The recent announcement by the health authorities on a recruitment of 2,000 doctors and 6,000 nurses came as a sign of denial and has been demoralizing for medical technologists who had expected to be included in the list.
They said in pandemic conditions, while a virus has strong contagious ability, it is medical technologists who become the frontline fighters since the system is built in a way that they have to be in contact with patients first.
Almas Ali Khan, President of Bangladesh Medical Technologist Association (BMTA), said: “Not naming the medical technologists at their briefing showed how our role is being denied by the authorities.”
And as there is a lack of medical technologists, the testing process requires a longer time, he said, explaining that an exam that could have been conducted in hours is taking two days.
No medical technologists who conduct tests and analyze body fluids at laboratories were appointed at government hospitals in the last 8 years, he said.
The last circular of the recruitment was issued in 2008 when the then director general of Directorate General of Health Services (DGHS) Prof Shah Monir Hossain was in-charge. The process ended in 2011. Since then no recruitments were made, Almas Ali Khan said.
The BMTA noted that according to World Health Organization guidelines the ratio of doctors and medical technologists should be 1:5. But the situation is almost the reverse in Bangladesh.
In Bangladesh the ration is 4:1. It means, the country has only one medical technologist to attend to 100,000 people on average.
The case that halted the process
There was a legal crisis in 2006. The crisis emerged as some medical technology courses were initiated under the Board of Technical Education.
The feud between the Medical Education Department under the Ministry of Health and Family Welfare and the board delayed the recruitment for the past 8 years.
Scene in Bangladesh
According to a DGHS bulletin published in November 2018, a total of 2,736 posts (out of 7,920) were lying vacant in the country.
Some 6,500 medical technologists have been recruited till now. Of them, some have already retired.
Of the total, only 2500 are lab technologists, said the BMTA president.
The Bekar (unemployed) and Private Services Medical Technologists Associations (BPSMTA) said some 30,000 medical technologists who graduated from the institutions under the Health Ministry were unemployed at present.
Till Sunday afternoon, more than 20 medical technologists had been infected with coronavirus.
Only 430 medical technologists collecting samples
As low numbers of medical technologists are working at facilities throughout the country, huge pressure is piling on them, resulting in faulty results.
BPSMTA Press Secretary Ripon Sarkar Pallab said at present some 430 medical technologists were collecting samples throughout the country.
Many of them have to work in labs as well after collecting the samples. As the burden of work is high on them the chances of results being faulty have increased.
BMTA President Almas Ali Khan said in an upazila health care at least three medical technologists were needed and if one of them got infected, the remaining two had to go into home quarantine.
“It means the process of collecting samples in an upazila remains suspended for a certain time,” he added.
"It is not possible to collect samples and test throughout the country with the existing manpower," Almas Khan said, adding that it was unfair not to recruit the skilled manpower available in hand.
Collecting and testing sample: A highly technical matter
Sample collecting and testing is a highly technical matter and a little lapse can lead to a faulty result, said BPSMTA Press Secretary Ripon Sarkar Pallab, who is also a medical technologist at a private medical college hospital.
He explained how samples are collected and tested in laboratories.
At first a medical technologist collects nasal samples and saliva from the patients with a swab stick.
Then the swab stick needs to be kept in an upright tube and preserved in a box in controlled temperature to keep the sample intact.
Collecting and testing might not need much labour but it causes a huge mental pressure, Ripon said.
What govt says
DGHS DG Dr Abul Kalam Azad on April 11 for the first time disclosed that the authorities would collect Covid-19 samples with the help of community health care providers.
As collecting samples was a highly technical issue, it would be deadly to collect them without proper knowledge, which the community health providers lacked, BMTA President Almas said.
They are doing so to cover up their failure in recruiting the medical technologists on time, he added.
When contacted earlier, DGHS Director (admin) Dr Belal Hossain told Dhaka Tribune that the DGHS was rightly the responsible authority to hire medical technologists. And the recruitment procedure could not be started as the authorities were yet to receive directives from the Supreme Court.
But on Sunday, he said in this emerging situation more health care professionals were needed and the process of recruiting medical technologists had started.
He, however, did not mention how many medical technologists would be recruited.
History behind crisis
In 2007, an inter-ministerial committee resolved the crisis behind the feud between the Medical Education Department and Board of Technical Education on the basis of a One-Umbrella concept. The 2008 circular was also made on that basis.
The recruitment ended in 2011. The next circular came in 2013. This time, a group of people who studied in institutions under technical boards filed a writ with the High Court where the court allowed them to be recruited.
So the BMTA filed a writ with the Supreme Court. The apex court in 2016 ordered that the directives of the inter-ministerial committee be followed.
The ministry was so negligible over the issue that it was not able to start the recruitment process within the next three years, which resulted in another legal notice being sent to the ministry.
This time the problem drew the attention of the prime minister and a new eight-member inter-ministerial committee was formed last November to resolve the appointment-related problems. It was headed by Rois Uddin, an additional secretary in the public administration ministry, BMTA President Almas said.
The committee in its report the following month asked the Technical Education Board to stop new admissions to medical technologist courses and make an amendment to their laws.
The committee gave charge of the education of the medical technologists to the Health Ministry and said all health educational institutions would be brought under the same board to implement its "One Umbrella" concept.
The Technical Education Board suspended enrollment by issuing a notice in February this year.
