When the clock struck one on a Thursday afternoon, patients Dhaka Medical College Hospital (DMCH) Ward 112 got ready for a routine dose of medicine.
But the only nurse on duty was nowhere to be found. Time ticked on and eventually all the patients got late for their doses.
A little later, Nasima Begum, the senior staff nurse in charge of the ward, was found surrounded by attendants and relatives of patients.
She could not come on her routine visit because she was busy serving them.
There were supposed to be three nurses for looking after the patients in this ward, but Nasima happened to be the only nurse available at the time.
Some of the patients and their attendants said its not just ward number 112, but almost none of the wards at the DMCH have the required number of nurses.
Assistant director of the Directorate of Nursing Services, Morium Begum, said nurses at the DMCH had to attend 20 to 25 patients at a time while the standard nurse to patient ratio is 1:5 at best.
Registrar of Bangladesh Nursing Council Suraiya Begum told the Dhaka Tribune that the acute shortage of nurses was not only affecting the DMCH but also all the other public healthcare facilities in the country.
She said at least 2,000 posts are vacant out of the 17,000 designated posts at the various government facilities. The government has increased the number of beds at upazila and district levels but left the number of nurses the same.
Around 30,000 nurses were working in the private sector because the pay is better, she also said.
The 2,300-bed DMCH is the biggest public hospital in the country where around 2,500 patients on an average come for treatment every day.
In 1984, DMCH was an 800-bed hospital with around 600 nurses. In about three decades, the number of beds had increased nearly three times, in phases.
But the number of nurses remained at 600, of which 90% are female, hospital sources said.
Jahanara Begum, nursing superintendent of DMCH, said the daily workload on each nurse was inhuman: attending more than 20 patients, push saline, injections and give medicines, collect blood and other samples for pathological tests, sending the reports to the doctors, maintaining register books, and so on.
Often the nurses have to carry out the additional duties of a doctor, a ward boy and also those of the sweeper at crunch times, she said.
Referring to a training that she once attended in the Philippines, Jahanara said: “In the Philippines, I saw one nurse looking after just one patient. We do not want that much but at least we can expect the minimum number of nurses to run a ward.”
DMCH Director Brigadier General Mustafizur Rahman said: “The severe shortage of nurses is a big problem for such a huge hospital, especially, with the immense pressure of patients.
He said the hospital authorities were trying really hard to provide the best possible services with limited manpower.
Asaduzzaman Jewel, an ex-officio of Bangladesh Diploma Nurses Association, said the health ministry had created 4,744 new posts at public hospitals and would recruit 2,300 nurses by 2014.
However he said the he process had been going forward very slowly.