government.