Disability grips Pongu Hospital

A patient runs a treadmill without any aide at the poorly maintained physiotherapy centre of the hospital.Photo: STAR

Believe it or not, Pongu Hospital, the country's biggest hospital for orthopaedics treatment and rehabilitation, is running with only two physiotherapists against the need of at least 50 of them.
Officially known as the National Institute of Traumatology and Orthopaedics Rehabilitation (Nitor) the hospital has 10 sanctioned posts of physiotherapists, but it is delivering treatment amid severe shortage of manpower and equipment.
"One of the main aims of Nitor is to prevent disability and to rehabilitate them for which physiotherapy plays a vital role," said one of the two physiotherapists at the hospital.
According to the doctors and physiotherapists working at the hospital, at least 50 therapists are needed to cope with the large number of patients coming to this hospital. But no physiotherapist was recruited in the hospital in the last 25 years.
After a few visits to the outdoor section and physiotherapy department of the hospital this correspondent found that even though doctors are advising the patients for physiotherapy on daily basis, patients are asked to come twice a week for physiotherapy due to lack of qualified manpower and required instruments.
Ripon, suffering from pain in his spinal cord, was waiting to get physiotherapy at the outdoor section of the hospital but he was asked to come twice a week for the treatment.
“I came here for physiotherapy as the doctor in the outdoor section prescribed me to start it from this moment. But when I got there they told me to come on Saturday and Tuesday only,” he told Star City.
Talking to this correspondent, another patient Shahida Begum said she came for treatment of neck pain but she was also asked to come on the stipulated days.
Dr Kazi Humaun Kabir, assistant professor and course coordinator of physiotherapy, Nitor, said at present the hospital has only two qualified physiotherapists.
“This patient has broken his knee joint. I have prescribed him for physiotherapy on daily basis for one month but I know that he will get treatment only twice a week here,” said the doctor showing a patient who fell from tree.
If a patient gets proper physiotherapy then the possibility of full recovery is 80 to 90 percent. If proper therapy is given then in most cases the patient may not need operation. In many cases the intermittent therapy offered by the hospital proves insufficient and ineffective, the doctor said.
“As the service is given twice a week if a patient needs one month's therapy it takes three to four months to complete the treatment. Besides, the intermittent treatment ultimately may not give the desired result,” Dr Kabir said.
Due to the lack of qualified physiotherapists, health technologists from the Institute of Health Technologists, Dhaka are being engaged to give therapy, he said.
Moreover, the two physiotherapists have to attend classes and do other administrative jobs, which hamper their duty at the hospital.
"It is not possible for me to sit in the outdoor section every day as I have to take classes in the college, take examinations and do the administrative jobs," Dr Kabir said.
Patients have to wait several days to get the serial for required treatment at physiotherapy section of the hospital for shortage of manpower and equipment.
Dr Nazrul Islam, lecturer of physiotherapy and a doctor of the hospital, said that it is very hard to attend all the patients every day as people from all over the country come to the hospital for orthopaedic treatment.
“On average we have to attend 50 patients a day and it is very difficult for us. Apart from patients from Dhaka city, we get patients regularly from across the country as there are no physiotherapists at the district level hospitals,” he said.
At present there are 3 traction machines, 2 short wave diathermy machines (SWDs) and one ultrasound therapy (UST) at the physiotherapy centre. There were 3 infra-red ray radiation (IRRs) machines but these are not working at present.
Doctors said they need at least 6 SWDs, 6 IRRs and 6 USTs.
"Patients have to wait in queue for at least two hours to get a 10-minute heat therapy," said a duty doctor seeking anonymity.
"Patients do not stay at this hospital for regular physiotherapy which is very important for rehabilitation and to prevent disability. Nitor is for rehabilitation but nothing significant is being done for the rehabilitation," he said.
At present eight intern doctors are working in the hospital from 8:00am to 2:00pm -- two in the outdoor section and six in wards where physiotherapy is given without using instruments. There are some assistant therapists who have passed diploma course. They work under the intern doctors.
In spite of the acute shortage of qualified physiotherapists, there were no recruitments to the vacant posts or no new post created in the last two decades.
“I have joined the hospital in 1985 and since then I have not seen any new face (physiotherapist). Due to retirement some posts fell vacant,” said Dr Kabir.
"Physiotherapy students are doing internship here but they are not being recruited."
“There was no new recruitment in the last 25 years by the Public Service Commission. Even though demand notes were sent by the director of this hospital, PSC is yet to put advertisement for recruitment,” Dr Kabir added.
The physiotherapy students who are doing graduation at the institute are not getting the opportunity to apply for the vacant posts as the PSC has not advertised for it. Some of them are working at the private sector and many brilliant students are leaving for developed countries where physiotherapists have a good demand.
At present there are only two permanent teachers, including the principal, for the physiotherapy course under the Medicine Faculty of Dhaka University. At least six teachers and six demonstrators are needed, said students.
“The authorities introduced internship for us under pressure from last year but we are not getting any allowance. We are afraid to ask the authorities for payment fearing that the internship might be stopped,” said an intern physiotherapist, seeking anonymity.
Asked about the lack of physiotherapists and lack of daily physiotherapy treatment, Dr Muhammad Sirajul Islam, director, Nitor, said that necessary documents are sent to the PSC to start the recruitment process.
"At present we are giving advice to the patients so that they can do exercise at home. We have to attend lots of patients who need physiotherapy so some satellite physiotherapy centres can be established to lessen the pressure on us," he said.