The standard of public health services continue to plummet despite hefty budgetary allocations every year, as the authorities remain increasingly indifferent to field-level health complexes.

Many a stakeholder blames the sustained downslide on the lack of accountability and supervision by higher authorities. In most of the health complexes, cleanliness remains a far cry while doctors flout duty rosters at their will.

Development in recent years has been more quantitative than qualitative, a doctor, who works at a district hospital, said. ‘The number of beds has been increased in many hospitals without any attention being paid to logistic enhancement.’

At an upazila health complex in Netrakona, about 140 kilometres northeast of the capital Dhaka, a non-medical employee was found treating patients, most of whom were poor and illiterate, and prescribing medicines in the absence of medical officers, who were supposedly busy with their private practices during working hours.

‘Aravinda Dey attends to almost all outdoor patients,’ one employee at the Atpara health complex told New Age on May 28. ‘He has a diploma in pharmacy but is very popular among local people. Even the health officers rely on him.’

The residential medical officer of the complex, MA Quddus, said only ‘two MBBS doctors, including myself, have to deal with a large number of patients. Aravinda sometimes extend a helping hand with outdoor patients when we are busy with emergency patients.’

Aravinda had, however, a different story to tell. ‘I have to treat outdoor patients as the medical officers are busy with their private practices.’ ‘I have treated 18 patients today,’ he said on May 28. ‘I have no certificate in medicine but I have years of experience in the area and the doctors also have confidence in me.’

The outdoor department of the 100-bed hospital in Netrakona was found closed at 1:15pm. ‘The doctors have left the hospital early today as there were a few patients due to rough weather,’ the residential medical officer, Md Ali Akber Talukder, told New Age.
           
Close to the hospital, there are a number of diagnostic centres and clinics where, according to sources, the doctors run their private practices. ‘Although the outdoor department is open from 8:00am to 2:00pm, the doctors usually come at 10:00am and leave at around midday,’ a nurse said.

The proposed allocation for the health and family welfare ministry in 2006-07 is Tk 4,766 crore – Tk 2,391 crore for non-development and Tk 2,375.00 for development projects. The allocation was Tk 4,240.16 crore in 2005-06. Health ministry projects are being implemented under a three-year health, nutrition and population sector programme of Tk 9,410 crore launched in 2003.
  
The previous government of the Awami League earlier undertook a five-year health and population sector programme of Tk 12,500 crore, which ended in 2002. The health and family welfare minister, Khandaker Mosharraf Hossain, attributed the poor condition of the health complexes to shortage of medical officers.
           
            ‘There are four doctors on average at every upazila health complex whereas the number should have been nine,’ he said when talking to New Age on Thursday. ‘The cabinet committee has approved our proposal to appoint 3,176 fresh MBBS doctors at the union-level health and family welfare centres through the Public Service Commission.’
           
The health ministry plans to increase the number of beds at Comilla Medical College Hospital from 250 to 500, and construct a new nursing college at Shahid Ziaur Rahman Medical College in Bogra, and a 250-bed TB hospital at Shyamoli and a 500-bed hospital at Kurmitola in Dhaka in the next fiscal year.

Source: New Age, June 05, 2006