Amzad Hossain, a trader, sustained a head injury after falling out of a tree a week ago. He was admitted into the neurosurgery ward of the Dhaka Medical College Hospital (DMCH). Doctors bandaged his wound and advised him to change his dressing every day.
A so-called “special ward boy” helped him change his dressing on the first day. The next day the boy asked for Tk200 for the same service; otherwise, he said, he could not help the injured man.
Like Amzad Hussain, many DMCH patients, including those in critical condition, have to give in to such unscrupulous demands at the country's largest public hospital.
The 17,000-bed DMCH is riddled with unauthorised personnel like the “special ward boy,”a result of the hospital's serious staffing shortage. These unofficial employees have been known for extorting patients at the DMCH.
A total of 357 posts for third and fourth tier employees have been lying vacant for the last three years. The lack of adequate numbers of employees has taken its toll on the quality of the hospital's services. The DMCH is managing its workload by utilising "special ward boys" instead of fully qualified nurses.
The parliamentary standing committee of the ministry of health has discussed its concerns over the manpower problem within major health facilities such as the DMCH. At a recent meeting it asked the hospital's authorities to take initiatives to fill the vacant posts of third and fourth tier employees.
Brig Gen Mustafizur Rahman, director of the DMCH,said: “We are in a great deal of trouble due to a lack of human resources. Between 4000 and 5000 patients receive health services daily from the hospital, but we cannot afford to give them proper attention.”
He said the number of vacant posts is increasing by the day, damaging the image and, more crucially, the levels of care at the public hospital.
In 2009, the DMCH placed a job advertisement in the newspapers for the posts of 171 third and fourth tier employees.
However, this came under huge nepotistic pressure from ministers, parliamentarians, political leaders, doctors and hospital administrators, who wanted to influence the DMCH recruitment process for the benefits of their relatives and other personal connections.
The hospital authorities, giving in to the pressure, appointed 354 employees, with each job seeker having to pay from Tk200,000 to Tk300,000.
Almost all the national newspapers and electronic media published and broadcast reports on the corruption involved in the appointment process.
As a result, the health ministry had a team perform an inquiry and eventually cancelled the appointments. The employees however already appointed filed eight written petitions contesting the decision of the ministry. Three years have gone by since then, the director said, in the hope that everything would be resolved after the judgment.
Because of the subsequent capacity crisis, a large number of unauthorised personnel are working throughout the hospital, including the emergency rooms, without official appointment from the authorities concerned. However, they are believed to work only after attaining the verbal consent of doctors and hospital administration.
The unofficial workers allegedly ask patients for extra money for the slightest service they provide. Nobody obtains services from them without payment and quite often they demonstrate a lack respect for the patients.
Rahman conceded that these people are not paid by the hospital; therefore they have to ask the patients for money in exchange for their services. “We know this is unethical but we can't take any action against them because they are not government employees. Not allowing them to work could result in the collapse of the hospital's system.”
Another high official who wished to remain anonymous said that unauthorised hospital workers demand money from patients like extortionists.
He also alleged that the unofficial workers were on good terms with a number of influential doctors and hospital administrators.
