Some hospitals in the country continue to deny treatment to patients, even though the government has repeatedly instructed them to ensure all types of medical services for patients during the Covid-19 pandemic.
On May 24, the Health Services Division ordered hospital authorities to recast all hospitals, public and private, separating covid and non-covid units to ensure treatment for everyone.
However, many patients have complained that they are denied treatment for diseases other than Covid-19 even after visiting several hospitals, if they have symptoms such as cold, fever, or cough.
Hospital authorities claim various crises including shortages of manpower, beds, and other facilities are hampering their ability to provide services. The situation is the same in both government and private hospitals.
The government has warned that private hospitals and clinics risk getting their licenses revoked if they refuse to provide treatment to patients. However, public health experts have said that only directions and warnings are not enough.
Specific guidelines and coordination between government, non-government, and other subordinate medical wings are needed, as well as a means to ensure accountability.
Patients are the victims of the lack of coordination and accountability, and there are cases where people have died after being refused treatment until it was too late, they also said.
Israt Jahan was a student of accounting at Kabi Nazrul University College, one of seven colleges affiliated with Dhaka University. She lived in Sonargaon, Narayanganj, and died after visiting two hospitals and not being admitted to an ICU. She had been suffering from shortness of breath.
Israt gave birth to a baby girl at Matuail Shishu Matrisadan Hospital on June 6. She was discharged from the hospital on June 11.
The following day, after returning to her home in Soargaon, she started suffering from breathing problems. Her relatives rushed her back to Matuail Shishu Matrisadan Hospital, but the hospital did not admit her claiming they did not have any room in the ICU.
Israt was then sent to Dhaka Medical College Hospital (DMCH), but could not gain admittance there as they also did not have an available ICU bed. She died in an ambulance on the way to a private hospital around 3pm on June 12.
In another incident, an Awami League leader from Chittagong was rushed to a hospital with severe chest pain but denied admittance, and eventually died in his car. The deceased was Shafiul Alam Chagir, general secretary of Bayazid Thana Awami League.
Similar incidents of patients being denied treatment at hospitals have been reported in the media a number of times since the Covid-19 pandemic arrived in the country.
Private Medical College and Hospital Owners Association President Mobin Khan said: “Warnings or issued directions alone cannot be a solution. We need to consider reality. So far, more than 30 doctors have died from Covid-19 in the country. The hospital authorities first need to ensure that patients are tested for coronavirus and then they can provide treatment as per the hospital’s ability and facilities.
“Most of the hospitals are already filled with patients. There are no empty beds. So, the hospital authorities are facing two problems: A lack of manpower and facilities, and they only want to admit patients after testing for coronavirus because their staff members were infected by patients who were hiding their history,” he added.
“We will not deny that one or two incidents [of patients being denied treatment] have happened, but it is not true that it happens frequently,” Mobin Khan continued.
Dr Aminul Islam, director (hospital) of the Directorate General of Health Services (DGHS), said: “We have issued a letter and have held several discussions with the authorities of hospitals so that they can implement the government directions and policy for ensuring all kinds of treatment.”
He did not comment when asked about who would take responsibility if patients were denied treatment.
Director-General of the Department of Health, Prof Abul Kalam Azad, said: “We are taking a long term treatment plan. We hope that increasing the number of hospital beds will help address the problem [of patients being denied treatment].”
Dr Shah Monir Hossain, head of the expert committee under DGHS, said: “The lack of a sustainable plan to ensure lives and livelihoods in the health sector is due to a bureaucratic crisis. We fail to bring the public and private health sector under the fold to provide proper medical service to all.
“Health services cannot be ensured by mere planning in just name only. We need an adequate budget allocation and health surveillance of the population. We are busy buying materials but not implementing any measures,” said the former DGHS director.
Not all hospitals capable of treating all kinds of patients
According to DGHS, 654 hospitals are operating under government management with 51,316 beds. There are also 5,055 private hospitals and clinics with 90,587 beds.
But only a few hospitals can reshape their hospitals to provide separate Covid-19 and non-Covid-19 units.
“As we said, it will take more time to segregate hospitals as this requires a lot of preparation,” said Habibur Rahman Khan, additional secretary of the Health Services Division.
However, he said complaints of patients being denied treatment are decreasing as some private hospitals have already started to provide services to both Covid-19 and non-Covid-19 patients.
“There are huge challenges to maintaining coronavirus isolation units properly as Covid-19 is a highly contagious disease,” said Dr Nazrul Islam, virologist at Bangabandhu Sheikh Mujib Medical University (BSMMU).
“The number of coronavirus patients is increasing rapidly and it is not possible to prepare a hospital quickly to meet the demand. This is why providing basic treatment is a challenge now,” said Prof Nazrul, also a member of the National Technical Advisory Committee.
Dr Nazrul pointed out the shortage of manpower as another reason why hospital authorities are struggling to implement the new system.
A special duty roster is implemented in hospitals for doctors attending coronavirus patients, which is also causing a shortage of manpower at hospitals.
