If a hospital has no doctors, is it even a hospital?

We are dismayed by the poor state of affairs at the Kalia Upazila Health Complex in Narail where, according to a report by The Daily Star, 15 out of the 21 posts for medical staff are lying vacant. There are only six doctors, and only three of them are currently at work, making up barely one-seventh of its required manpower. As a result, the hospital is struggling to provide health care for the sick and infirm who rely on it on a daily basis. What makes it worse is the lack of essential equipment such as X-ray and ultrasound machines. These problems have combined to cripple the hospital's emergency, outdoor and indoor services—the three important areas of service vital to the functioning of a healthcare facility—to the predicament of ordinary patients. This, unfortunately, represents a crisis that is not unique to this health complex. It's one shared by most public hospitals and health complexes outside Dhaka.

The scarcity of doctors and other medical staff in these facilities is best explained by its self-perpetuating nature: it's a failure both of the recruiting authorities (the government) and doctors, who are unwilling to be posted to hospitals away from major cities. And the problem has refused to go away despite pledges and stern warnings from the highest level of the government. We have often said in this column that unless these facilities are provided with adequate manpower and equipment, the flight of desperate, Dhaka-bound patients will not stop. A failure to do so has proved to be costly on many occasions in the past. We think each upazila and district should be able to provide proper clinical and nursing care on their own, and the government should inject more money into recruiting doctors and enforce discipline to make sure the hospitals are self-sufficient. We are talking about the life of citizens here—and nothing less than absolute honesty and professionalism will do.