The quality of healthcare in Bangladesh has come under scrutiny once again as reports of patients dying due to improper treatment or clashes between doctors and patient’s relatives continue to surface. Absenteeism and strikes among doctors in the workplace have also become more common as the population grows, adding to the growing number of medical negligence-related issues in the country, which have marred the government’s mentionable other successes in the sector.
Furthermore, unauthorised clinics have been found to continue IVF practices, increasing the public’s unease about the reliability and safety of the healthcare system. The government has promised to investigate these issues and hold those responsible accountable, but the public remains sceptical and demands more action to improve the state of healthcare in the country.
NEGLIGENCE IN UNLICENSED ‘HOSPITALS’
On February 17, a tragic incident occurred when Rekha, a pregnant woman carrying twins, died while undergoing kidney stone removal surgery at an unlicensed hospital in Mymensingh city. According to her husband, Rekha was the mother of a four-year-old child and passed away as a result of the doctor’s negligence during the operation that occurred around 1 am on Friday. She was 13 weeks into her pregnancy at the time of her tragic passing.
The incident has sparked public outrage and once again highlighted concerns about the safety and reliability of medical services, particularly at unlicensed facilities in the country. These horrific incidents can be seen across the charts in the medical history of the country. Time and again, people are losing their lives due to careless and reckless operations in unlicensed hospitals.
In addition, on December 4, 2022, a 5-year-old girl from Kurigram died while undergoing finger surgery at Mirpur’s Alam Memorial Hospital. While investigating, it was found that the hospital was unregistered. Following the case, three doctors; National Cancer Research Institute and Hospital’s Assistant Professors Md Ahsan Habib, Shariful Islam, and Dr Ronnie were suspected of charges related to the tragic death of the child.
Not only that, on May 25, 2022, one 20-year-old pregnant woman died after losing too much blood because of the doctor’s mistake. Sabina went to the “City Hospital and Diagnostic Centre” for treatment. During the C-section operation by Emma Binte Yunus, a self-proclaimed doctor who had no license, Sabina died due to blood loss. Later, it was revealed that the hospital did not have any license either.
INSURGENCY OF ‘PRIVATE-UNLICENSED’ HOSPITALS
Due to the inadequacy of health care, only 35 percent of patients can be treated in government hospitals in Bangladesh. The remaining 65 percent have to resort to private hospitals or private clinics for treatment. Due to a shortage of beds and insufficient manpower in government hospitals compared to public demand, patients are forced to rush to private clinics or hospitals not judging the legitimacy of the clinics or hospitals and their doctors even after knowing the reputations. And with that opportunity, the number of unlicensed private hospitals, clinics, and diagnostic centres is increasing.
Most of these private hospitals are illegal and mostly practice their treatments illegally with unlicensed doctors. They print fake license and paperwork in order to legitimise themselves. According to the calculations made by the Directorate of Health in 2020, the number of private hospitals, clinics, and diagnostic centres across the country was 17,244, even though the actual number is almost double. But, the harsh truth is only 519 of them are licensed. Initiatives have been taken to close illegal hospital clinics due to various complaints against most of these hospitals.
Bangladesh’s unlicensed hospitals and clinics have been accused of conducting tests without specialists, using expired equipment and drugs, and operating in unhygienic environments. In July 26, 2020, the Ministry of Health formed a nine-member task force to improve healthcare quality and stop the irregularities, including the renewal of licenses and registration of private hospitals and clinics. 45 officials have been tasked with monitoring healthcare quality across the country. A task force committee meeting on August 8, 2020, set the deadline for license renewal or registration at August 23. The number of approved and applied clinics and diagnostic centres in the country is about 11 thousand.
According to the government’s announcement, approximately 4000 hospitals were to be closed. But none were closed. The deadline to apply for hospital license renewal in 2020 was August 23 of that year. It was said that the campaign would continue against those who did not apply. But there was no raid against anyone. Of the 13,000 applications submitted, only 5,519 have up-to-date licenses. 7,041 are awaiting verification and inspection. 3, 304 incomplete application forms were found too. None of them have trade licenses; none have environmental clearances or locational clearances; some have other defects.
GOVERNMENT POLICIES TO COMBAT ILLEGAL HOSPITALS
The government has drafted the Medical Services Act of 2016 in response to these issues. Officials of the health directorate said that according to the department’s ultimatum issued on May 25, 2022, the list of illegal medical institutions closed across the country is being co-ordinated. After that, a raid will be conducted across the country on the list of legal and voluntarily closed illegal institutions. In addition, the local health department also conducted raids in various districts of the country. The health department received information about the closure of 882 unlicensed establishments across the country.
At this time, if the authorities do not close their illegal establishments voluntarily, they will take a firm stance to do so through raids. According to the latest information, 167 illegal hospitals, clinics, and diagnostic centres were closed in Dhaka, 229 in Chittagong, 78 in Rajshahi, 14 in Rangpur, 96 in Mymensingh, 59 in Barisal, 35 in Sylhet, and 204 in Khulna division during the three-day operation. According to a briefing following the raid, a total of 1,641 institutions were shut down in the last three months, while 1,489 received licenses, and the registration of 2,930 was renewed.
Before this, the Additional Director General of the Directorate of Health, Professor Dr Ahmadul Kabir, said that action against unregistered clinics, hospitals, and diagnostic centres will continue. This activity should be coordinated with local administration and law enforcement agencies. Organisations that have registered but not renewed license, have to renew within a fixed period. Failure to register on time will result in the suspension of all activities. It is also claimed that in private hospitals and clinics, no unregistered doctor or anyone else can be kept during anaesthesia. If this is done, strict action will be taken against those institutions and persons, including license cancellation. Before registration, no establishment can operate.
