Hospital suffers, so do patients
Patients are deprived of an intensive care unit at the National Institute of Ear, Nose and Throat as the authorities have failed to make it functional over the years due to the dearth of necessary workforce.
While the ICU lies idle, costly artificial respiratory ventilator (ARV) machines have remained unused at the institution for around two years.
Eight ARV machines and other equipment gathering dust for years in a store room and the non-functional ICU were highlighted in an Implementation Monitoring and Evaluation Division (IMED) assessment report in March last year.
"In many cases, critical patients needed ICU support after complicated operations. But the patients are not getting this service in the hospital," the report read.
One biochemistry semi auto analyser, Eliza auto washer, Eliza plate incubator, eight ICU ventilators, one CO2 laser, diode laser machine, and one unit sleep lab equipment were found to be non-functional, the IMED also found.
In the year since the report was released, little has changed at the National Institute of ENT, located in the city's Tejgaon area, The Daily Star found from hospital sources.
The government spent Tk 62.41 crore under a project called the "Establishment of National Institute of ENT 1st Phase in Dhaka", aimed at supplying the lone specialised ENT hospital with modern equipment so that it could better serve patients.
While the project was officially completed in 2014, most of the equipment reached the hospital in 2018.
All the eight costly ARV machines had been lying idle in a store room since, and much of the hospital equipment had gone out of order in the meantime, said the report.
According to hospital sources, six ARV machines after necessary repairs were sent to Jashore General Hospital in April last year to support Covid-19 patients.
"The ICU is yet to be functional due to the manpower crisis," said the report of the government project monitoring agency, following a field visit in March last year.
It also noted the overall responsibility for procurement of equipment was with the Central Medical Stores Depot (CMSD) and the failure to install the equipment on time hampered the delivery of healthcare services.
Each ARV machine was purchased at a cost of Tk 70 lakh "but these were not used a single time," the report stated.
Transparency International Bangladesh Executive Director Dr Iftekharuzzaman told The Daily Star that this oversight shows the many faces of corruption and irregularities.
"There was clearly a lack of proper planning and more importantly a remorseless absence of accountability. This also shows the priorities attached to procurement per se in the name of project implementation because that is where lies the scope of making illicit profits by collusion with vendors."
Contacted, Dr Farid Hossain Miah, director (hospitals and clinics) of the Directorate General of Health Services, said the equipment was purchased to turn the National Institute of ENT into a "complete" organisation.
"Those were probably not required and that's why they were not used. But one cannot say it is a wastage of public money," he told The Daily Star on Wednesday.
TIB's Iftekharuzzaman said, "The story also shows a lack of a minimum sense of responsibility taking advantage of absence of internal control and accountability."
The TIB boss added those responsible for such ruthless wastage of public resources must be brought to justice in an exemplary manner, failing which such instances will continue to be replicated.
The hospital also desperately needs radiotherapy and chemotherapy facilities for ENT cancer patients.
"From hospital statistics, it was found that out of the total operated patients 56 percent are cancer patients. In many cases, radiotherapy is needed before and after operation," the IMED report observed.
Prime Minister Sheikh Hasina inaugurated the hospital on June 19, 2013. It started as a 100-bed hospital before being upgraded.
By now a popular destination for ENT patients, it treats around 500-600 patients daily at its outdoor facility. The occupancy rate at the indoor unit of the now 135-bed hospital is 100 percent, according to hospital authorities.
STAFF APPOINTMENT REQUESTS UNHEEDED
Patients continue to suffer in the absence of the necessary workforce to operate the equipment and run the unit, said Prof Dr Mohammad Abu Hanif, director and principal of National Institute of ENT.
He said they have sent a number of letters to the health ministry these last five years for the allotment of doctors and nurses so that they could start ICU operations.
The hospital authorities sent a letter on January 12, 2020 to the secretary of health services department of the health ministry, seeking appointments of one associate professor and three junior consultants for vacant posts in the anaesthesia department and another eight medical officers/consultants.
In another letter on the same day sent to the director general of the nursing and midwife directorate, the hospital authorities sought the deployment of eight senior staff nurses to start the ICU.
The National Institute of ENT also sent two separate letters to the secretary of the health ministry in 2016, seeking anaesthetists and nurses to launch the ICU.
The first letter, dated April 3, signed by the then director of the institute Prof Dr Mahmudul Hasan, said, "In the absence of necessary anaesthetists and trained nurses the authority is facing difficulties to start the ICU service."
It also sought allotment of one associate professor (anaesthesiology) for a vacant post and some anaesthetists/nurses on emergency basis to ensure treatment of patients.
The second letter on November 3, also signed by Prof Dr Mahmudul Hasan, asked for 23 nurses including one superintendent, two deputy superintendent, and 10 nursing supervisors.
However, these staff appointment requests are yet to be heeded.
Asked, Prof Abu Hanif said, "We are yet to get any deployment of nurses and anaesthesiologists."
He said that since joining the institute in February 2019 he tried to start the ICU on a limited scale with the support of the anaesthesia department. It was at that time they came to know that not all the ARV machines were totally functional.
Regarding the radiotherapy department needs, Prof Abu Hanif said they have also written to the authorities concerned in this regard.