Amdadul Haque
Hospitals in Bangladesh are fighting against the coronavirus with an acute shortage of specialists while patients suffering with other diseases cannot find proper treatment.
Except for one or two hospitals, most others do not have specialist doctors while the treatment system at private hospitals depends on the medical officers, as many doctors have decided to stay home to avoid contracting Covid-19.
Physicians with expertise in handling the outbreak of deadly viral diseases are a must in all the country’s hospitals to fight the virus, experts say.
Amid all odds and even risks to life, doctors, nurses and other medical workers are working hard round the clock to provide treatment to infected people, experts said, while adding, they do not have any expertise on the disease, first identified in Wuhan, Hubei, China in December 2019, just five months ago.
“The physicians now working at different hospitals will have to be given training on an urgent basis,” Bangladesh Medical Association-BMA Secretary General Dr Ehteshamul Haque Chowdhury Dulal told Bangladesh Post.
Meantime, the number of patients infected with coronavirus is increasing day by day in the country, and so is the death toll. Though elderly and critically ill patients have died in different parts of the world, there are now reports of deaths in all age brackets in Bangladesh.
Muhibur Rahman, is a senior doctor who has worked in private and government hospitals for 12 years. He now works at a state-run hospital that treats both Covid-19 and other patients despite various challenges.
“I have not worked in such a situation in my life. This is a very risky time for us and other medical personnel,” Muhibur told Bangladesh Post.
“We work and we get money for it, but money is not all. We have taken vows to serve patients in any situation. I am proud to be a medical person as I am now a part of the fight against Covid-19,”he added.
According to specialist doctors, coronavirus patients may have other complex diseases like heart disease, neuro, diabetes, respiratory problems, kidney complications, etc. These patients have many types of complications. Specialist doctors are essential for their proper treatment and well-being. In addition, patients are being deprived of proper treatment and advice as most hospitals do not have experienced senior doctors. This is creating fear in the minds of patients, and accelerating the deaths.
Therefore, in the covid-19 hospitals, where there are no specialist doctors, at least specialist doctors should visit the patients if necessary. Otherwise, the mortality rate will increase further. 2,000 doctors have been recruited recently. It is good, but they are totally new. If these doctors do not seek the help of appropriate specialists in the treatment of covid-19 patients, they will suffer from indecision in the treatment, specialist doctors warned.
In this context, the former Vice Chancellor of Bangabandhu Sheikh Mujib Medical University and member of the National Advisory Committee on Covid-19, Professor Dr Nazrul Islam told Bangladesh Post that Covid-19 patients may have other complex problems. In that case, the opinion of the concerned expert is very important. So it is better to treat such patients in the hospitals that have specialist doctors.
According to the Department of Health, the hospitals currently treating coronavirus patients in the capital include Dhaka Medical College Burn Unit with 320 doctors, Kuwait Maitri Hospital with 128 doctors, Kurmitola General Hospital with 265 doctors, Infectious Diseases Hospital with 20 doctors, Sheikh Rasel Gastroliver Hospital with 173 doctors, Mohanagar Hospital with 54 doctors, 33 doctors at Central Railway Hospital, Private Regent Hospital (Uttara) 22 doctors, Regent Hospital (Mirpur) 11 doctors, Sajeda Foundation Hospital (Jatrabari) 10 doctors, Rajarbagh Central Police Line Hospital 45 doctors, Lalkuthi Hospital (Mirpur) 37 doctors and Mugda Medical College Hospital with 420 doctors.
According to concerned circles, there are a lot of specialist doctors in the burn unit of Dhaka Medical College and Mugda Medical College Hospital. Sheikh Rasel Gastroliver Hospital and Kurmitola General Hospital have a number of specialist doctors also. The rest of the public and private hospitals are dependent on medical officers.
According to the Institute of Epidemiology, Disease Control and Research (IEDCR), 31 percent of patients in the country who have died of covid-19 infection are under 50 years of age. Statistics show that mortality is 2% among 0-10 years old, 3% for 21-30 years old, 7% for 31-40 years old, 19% for 41-50 years old, 27% for 51-60 years old and 42% for over 60 years old.
There are a total of 1,200 ICU beds, including 192 dedicated to coronavirus patients, in the public and private-sector hospitals across the country, but there is not enough skilled manpower to operate them.
Trained doctors and nurses are needed to operate an ICU. At present, the country has a requirement of at least 600 critical care medicine specialists. However, only 30 doctors have so far earned MD degrees in critical care after the course was introduced in the country in 2008.
Only Dhaka Medical College, Birdem, and Bangabandhu Sheikh Mujib Medical University currently run postgraduate courses in critical care medicine.
Pointing to the shortage of doctors and nurses with expertise in critical care, Prof Mohammad Omar Faruq, president of Bangladesh Society of Critical Care Medicine told Bangladesh Post that on an average, three doctors complete the course in critical care in the country every year, which is very low against the actual need.
There is no institution to educate nurses in critical care. Nurses who provide critical care services at ICUs have basically learned by working with others. They do not have any formal education on this subject, he mentioned.