When quackery takes a toll in human life
Friday, 17 August 2007
Enayet Rasul
A female aged about 40 years died in a so-called private hospital located in the old part of Dhaka city recently. It would be counted as routine death but for the fact that the relatives of the deceased seemed to rightly raise a hue and cry that the death was the cause of wrong treatment and negligence. The death news received considerable media focus and lent afresh to rising concern about the state of medical care in the country. Sub-standard medical centres are found to be doing good business exploiting often the innocence and helplessness of their victims as they rush to these in desperation from not finding a berth in the overcrowded public hospitals.
There are services which are extremely important for the simple reason that these involve human life. The same are the medical services and for the obvious reasons no compromise can be allowed in running them properly or in their standards. Therefore, it is shocking to learn that there are medical centres in this country which are functioning without any authorisation from the official health authorities though such approval is a basic legal requirement for their treating patients.
The authorisation is supposed to ensure that these privately run clinics, diagnostic centres and hospitals are properly equipped in the sense of having the necessary equipment and trained and qualified people to treat patients safely and effectively. It is not that authorisation cannot be bought and sold for money in this country. Even then, it provides the assurance of a minimum of standard whereas the unauthorised ones are not binded by any regulation or supervision and prove to be like death houses than curing places.
And that is what is happening to patients who get admitted to such unauthorised clinics at Khulna. According to a report, there are some 123 functioning clinics in the city out of which only 32 have been officially permitted to function while the rest are yet to get approval. The unauthorised clinics without proper operating chambers, equipment and well-qualified doctors and staff are in no position to discharge proper treatment to patients. In one of them, a caesarean operation was attempted under candlelight and the mother had to fight for survival in the post-operation period. In another reported case, the so-called surgeon of an unauthorised clinic had cut off the respiratory passage of a patient when he was doing a tonsillitis operation under the light of a kerosene-lamp. The same kind of bungled operation attempt on the nose of the female patient on Saturday in a Dhaka clinic was probably the cause of her death.
The health risks to people at such unauthorised medical centres are countrywide. The picture is the same in all major cities and townships throughout the country. According to another report, there are now more than 2,000 clinics and diagnostic centres in Dhaka city but the government's Directorate General of Health Services (DGHS) gave license to only 898 of them to operate.
The present drive of the government against all sorts of illegal and harmful activities, needs to also target hard these unfit and unacceptable medical centres. Some may contend that such a drive may create a dearth of services for sick people. But probably the sick ones would be better off not receiving any services from such dubious centres where they are most likely to get inadequate, ineffective or even wrong treatment. As it is, these medical centres are quite adept at making money at the expense of unsuspecting people. Taka 500 may be charged for a pathology test which should fairly cost no more than Taka 50. An operation charge might be Taka 10,000 or much more depending on cases and done by an unskilled person in conditions to be hardly considered as safe for the patient.
Like the clinics and diagnostic centres which hardly do justice to their names, the state of medical education and training in large part is found to be no different. There are certain areas where training of professionals must be foolproof. Teaching and training to create such professionals is held to be like a sacred duty where there cannot be any room for concessions, compromise or acceptance of poor quality. Medical training is one such very vital area because those who train to be doctors are entrusted to discharge duties that relate directly to the life and physical well-being of humans.
The number of privately-run medical colleges in the country is 35. But most of them are, reportedly, medical colleges in name only. Out of these medical centres of learning and training, 25 were allegedly given operating licenses on political considerations and connections to influential persons under the past administrations. Certain criteria have to be met prior to getting official approval to run such medical colleges. The criteria were hardly fulfilled while this approval was given to them on political consideration and influence peddling. Not even a few of them have satisfied the initial requirements or infrastructures needed to qualify as higher centres of learning in the medical field. All or nearly all of them do not even have an hospital within or near the campus area. But this requirement is an indispensable one for laying a claim as a medical college.
Doctors with high qualifications and experience who can be relied on to impart proper medical training or to teach successfully at that level, are non-existent in these colleges. Facilities for practical classes on anatomy that require morgues, dissection units and other related paraphernalia, are also not to be found in these so-called medical colleges. Laboratory facilities for learning in pathology and related areas are similarly non existent or exist in very inadequate forms. Libraries are the main possessions of these medical colleges in most cases. But the libraries are also not so resourceful like the ones at the publicly-run medical colleges. The greatest inadequacy seems to be in the area of practical training. In the publicly operated medical colleges, the attached hospital proves to be a ready training ground and for acquiring practical knowledge of the illnesses and procedures for their treatment. Lacking in this vital area, the private medical colleges can hardly provide this invaluable experience and training to their students.
Private medical colleges should be immediately warned to go for improving their standards, fully, in every respect or face penalties including closure. They may be given deadlines to meet in this respect. The ones who have already got degrees from the privately-run medical colleges should be identified and obliged to go through a certain period of internships in the public medical colleges and universities to reduce their skill and knowledge gaps.
A female aged about 40 years died in a so-called private hospital located in the old part of Dhaka city recently. It would be counted as routine death but for the fact that the relatives of the deceased seemed to rightly raise a hue and cry that the death was the cause of wrong treatment and negligence. The death news received considerable media focus and lent afresh to rising concern about the state of medical care in the country. Sub-standard medical centres are found to be doing good business exploiting often the innocence and helplessness of their victims as they rush to these in desperation from not finding a berth in the overcrowded public hospitals.
There are services which are extremely important for the simple reason that these involve human life. The same are the medical services and for the obvious reasons no compromise can be allowed in running them properly or in their standards. Therefore, it is shocking to learn that there are medical centres in this country which are functioning without any authorisation from the official health authorities though such approval is a basic legal requirement for their treating patients.
The authorisation is supposed to ensure that these privately run clinics, diagnostic centres and hospitals are properly equipped in the sense of having the necessary equipment and trained and qualified people to treat patients safely and effectively. It is not that authorisation cannot be bought and sold for money in this country. Even then, it provides the assurance of a minimum of standard whereas the unauthorised ones are not binded by any regulation or supervision and prove to be like death houses than curing places.
And that is what is happening to patients who get admitted to such unauthorised clinics at Khulna. According to a report, there are some 123 functioning clinics in the city out of which only 32 have been officially permitted to function while the rest are yet to get approval. The unauthorised clinics without proper operating chambers, equipment and well-qualified doctors and staff are in no position to discharge proper treatment to patients. In one of them, a caesarean operation was attempted under candlelight and the mother had to fight for survival in the post-operation period. In another reported case, the so-called surgeon of an unauthorised clinic had cut off the respiratory passage of a patient when he was doing a tonsillitis operation under the light of a kerosene-lamp. The same kind of bungled operation attempt on the nose of the female patient on Saturday in a Dhaka clinic was probably the cause of her death.
The health risks to people at such unauthorised medical centres are countrywide. The picture is the same in all major cities and townships throughout the country. According to another report, there are now more than 2,000 clinics and diagnostic centres in Dhaka city but the government's Directorate General of Health Services (DGHS) gave license to only 898 of them to operate.
The present drive of the government against all sorts of illegal and harmful activities, needs to also target hard these unfit and unacceptable medical centres. Some may contend that such a drive may create a dearth of services for sick people. But probably the sick ones would be better off not receiving any services from such dubious centres where they are most likely to get inadequate, ineffective or even wrong treatment. As it is, these medical centres are quite adept at making money at the expense of unsuspecting people. Taka 500 may be charged for a pathology test which should fairly cost no more than Taka 50. An operation charge might be Taka 10,000 or much more depending on cases and done by an unskilled person in conditions to be hardly considered as safe for the patient.
Like the clinics and diagnostic centres which hardly do justice to their names, the state of medical education and training in large part is found to be no different. There are certain areas where training of professionals must be foolproof. Teaching and training to create such professionals is held to be like a sacred duty where there cannot be any room for concessions, compromise or acceptance of poor quality. Medical training is one such very vital area because those who train to be doctors are entrusted to discharge duties that relate directly to the life and physical well-being of humans.
The number of privately-run medical colleges in the country is 35. But most of them are, reportedly, medical colleges in name only. Out of these medical centres of learning and training, 25 were allegedly given operating licenses on political considerations and connections to influential persons under the past administrations. Certain criteria have to be met prior to getting official approval to run such medical colleges. The criteria were hardly fulfilled while this approval was given to them on political consideration and influence peddling. Not even a few of them have satisfied the initial requirements or infrastructures needed to qualify as higher centres of learning in the medical field. All or nearly all of them do not even have an hospital within or near the campus area. But this requirement is an indispensable one for laying a claim as a medical college.
Doctors with high qualifications and experience who can be relied on to impart proper medical training or to teach successfully at that level, are non-existent in these colleges. Facilities for practical classes on anatomy that require morgues, dissection units and other related paraphernalia, are also not to be found in these so-called medical colleges. Laboratory facilities for learning in pathology and related areas are similarly non existent or exist in very inadequate forms. Libraries are the main possessions of these medical colleges in most cases. But the libraries are also not so resourceful like the ones at the publicly-run medical colleges. The greatest inadequacy seems to be in the area of practical training. In the publicly operated medical colleges, the attached hospital proves to be a ready training ground and for acquiring practical knowledge of the illnesses and procedures for their treatment. Lacking in this vital area, the private medical colleges can hardly provide this invaluable experience and training to their students.
Private medical colleges should be immediately warned to go for improving their standards, fully, in every respect or face penalties including closure. They may be given deadlines to meet in this respect. The ones who have already got degrees from the privately-run medical colleges should be identified and obliged to go through a certain period of internships in the public medical colleges and universities to reduce their skill and knowledge gaps.