No dedicated doctors, staff for ICU at RMCH | The Daily Star
12:00 AM, April 11, 2021 / LAST MODIFIED: 01:24 AM, April 11, 2021

No dedicated doctors, staff for ICU at RMCH

Backup power took ‘too long’ to start during April 4 nor’wester, alleges family after Covid suspect patient dies

When the season's first nor'wester hit on the afternoon of April 4, the thought of a potential power blackout made Mokarram Hossain worried as he was attending to his brother Muhibullah Bahar at the Intensive Care Unit (ICU) of Rajshahi Medical College Hospital (RMCH).

Bahar, a principal officer of Agrani Bank's Pabna branch, was on oxygen support at the hospital's 20-bed ICU as a suspected Covid-19 patient.

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His elder brother Hossain, a teacher of Pabna Sudhir Kumar High School and College, felt relieved when he learnt that RMCH has a generator and the ICU was supported by two electricity connections and a system of instant power backup in case of a failure.

But Hossain's peace of mind was short-lived as the entire city of Rajshahi witnessed around seven hours of blackout following the almost two-hour storm since 3:55pm.

He switched on the flashlight of his phone as darkness fell over the ICU room. Attendants of other patients did the same.

"All of us panicked. Some even started to cry thinking about what will happen to their loved ones," he told this correspondent recently.

Doctors and nurses rushed in, tried to restore power, but they appeared to be helpless, he said, adding that some staffers were running around with portable machines not sure of what to do.

This is not an isolated situation at the ICU of RMCH. Even though the hospital's ICU was upgraded to 20-bed from 5-bed last year to cope with the coronavirus pandemic, it has been functioning without a single skilled and full-time dedicated or specialised staff member.

As a result, patients' attendants constantly remain at the ICU to look after them, even though no one other than skilled professionals is supposed to be inside such a special department of a hospital that provides intensive care medicine -- that too at a time of the pandemic.

In addition, an outage longer than a few minutes can become life threatening for patients, said senior doctors, adding that further treatment is rarely useful when oxygen saturation level of a patient fall even for once.

Authorities, however, say they have backup power supply to deal with the crisis, but have other limitations, which they are trying to address.

The ICU has been staffed with less than 100 doctors, nurses, technicians and cleaners from other departments of the hospital, RMCH director Brig Gen Shamim Yazdani told The Daily Star on Thursday.

"A 20-bed ICU requires at least 150 skilled staff members -- each patient requiring a doctor and two nurses on standby," he added.

The other districts in the division are not faring any better either.

Out of eight districts, only two districts -- Rajshahi and Bogura -- have 51 beds in four ICUs; all of those are lacking skilled staffers, said Dr Habibul Ahsan Talukder, Rajshahi divisional director of Directorate General of Health Services (DGHS).

Other than the 20-bed ICU at RMCH, Bogura has eight-bed ICU at Mohammad Ali Hospital, 13-bed ICU at Shaheed Ziaur Rahman Medical College Hospital and a 10-bed ICU at Combined Military Hospital, he said.

Meanwhile, Mokarram Hossain's brother Muhibullah Bahar was admitted to the ICU on April 2.

He became sick a week before he was taken to Pabna General Hospital on April 1. As his condition deteriorated, he was shifted to Rajshahi that very day.

His samples, taken on April 2, showed he was Covid-19 negative, but RMCH doctors recorded his case as a suspected Covid-19 one. They said infected patients, in most cases, were found negative in their last stage of infection.

His brother and wife stayed with him at the ICU in shifts.

RMCH authorities said as there were no skilled doctor or staff members, the ICU authorities allow patients' relatives to attend patients round the clock.

During the April 4 storm, Hossain was with Bahar. 

Standing beside Bahar's bed, Hossain looked outside through the ICU's windows, and saw the storm getting stronger.

He noticed that his brother was sleeping peacefully in his bed and his oxygen saturation level hovering near the normal 95 percent.

When the outage occurred, Bahar became restless.

Hossain saw Bahar's oxygen level rapidly dropping and at one moment, it went down to 35 percent, he said. "He [Bahar] started sweating… I felt panicked," he said.

After a while the power came back. "The power was out for nearly eight minutes, but it felt a lot longer," he said. "That day, the power at the ICU went out at least 10 times. Sometimes it returned quickly, and at one time it took at least eight minutes... I think the damage was done at that time," he said.

Bahar's oxygen level went up to 92 percent soon, when the authorities managed to get the backup power running.

But since 2am the next day, Bahar's oxygen level started to drop again.

Bahar, father of a three-year-old son, died at 5am on April 5.

He was 32.

"I don't want to accuse anyone for his death. All I want is that the system should get better. All supplies were there, still my brother had to pass some moments without oxygen. They need more skilled staffers at the ICU," said Hossain.

This correspondent also managed to speak to an attendant of a patient at the ICU on April 4. Wishing anonymity, the attendant said that day during the storm at least for one time, it took a while for the backup power to start running.

The attendant did not want to elaborate any further fearing it may affect their patient's treatment.

This correspondent tried to get in touch with the doctors and staffers working at the ICU, but they refused to talk. When this correspondent talked with hospital's director, he took time to inquire about the issue from the ICU.

RMCH director later told The Daily Star that the ICU department said they did not have any power backup failure during the storm and that the outage did not have any effect on the oxygen supply.

"If the ICU was out of power for eight minutes (as told by Hossain), all the patients would have died," he said.

"Our system is modern and programmed to switch on power backup within 26 seconds of any failure. The patient you're talking about may have been frightened when the lights went off. The lights can go off for some time during an outage, but the oxygen supply and ventilators have built-in functions to run those smoothly," he said.

He, however, did admit that Bahar's oxygen level dropped during the storm, and said that it regained after a while.

About the manpower issue, the director said, it's getting tougher for them to handle the pressure with the coronavirus infection rate increasing in Rajshahi and surrounding districts.

"We have asked for dedicated staff at the ICU from the government. But we have to keep in mind that the condition is worsening all across the country. Hopefully, we will get an answer from them soon," the director said.

On April 4 and 5, at least three Covid-19 and suspected patients died at the ICU, where at least 23 patients, both Covid-19 positive and suspected, died in the last eight days till Thursday, according to a report of Rajshahi Metropolitan Police.

However, the official data of the health services recorded a total nine deaths from Covid-19 in eight districts of Rajshahi division while 950 people were detected with the infection. 

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