Staff shortage hampers services at DMCH: TIB

Dhaka Medical College Hospital (DMCH), the country's largest public tertiary hospital with 2,300 beds, runs with a staff capacity appropriate for only 800 beds, resulting in below-standard health services, finds a Transparency International Bangladesh (TIB) study.
The study, “Good governance in Dhaka Medical College Hospital: Progress, Challenges and the Way Forward”, launched in the capital's Biam yesterday, says the services can be dramatically improved through staffing and bettering infrastructure and management.
The research is a follow-up of a 2006 diagnostic study by TIB which revealed how patients were deprived of free medicines and advised by doctors to visit their private practice chambers.
Conducted between April 2010 and August 2013, the study shows how the lack of anesthetists increases the risk to patients' lives and prevents the DMCH authority from performing more operations in its 29 operation theatres.
Similarly, the overall doctor to patient ratio is 1:37 while it is 1:150 in the outdoor medicine department and 1:200 in the ear, nose and throat department.
However, doctors present at yesterday's launching pointed out that apart from its 298 doctors, DMCH gets a constant flow of interns, trainees, and honorary doctors seeking hands-on knowledge.
Though the lack of doctors is somehow met, the nurse to patient ratio remains alarming low, especially in the outdoor (1:138) and neuro-surgery (1:125) departments. There is a high shortage of class III and IV employees too.
In fact, modern equipment, including a mammography machine, are left unused due to lack of a skilled workforce.
Sharing his experience, a journalist said he got an MRI of an injured fellow done at a private diagnostic centre after the DMCH staff claimed that their machine did not give good images.
Regarding absence of doctors and presence of medical representatives in doctors' rooms during office hours, recommending private diagnostic centres and clinics to patients, the study observes that lack of accountability among doctors, nurse and other staff led to such malpractices.
However, child specialist Dr Nazmunnahar and Associate Prof Dr Abdul Hanif (Tablu) of DMCH's Pediatric Surgery pointed out that the hospital's autonomy could make its staff accountable since the director was not empowered to bring the hospital staff to book.
Admitting the lack of services, DMCH Director Brig Gen Md Mostafizur Rahman reminded what a labour intensive organisation DMCH is and how many patients, mostly underprivileged, it caters to.
He said DMCH admitted an average of 250-300 patients after office hours. “If we close the hospital doors just for one day, saying all 1,700 beds (in the main facility) of our hospital are filled, processions of dead bodies will hit the streets."
Prof Dr Khondoker Md Shefyetullah, director general of the Directorate General of Health Services, said health budget had shrunk over time since 2004.
When the World Health Organisation recommends 14 percent of the national budget for health expenditure, the health sector in the 2013-14 fiscal received only 6.26 percent, he said.
TIB Executive Director Dr Iftekharuzzaman, National Chief Coordinator of the country's government-run burn units Dr Samanta Lal Sen, and Health Right Movement National Committee Chairman Dr Rashid-e-Mahbub were present.