General ICUs ill for manpower crisis
Causing huge sufferings to patients
Only three public hospitals in the country offer just 22 beds for general intensive care units (ICU). And that, too, are running with severe shortage of manpower, causing huge sufferings to the patients.
A large number of critical patients come to the ICUs of the three hospitals every day, as they get free treatment there. But majority of them are denied admission due to seat scarcity, doctors said.
Patients with neurological problem, brain haemorrhage, respiratory problem and other serious complications require ICU facility, most of them for a long time.
Dhaka Medical College Hospital (DMCH), the largest public hospital of the country handling more than 2,000 indoor patients every day, has an eight-bed general ICU.
According to its register, 169 patients came to the ICU last month. Only three of them could be admitted since no more bed was available.
In contrast to the public hospitals, around 50 private hospitals offer ICU facilities in the capital alone. But a bed there costs between Tk 10,000 and 50,000 a day, which is way too high for the poor.
Aside from the DMCH, Mymensingh Medical College Hospital has a four-bed ICU and Chittagong Medical College Hospital a 10-bed one. There are 18 public medical college hospitals in the country.
Bangabandhu Sheikh Mujib Medical University (BSMMU), which is an autonomous body, provides an eleven-bed general ICU but a bed there costs Tk 10,000 per day on an average.
There is a 17-bed ICU at the National Institute of Cardiovascular Diseases (NICVD) only for the patients with heart problems.
"Setting up an intensive care unit is not an easy job. Moreover, we lack adequate resources and trained manpower," said Health Secretary Mohammad Humayun Kabir.
He added that the health minister has announced to set up ICUs in district hospitals, but it will take time.
Bangladesh Society of Anesthesiologists, however, says the government lacks vision to ensure treatment for the critically ill patients.
Maintaining a bed at ICU costs around Tk 10 lakh per year but it is possible to set up ICU in district hospitals, as the required infrastructure and manpower are there, they added.
SITUATION OF THE EXISTING ICUs
According to medical experts, there should be one nurse for every two patients at the ICU with sufficient doctors. But the eight-bed ICU of the DMCH has only 13 nurses against the need for at least 32 in different shifts. As for the doctors, 10 junior consultants on deputation are struggling to attend the patients. Dr Mozaffer Hossain, assistant professor of anesthesia department of DMCH, said they cannot provide quality treatment to the patients, as they do not have permanent doctors or nurses. The unit has an acute shortage of support staff as well, he said, adding that the support staff there are paid by the doctors and the nurses instead of the government. The DMCH authorities have recently decided to extend its ICU to a 20-bed one and have managed 15 nurses to attend the additional patients. But they are yet to appoint 10 consultants and 20 medical officers, and adequate support staff. There is a similar picture at the four-bed ICU of the Mymensingh Medical College Hospital (MMCH), which started operation in 2007. Despite repeated appeals to the health ministry for manpower, the ICU has no sanctioned doctors or nurses. "We've to send back most of the patients," said Dr Fazlul Haque Pathan, the ICU in-charge.
According to medical experts, there should be one nurse for every two patients at the ICU with sufficient doctors. But the eight-bed ICU of the DMCH has only 13 nurses against the need for at least 32 in different shifts. As for the doctors, 10 junior consultants on deputation are struggling to attend the patients. Dr Mozaffer Hossain, assistant professor of anesthesia department of DMCH, said they cannot provide quality treatment to the patients, as they do not have permanent doctors or nurses. The unit has an acute shortage of support staff as well, he said, adding that the support staff there are paid by the doctors and the nurses instead of the government. The DMCH authorities have recently decided to extend its ICU to a 20-bed one and have managed 15 nurses to attend the additional patients. But they are yet to appoint 10 consultants and 20 medical officers, and adequate support staff. There is a similar picture at the four-bed ICU of the Mymensingh Medical College Hospital (MMCH), which started operation in 2007. Despite repeated appeals to the health ministry for manpower, the ICU has no sanctioned doctors or nurses. "We've to send back most of the patients," said Dr Fazlul Haque Pathan, the ICU in-charge.
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