When patient safety takes a back seat
The deaths of Mahbuba Rahman Akhi and her newborn, following a botched C-section at the Central Hospital, have raised a few questions about the condition of gynaecological care in the country.
The questions being asked are about the effects that doctors' promotional videos on social media may have on attracting more patients at the expense of the latter's safety.
Dr Sangjukta Saha posted many promotional videos on her Facebook page about normal deliveries she had supervised as a gynaecologist at Central Hospital. In her videos, she presents herself as an advocate of natural childbirth at a time when C-sections are growing at an alarming rate. Her videos are available on YouTube and Facebook.
Hooked by her videos, Akhi, who had wanted a normal delivery, consulted Sangjukta and was supervised by her for three months. When she went into labour on June 9, she was admitted to Central Hospital and was told that Dr Sangjukta would oversee her delivery.
Later, Dr Shahzadi Mustarshida Sultana and Dr Muna Shaha, who worked as part of Dr Sangjukta's team, performed a C-section which went wrong and led to the death of both the newborn and the mother.
Later, Akhi's husband Yakub Ali Sumon alleged that Dr Sangjukta entrusted his wife to her fellow physicians without their knowledge for financial gain.
But Sangjukta is not alone in advertising her practice. Posting promotional videos is a recent trend among many doctors. Such campaigns are aimed at attracting more patients.
A section of medical practitioners believes that posting promotional videos is a questionable campaign for doctors.
Attracting patients through social media campaigns is unethical for a physician, said Prof Dr Rashid-E-Mahbub, president of Bangladesh Health Rights Movement.
Addressing the issue, Bangladesh Medical and Dental Council, which protects and promotes the health and safety of the public in the practice of medicine, stated on Friday that it is unethical for doctors to run social media campaigns to attract more patients.
In a video posted on YouTube on May 5, 2021, D Sangjukta features a newborn she's just delivered and says, "We have an expert team." Evidently, she promotes her team working at the Central Hospital.
Between May 1 and June 9, Dr Sangjukta saw patients for 23 days and she provided consultations to 1,426—around 62 patients per day on average, according to data obtained from the Central Hospital.
However, both the hospital authorities and Dr Sangjukta confirmed that there were more patients who sought her consultation but whose names were not recorded by the hospital.
During the same period (May 1-June 9), Dr Sangjukta assisted in 163 normal deliveries, 93 C-sections and 72 other surgeries.
"I wonder how a physician sees such a large number of patients in a single day. The Central Hospital authority has allowed her to do so," said Prof Dr Rashid-E-Mahbub.
Although she presents herself as an advocate of natural childbirth, data from the hospital revealed that the rate of C-sections for all childbirths under her care was over 36%, which is more than double the WHO-recommended rate of 15%.
A survey by Bangladesh Bureau of Statistics reveals that the C-section rate was 41.4 percent in 2022 across the country. This rate is higher in cities.
Dr MA Quasem, vice president of the board of directors at Central Hospital, said, "We verbally warned Dr Sangjukta Saha that she should not see so many patients per day."
Refuting Dr Quasem, she said, "They never told me any such thing."
After the incident, Dr Sangjukta blamed Akhi's death on the hospital authorities and said she was not responsible because she was not present at the hospital during the C-section. She also said she did not know anything about Akhi's admission to the hospital.
However, speaking at a press conference at her residence yesterday, she admitted that Zamir, her personal assistant and driver, had informed her that her patient Akhi was on the way to Central Hospital to meet her.
Replying to a question about why she did not renew her registration with the BMDC in the last 13 years, she said she could not manage time to do so.
Talking about providing consultation to so many patients per day, Prof Rowshan Ara, former president of the Obstetrical and Gynaecological Society of Bangladesh, said, "If a doctor sees such a large number of patients per day, it is highly likely that quality service will be compromised. A physician must examine and provide counselling to each of their patients very carefully."
Akhi's husband Yakub Ali filed a case with Dhanmondi Police Station on Wednesday accusing the doctors and the hospital authorities of wrong treatment and falsehood. Later, the two doctors who proceeded with the C-section were arrested and sent to jail by a Dhaka court.
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