Dhaka Medical College Hospital, the cornerstone of Bangladesh’s public healthcare system, is currently struggling with ‘widespread’ irregularities, including serious shortages of medicines, leaving poor and middle-class patients without the proper care they desperately need.

Constantly exceeding its bed capacity, the hospital is struggling with overcrowded wards and an overload of patients, seriously compromising its ability to provide appropriate medical care.

Reports from various departments highlight a grim picture: dirty environments, poor quality food, understaffing and patients often being forced to lie on the floor in overcrowded corridors and wards.

Hospital Director Brigadier General Asaduzzaman Khan acknowledged the seriousness of the situation by acknowledging the increasing patient complaints.

“We are aware of these issues and steps are being taken to resolve them,” he said.

But the situation seems to have gotten worse; One of the most worrying problems is chronic drug shortages.

One patient, who preferred to remain anonymous, spoke of the difficulties of obtaining essential medications from the hospital pharmacy.

“Most of the necessary medicines are not available here. Most of the time, we are left with no option but to buy them from outside pharmacies at higher prices,” the patient said.

The stark difference between the hospital’s shortages and the full stock of nearby pharmacies has raised doubts about the management of drug supplies within the facility.

Once a woman from a rural village was seen going to a nearby pharmacy accompanied by a man. When asked about their destination, the woman confirmed that she would take medicine.

But when asked about the man’s identity or whether he received kickbacks for referring patients to the pharmacy, he immediately declined to answer.

Brigadier General Asaduzzaman Khan explained that the problem lies in the supply chain when shortages are encountered.

“What can we do if the government does not provide the necessary medicines? There are many products we need that are not available,” he said.

In addition to medication shortages, some patients reported receiving only one type of medication for several days due to a lack of necessary supplies. Families often have to purchase medications from outside sources, placing an extra financial burden on already struggling patients.

A hospital staff member stated that budget constraints were the main reason behind the shortages.

“The government has no supply. We cannot provide every medicine all the time due to budget shortfalls. We need to double our budget to provide full service,” the staff explained, but they refused to provide further details on the details of the hospital’s current budget allocation.

Allegations of Unionization and Bribery Practices

Widespread allegations of bribery and corruption practices at the hospital further complicate matters.

Many patients alleged that hospital staff and ward assistants demanded bribes ranging from Tk 50 to Tk 100 for basic services such as providing wheelchairs and facilitating medical tests. These practices further increased the already heavy financial burden on families needing basic medical care.

An unregistered worker seen helping a patient admitted to accepting tips for his services.

“We don’t force anyone to give us money, but if they do, it will help with our expenses,” he said.

Brigadier General Asaduzzaman Khan acknowledged the existence of such practices and stated that the hospital was actively working to resolve these issues.

“Both parties share the blame. We have fired several people because of these complaints and are working to eliminate such practices, but complete elimination has not yet been achieved.”

Earlier this year, in February, the Supreme Court weighed in on the pervasive influence of unions in the healthcare industry.

The court said the unions were playing a “game of duck and dragon” with people’s lives, accusing them of providing expired medicines and medical equipment for profit.

The court called on all parties involved to remain vigilant and take action to protect vulnerable patients from such exploitative practices.

Zorlu Medical Supply Chain

Medicine supply has long been a challenge for Bangladesh’s public healthcare system.

A 2020 survey found that 72% of public hospitals face regular drug shortages, further exacerbating the challenges for patients who rely on these facilities for care.

A number of factors contribute to these shortages, including inadequate budget allocations, limited health insurance, and large numbers of outpatients.

The public healthcare sector has historically received less than 1% of the country’s GDP over the past 12 years, which is not enough to meet the demands of a growing population. The fact that many patients without health insurance have to pay for outpatient services further increases the burden on public hospitals.

Despite these difficulties, some efforts have been made to improve the situation.

The World Bank has provided critical assistance, including the supply of vaccines, syringes and medical equipment, to help Bangladesh manage the COVID-19 crisis.

Additionally, the government heavily subsidizes public healthcare, but these subsidies are often insufficient to meet the increasing demands of the system.

A study conducted at Dhaka Medical College Hospital in 2013 highlighted other problems in the hospital’s medical supply chain.

The study, which surveyed hospital store employees, found that more than half of the drugs were purchased through open tender, with a significant portion coming through direct purchases and donations.

However, the hospital’s pharmacy faces problems such as lack of proper storage facilities and lack of air conditioning or refrigeration in the store.

Management called for improvements in quality control, storage facilities and training to improve the system.

Looking Forward

The situation at Dhaka Medical College Hospital paints a worrying picture about the state of public healthcare in Bangladesh.

From shortages of essential medicines to widespread bribery and corrupt practices, the hospital’s problems are a small sample of the systemic problems plaguing the broader healthcare system.

As efforts to improve the situation continue, patients and healthcare professionals are calling for more significant reforms, more funding and more transparency to ensure Bangladesh’s public healthcare system can truly meet the needs of its people.