A medical roller-coaster

Are you happy with the standard of medical care in Bangladesh?

In the 1980s and 1990s when the British High Commission had their own health facility, NGO workers such as myself and the many VSO volunteers in Bangladesh were able to register with and take advantage of the friendly facility. 

By the early 2000s when “5-star” hospitals were being set up in Dhaka and the British authorities were looking to cut administrative costs, non-high commission staff were not able to access the facility any more. Therefore for the last 15 years or so, I have used the services of three prestigious facilities: Evercare (formerly Apollo), United, and Square hospitals. 

As a result of my involvement, in 1971, in refugee relief work, and as an observer of Bangladesh’s journey since then, in every month of March, for the last few years, I am usually busy with seminars, interviews, and writing articles about those days. This year in early March I was invited to show the film, Friends of ‘71 and speak to members of one of the Dhaka Rotary Clubs about my 1971 experiences. After the event, the organizers kindly dropped me back to my apartment in Banani at about 10:30 pm. 

At about 2am, I woke up with extreme abdominal pain, an intensity of which I had never experienced in my whole life. I contacted the excellent doctor who had looked after me during my Covid illness a year ago and antacid medicines were prescribed. When no improvement had taken place, after a couple of days we decided that I should seek admission in hospital on an emergency basis so that I could receive intravenous painkiller medicine and further investigations could take place.

My home helper, who has been with me for 20 years, accompanied me to the emergency department of the hospital where we were told that I could not be admitted until a Gastric doctor (gastroenterologist) had signed off on my admission papers. When we met the doctor, he hardly asked any questions nor did he look at the blood test reports that I carried with me. 

Then he said: “You cannot be admitted until the following tests are done -- endoscopy, colonoscopy, and a CT scan of abdomen.” 

To my astonishment, he then went on to say: “It is 12 o’clock now, tomorrow is Friday, so please come at 9 am on Saturday morning.” I said “What about the pain? And do you not consider me to be an emergency case?” I received no reply.

Somehow I managed to get through the Friday and we reported at 9 am on the Saturday morning. The “day ward” was spacious and relatively clean with not many patients but there was a large number of staff all, it seemed, talking at the top of their voices, which was most disturbing. 

Though we reported at 9 am, the procedures of endoscopy and colonoscopy would not take place until 3 pm. To flush out the intestines, it is necessary to drink a few litres of a laxative fluid and visit the washroom multiple times. On one occasion, I had a bit of an accident so I told the staff that the washroom needed cleaning. 

Nobody came to clean for over 3 hours!

In the evening, with the effect of the anesthesia wearing off, we went to the doctor to receive my file and medicines. I do not remember the discussion but I do remember that I asked, “What about a follow up appointment?” “You can come if you like,” was the reply. 

The doctor had prescribed two medicines for two weeks and one for one month, so, normally a doctor would have said: “Follow up after two weeks unless there are any concerns before that.” What a strange attitude! One thing I was clear about was that I was not going to go to that doctor again. 

And then something miraculous happened. In discussion with an old friend I learnt that the head of the gastro-liver unit in that hospital was a childhood friend and college friend of someone who had been on my Oxfam staff in Calcutta in 1971. He and his friend in Chittagong then briefed the head of the unit in the Dhaka hospital and I was very well received when I went on a follow up visit. 

It seems that it is very important that you are well connected!

Now that I have been to that hospital a number of times, I can say that the administration is very bad. There are notices everywhere “NO MASK, NO SERVICE,” yet behind the reception desk of an OPD area, there are often three receptionists with masks round their chins. 

Also, in early 2021 I went to the hospital OPD because of a cough. I was told by the doctor, “In this hospital it is mandatory to have a Covid test if you have a cough or fever. However, we have found that the Covid test is not that accurate so first please have an Xray.” 

I went to pay Tk800 for a chest Xray but was told that I have to pay Tk14,500. On enquiry, I found out that a CT Scan of the lungs had been ordered. I went back to the doctor and told him that I was not carrying enough money, to which he replied that a nearby hospital charges Tk4,500 for the same test and another hospital Tk8,000. 

Why is the government not on top of this kind of exorbitant corruption? The answer, almost certainly, is that the civil servants are beneficiaries of this corruption.

I referred the details to my doctor son in London who said at the very beginning of Covid in early 2020, and before proper testing had been set up in the UK, it was thought that a CT scan of the lungs would be a quick way to diagnose Covid but it had been found out that having a CT scan of the lungs was totally useless. And yet a year later, this expensive, unnecessary test was being ordered here in Bangladesh!

It is also amazing what great pain can do. When I was very ill with Covid last year, two dear friends, the late Kamla Bhasin and Khushi Kabir, appeared in my dream and shouted at me. 

“You cannot leave us now, there is too much work still to do,” said Khushi and “Have you forgotten that you have promised to live to the age of 120?” asked Kamla. When I was in extreme pain again last month, they appeared again, encouraging me not to give up. I am blessed with such wonderful friends who encourage me not to give up.

The question, however, remains loud and clear. Who is going to clean up the health sector in Bangladesh?  

Julian Francis has been associated with relief and development activities of Bangladesh since the War of Liberation. In 2012, the Government of Bangladesh awarded him the ‘Friends of Liberation War Honour’ in recognition of his work among the refugees in India in 1971 and in 2018 honoured him with full Bangladesh citizenship.