Stretched yet undaunted

Doctors and nurses in hospitals around the city are strained and resources are stretching thin due to the ongoing record dengue outbreak.

The associated stress is also taking a toll on the personal lives and health of both physicians and caregivers.

Mahiuddin, indoor medical officer of Dhaka Medical College Hospital, has to look after his father-in-law, a patient of brain tumour, every day before coming to work. 

For the past week, however, Mahiuddin has had little time for anything else apart from work, as he has to put in extra hours due to the excessive number of dengue patients. “Every day I feed my father-in-law and also take care of him after returning home. As my wife is also a doctor, she too remains very busy,” he said.

“Although my duty hours are from 8:00am to 2:30pm, I now have to spend several more hours to deal with the pressure of additional patients,” Mahiuddin said.

Most doctors this newspaper spoke to mentioned that they were having to work three to four extra hours per day, mostly without any overtime pay. 

“Every day, 60 to 70 additional patients are getting admitted to our medicine unit and we have to handle it with our existing manpower,” said Liakat Hossain, assistant registrar of unit-6 at DMCH.

He said they had 12 such wards, each with a capacity of around 50 patients. Now, however, they are dealing with around an extra 150 patients per unit. Each of the ward units has around 13 doctors attending to around 200 patients.

“Apart from this, many other patients do not get admitted but we still have to treat them.” 

He said the number of dengue patients has been increasing daily and they were handling three to four times the average number of patients in the hospital.

“On Saturday, we admitted 62 critical patients but many others who were not in a critical stage had to return as we could not accommodate them even on the floors,” he said.

As private hospitals do not want to take additional patients, the public ones bear the extra burden.

According to the DMCH data, of the 800 beds in its medicine wards, 540 were occupied by dengue patients till yesterday morning. The number was around 200 last week. At least 196 dengue patients were admitted to the hospital yesterday.

Sheuli Akhter, in-charge of nurses at a medicine ward, said, “The holidays of all the nurses have been cancelled for the last 15 days and it will remain in effect until further notice.”

She said she would normally go home at 2:30pm but now cannot go off-duty till almost 7:00pm. “I have a nine-year old son who has to stay home all alone until I return,” she added. 

Besides being overburdened, the work is also taking a physical toll on many of the nurses.

“We would have to administer around 20 saline packs a day in a ward but now it is around 200,” she said, adding some of the nurses were fall-ing ill as they had to stand for hours administering saline without any rest.  

The high use of saline is also becoming a cause for concern, as some hospitals are running low on the solution.  

Prof Uttam Kumar Barua, director of Shaheed Suhrawardy Medical Col-lege and Hospital (ShSMC), said they were facing a shortage of saline in the hospital for which they could not give it to all the patients for free.

“There is also a shortage of manpower, but we are trying our best,” he said.

“We are now seeking the help of senior medical students of our medical college and will issue a letter shortly in this regard.” 

The director also said they were arranging special treatment for dengue patients at the outdoors, adding that another issue was that some of the dengue patients were staying in verandas or walkways where they can-not hang mosquito nets.  

Despite the numerous challenges, doctors continue to treat as many pa-tients as possible. 

Pronoy Debnath, medical officer of children ward-11 of Shaheed Suhrawardy Medical College Hospital, said they do not get a single minute to take rest.

“We are doing additional work for the sake of humanity.” 

As there is a strict instruction from the director not to refuse any patients, they are accommodating dengue patients everywhere, such as on walk-ways, verandas or on the staircases of the hospital, he said.

This is a 60-bed ward, but 190 patients are now taking treatment, of whom 50 percent are dengue patients, Pronoy said.

“We are accommodating two or three children on a single bed, while many patients are taking treatment on the floor,” he said.

Data from the Directorate General of Health Services (DGHS) shows 11,654 people have been infected with the mosquito-borne disease till Ju-ly 28, the highest ever. Last year, the number was 10,148. 

Eight people have died of dengue so far. Sources at city hospitals, how-ever, put the number at 32. They said the number could be higher as many dengue cases go unreported.

In 24 hours since 8:00am on Saturday, 824 new dengue cases were re-ported at the hospitals, the highest instance of dengue cases on a single day, the DGHS data show.

In outdoor, 1209 patients have taken treatment in June and July, he said.

GOVERNMENT EFFORTS

As part of the government efforts to fight dengue, all public and private hospitals, and clinics have been asked to open special helpdesks to ac-celerate services to dengue-infected people.

A ward has been opened at the Bangabandhu Sheikh Mujib Medical University only for dengue patients, said Prof Abul Kalam Azad, director general of the DGHS.

An awareness campaign is also being launched where students of all public and private medical colleges will visit all educational institutions across the country on Thursday, he said.

The government has formed 50 training teams comprising skilled doctors and they will begin visiting all public and private hospitals from the current week, he said.

Besides, teachers of public medical colleges will hold awareness-building seminars at all these hospitals and clinics from next week, Azad said.

He also called upon all doctors of all public and private hospitals and clinics to follow the national guideline in providing treatment to the dengue-infected people.

Earlier in the morning, the DG of the DGHS held a meeting with owners and managing directors of private hospitals and clinics at his office.

All specialised hospitals have been asked to stay prepared to treat den-gue patients, the DGHS chief said.

Asked why the situation was not declared an epidemic yet, when specialised hospitals have been asked to be prepared, Abul Kalam Azad said, “What if we announce that? Actually, we have taken all necessary measures to tackle the situation.”

He also did not clarify the controversy over the number of dengue patients and the number of deaths.

From tomorrow, the DGHS will hold daily briefings at 11:30am to give updates on the dengue situation. 

Meanwhile, the Dhaka North City Corporation (DNCC) Mayor Atiqul Islam said they would bring all the mosquito control workers and garbage management workers under GPS tracking system to monitor them. 

Addressing a briefing as the chief guest in a programme in the city, the mayor said they had already given the names and mobile numbers of mosquito control workers, supervisors and monitoring officers in the website of the DNCC and urged people to ensure accountability. 

[Mohammad Moudud Sujan also contributed to this report.]