The Covid-19 pandemic has shed light on several recruitment and management issues of the health authorities of the country that require immediate solutions.
Unavailability of pharmacists’ services at government hospitals is such a case.
Pharmacists can work in the hospitals and provide medications to patients as per the instructions from the doctors. This important role can be met by recruiting clinical pharmacists at health care facilities.
Sadek Ahmed Sykat, general secretary (GS) of Bangladesh Pharmacist Forum (BPF), said one of the major job sectors for pharmacists is in hospitals or in healthcare facilitates, especially in the role of a clinical pharmacist.
But ironically, government hospitals do not employ any such pharmacists, he added.
Agreeing with Sadek’s claim, Prof SM Abdur Rahman, dean of Pharmacy faculty in DU said those who were employed and in the process of being recruited are actually pharmacy technicians or assistants.
Although it is unknown to people how they could get the best out of the pharmacists, the patients cannot avail it due to the ignorance of the health authorities, he added.
Why clinical pharmacist is needed
Prof SM Abdur Rahman said two types of pharmacists are common in general practices at hospitals or clinics – stock pharmacists and clinical pharmacists.
The role of stock pharmacists is ensuring the quality of the medicine, preserving it in a proper way to keep its ingredients active, deporting lower quality medicine from the storage, and keeping track of the medicine acquisition and supply.
They will also ensure the correct amount of dose for a specific medicine, the professor said.
Some of their work could be done by the technicians but there are many tasks like administering prescription medicine that requires proper knowledge.
Again the clinical pharmacists will work with the physicians under the Pathology and Therapeutics Committee (PTC) and provide information on the probable interactions or adverse impacts of the medications. They will also do clinical monitoring on the patients on any medication.
Evercare Hospital’s Senior Manager Abdur Rahman said a hospital needs 19 categories of pharmacists including clinical, prescriptions, and monitoring pharmacists.
Effective clinical pharmacists are saving lives and generating massive savings on drug budgets. They can also lower the amount of time a patient is required to stay at a hospital, he added.
An Australian study revealed in 2019 that pharmacists’ involvement in ward rounds results in significantly quicker interventions for patients while ensuring a decreased length and cost of the stay.
President of Bangladesh Graduate Pharmacists Association (BGPA) Ishtiaque Ahmed said 25% to 50% of patients suffer from long term health complications or even die due to the incorrect use of medications.
BPF’s Sadek Ahmed Sykat said if pharmacists were recruited in appropriated departments in every hospital and clinic, the malpractice of prescribing additional medicines would not occur.
Role during Pandemic
Ishtiaque Ahmed, who is also an advisor (Oncology) at Aristopharma Ltd said the role of pharmacists is of much importance during a situation like an epidemic, pandemic or an outbreak of diseases.
Physicians learn more about human bodies and their needs while pharmacists know about the ins and outs of medicines and their reactions. But when the enemy is invisible and is constantly changing its morphology (RNA alignment), the importance of pharmacists grows higher.
In this case, a vaccine is the remedy, or otherwise with the symptomatic medicines, growing strong immunity is the key and that is what exactly pharmacists do in the hospitals, he added.
Private hospitals employing pharmacists while govt keeps overlooking
Experts and leaders of the pharmacy sector said while the top private hospitals in the country are recruiting more and more pharmacists to upgrade their health care facilities on demand, none of the government health facilities has any clinical pharmacists.
DGHS said they are authorized to recruit pharmacists only in grade-11 and recruitment of ninth grade officials is a matter of PSC.
Pharmacists who will be recruited in grade 9 are categorized in A grade pharmacists while grade-11 pharmacists are in B category of pharmacists, according to Bangladesh Pharmacy Council.
Senior Manager (Pharmacy) of Evercare hospital in the capital city, Abdur Rahman said nowhere in the world one will find A and B categories of pharmacists.
There are some 2,740 posts for grade-11 pharmacists at government hospitals while some 1,300 are working at the hospitals, a source from Bangladesh Diploma Pharmacists Associations said.
BGPA President Ishtiaque Ahmed said the four organs - physicians, nurses, pharmacists, and paramedics - should work in one fine-tune and only then the health system would be much more patient-friendly.
BPF’s Sadek Ahmed Sykat said after adopting “The rules and regulations for recruiting non-medical employees” in March 2018, the government initiated a programme to recruit around 50,000 non-medical officials and employees for public hospitals and health complexes across the country.
At that time the then health minister Md Nasim planned to recruit some 1500 pharmacists but that never came true, he added.
He also promised to recruit pharmacists at least at the government medical college hospitals and district hospitals but all went in vain, said BGPA President Ishtiaque.
Sadek said he sent an email urging the DGHS to give them a scope of working at the hospitals on a volunteer basis during the pandemic as they would never get a chance to work in such a crisis.
He sent the mail to the Director (Hospital Services) on April 7 but did not get any response and later the forum submitted an application to the DG of DGHS on May 3 to facilitate them into the hospitals.
But they did not get any response yet, he added.
What the authorities say
Director (administration) of DGHS Belal Hossain said they have no plan to recruit more pharmacists right now as they do not feel the need although there is still some scope.
When asked about the volunteer request he said he was not aware of the submission but he has already sent such applications to the ministry.
Director (Hospital) Aminul Islam could not be reached over the phone.
Meanwhile, Professor Abdur Rahman, also a member of Bangladesh Pharmacy Council, pointed his finger at the council for its ineffectiveness to bring them into the services.
It’s not a luxury, it’s a necessity for the betterment of the patients, he said.
Council’s current Secretary Muhammad Mahbubul Haq could not be reached over the phone for comments.
