Family members of patients with mental illnesses seeking treatment at Pabna Mental Hospital are being harassed by brokers outside who demand money to get them an appointment with a doctor inside or lure them to privately run so-called mental health clinics.
Long understaffed by doctors and facilities overstretched, services at the country's first specialised hospital for treatment of mental illnesses have further been diminished over the last few months due to the Covid-19 outbreak.
Amidst the global pandemic fallout, World Mental Health Day 2020 is being observed today with the goal of increased investment in mental health programmes at the national and international levels.
The 500-bed public hospital is running with 350 general beds and 150 paying ones, said the hospital director, Dr ATM M Morshed.
"Before, we would treat and release patients regularly and admit patients five days a week. Due to the pandemic, we have had to cut down indoor services in the hospital," he told The Daily Star.
Currently, new patients are only admitted every Monday and first taken to the isolation unit before being shifted to beds after one week to avoid the risk of Covid-19 spreading among existing patients, he said.
"So, the flow of patient admission has been slower over the last seven months."
This has led to greater pressure on outdoor patient facilities, where many admission seekers are being extorted by brokers for limited serial numbers to get an appointment.
Md Aziz Matobbar, from Chandra in Faridpur's Bhanga upazila, came early Monday morning to get his 25-year-old son admitted but failed to get a serial number. That meant he could not try again until next Monday.
"My son Md Abdullah was born with a mental illness, which has now become severe. We cannot keep him free at home because of his violent tendencies, so we tie him up with an iron chain," Aziz said.
"After travelling a long distance, I was harassed outside the hospital as there are so many brokers who actually decide who gets to see a doctor."
The brokers tried to pressure him into admitting his son to a private clinic, he said, but he declined because he cannot afford it.
After waiting all morning, Aziz managed to get an appointment with a doctor at the outdoor facility around noon.
"I was unable to get an appointment with a doctor though I came here early this morning," said Russel Sarkar, from Sirajganj's Ullapara upazila, who brought his mentally challenged brother Abdur Rahim.
He also had to face the brokers.
"As I turned them away, I have had to wait for hours," Russel said.
Homemaker Shanjida Shahin from Magura also came to the outdoor patient facilities on Monday morning with her mentally challenged brother Atikul Islam, whose condition had been deteriorating due to a lack of medicine.
Through the brokers, she was able to get an appointment with a doctor at the outdoor facility early in the day, she said.
After prescribing some medication, the doctor asked her to bring her brother again next week and if necessary, he would be admitted to the hospital then.
At the outdoor unit of the hospital, this correspondent found a group of locals, agents of various private clinics and even some hospital staff bargaining with patients' families looking for access to services.
As many patients and their family members come from outside the district, they are often lured by these brokers who promise fast access or treatment elsewhere, hospital sources said.
Talking with The Daily Star, Md Abdul Bari, ward master of Pabna Mental Hospital, said most of the brokers are locally influential people who work as agents of various private clinics.
Dr Morshed admitted the frequent presence of brokers at the hospital, but claimed he is helpless in the situation.
"We have repeatedly requested law enforcers about the presence of brokers at the hospital. If the law enforcers do not take action, I have nothing to do."
A lack of doctors has long been a barrier to better health services -- of the 25 allotted posts for doctors, 13 remain vacant.
"Of the 12 doctors working, around three of them work to provide outdoor patient services while around seven are available to treat patients indoors," a hospital official, seeking anonymity, told The Daily Star.
"Even indoor patients often do not get to see doctors in the wards, unless there is an emergency. Instead, hospital nurses often meet with the patients," the official added.
It is tough to operate with such a limited number of doctors, when most of the beds indoors are occupied and over 300 patients take outdoor services every day, said hospital director Dr Morshed.
The director added that the hospital has submitted repeated letters to the higher authorities for fulfilling the allotted number of doctor's posts at the hospital.