Bangladesh

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LOOKING BACK 2019

Health sector mired in graft, unmet pledges, low ability

Manzur H Maswood | Published: 00:00, Jan 04,2020

 
 

Country’s health sector in 2019 provided usual scanty services, saw corruption and medicine price hike and struggled to deal with an unprecedented dengue epidemic.

Besides, the government backtracked on its decision to appoint intern doctors at the upazila hospitals to ensure services at the grassroots level.

Zahid Maleque, however, became the cabinet minister for health and family welfare in the year as the Awami League formed government for the third consecutive term in January.

He had served as the state minister for health in the previous AL term but failed to make any difference after getting the promotion, evidence suggests.

Considerable corruption was detected in purchases of equipment at Sheikh Hasina Medical College Hospital in Habiganj, Faridpur Medical College Hospital in Faridpur, Suhrawardy Medical College Hospital in the capital, and Chittagong Medical University in Chattogram.

In addition, a huge accumulation of illegal wealth by an accounts officer at the health education wing of the Health Services and his wife, a stenographer at the same wing, rattled the country.

Sheikh Hasina Medical College spent over Tk 35 lakh to buy 450 anatomical charts with each costing Tk 7,800 but the actual price of a chart was Tk 100 to Tk 150. It bought 67 Lenovo laptops at Tk 1.48 lakh each while the market price was Tk 30,000 to Tk 45,000.

Unusual high prices were also reported in the purchases of an interactive whiteboard at Tk 15.35 lakh (actual price about Tk 1.40 lakh), a printer at Tk 2.48 lakh (actual price about Tk 60,000), and a digital weighing machine at Tk 6.40 lakh (actual price about Tk 60,000).

At Faridpur Medical College Hospital, a window curtain was bought at Tk 37 lakh. Some Tk 41 crore was embezzled at the hospital through corruption in purchasing equipment.

The ACC also filed cases against Rangpur Medical College principal Noor Islam and five others for embezzling Tk 4.50 crore in purchase anomalies.

Purchase proposals placed by Chittagong Medical University were rejected by the Planning Commission also for quoting sky-high prices of equipment.

The corruption of health education wing accounts officer Abzal Hossain and his wife stenographer Rubina Khanam was revealed by the Anti-corruption Commission, which found out that they had four five-storey buildings and lands at Uttara in the capital and a house in Australia.

The Awami League in its manifesto for the December 30, 2018 election pledged  that it, if elected, would make the health services free for children and elderly people, but the commitment remains unfulfilled.

The party had also promised that their government would ensure the availability of doctors at the rural health facilities and improve the services, but the government failed to keep its words on these counts, too.

The government in 2018 announced that 10,000 doctors would be recruited but it recruited some 4,400 in late 2019.

The government also went back on its promise to appoint intern doctors at the upazila hospitals.

It withdrew its directive of making mandatory for the interns to stay at a upazila hospital in their second year of the two-year internship after graduation.

The 2019 dengue outbreak exposed the national health system’s weakness in health crisis management.

Since May, the media had abounded with stories about hospitals overrun with dengue patients, private hospitals cashing in on the situation, ineffective mosquito killing medicines, untackled mosquitoe breeding habitats, spread of the fever all over the country and a denial of the menace.

Primarily dubbing the dengue outbreak as a rumour, the government later responded with ordering more beds at government hospitals, limiting charges to patients for care, cancelling doctors’ leave, importing mosquito-killing medicines and dengue test kits alongside mosquito-killing drives.

The Global Health Security Index in October said that Bangladesh seriously lacked preparedness for the prevention and detection of and response to significant disease outbreaks.

Bangladesh’s position on the international health security index was even worse than that of African countries like Liberia, Ghana, Côte d’Ivoire, Namibia, Tanzania, Nigeria, Senegal, Zimbabwe, Sierra Leone, Kenya, Madagascar, Ethiopia and Uganda, according to the index.

In South Asia, India, Myanmar, Bhutan, Pakistan and Nepal were better prepared to manage disease outbreaks, according to the index.

The significant deficiencies in the preparedness for epidemic and pandemic of diseases were revealed by The Global Health Security Index, the first ever comprehensive assessment and benchmarking of health security and related capabilities across 195 countries.

In early 2019, the government for the first time postponed the nationwide Vitamin A Plus campaign.

It was later revealed that the vitamin capsules, meant for more than two crore children, were substandard and glued with each other.

The capsules were procured through a shady deal with an Indian firm, but the government did not disclose the probe report in this regard.

The probe report on the fire incident at Suhrawardy Medical College Hospital was not disclosed by the government either.

The fire occurred at the hospital store after the ACC launched an investigation into corruption at the hospital.

The government could not ensure the presence of doctors in rural areas as still 28 per cent of them were refraining from attending their duty at the workplace.

The Health Services in 2019 introduced a biometric attendance system and the rate of attendance rose to 72 per cent from 44 per cent.

At the end of the year, state-run research body Bangladesh Institute of Development Studies in a study revealed that the pharmaceutical companies in Bangladesh spend vast sums of money on marketing of their products burdening the consumers as they recovered the expenses through increased drug prices.

The BIDS on December 1 revealed that the drug companies spent 29.6 per cent of their turnover on marketing and the money was spent on ‘gifts to doctors in different forms’ as a marketing strategy.

According to the study, the companies employed 65 per cent of their workforce in marketing—medical representatives accounting for 46 per cent and sales representatives 19 per cent.

Their major tasks were to influence the physicians by briefing them on ‘the superiority of the drugs’ and giving ‘gifts to doctors in different forms’, the study said.

Regulatory authority Directorate General of Drug Administration was found completely reluctant to regulate drug prices, consequently compelling the people to pay high prices for medicines.

There were about 270 pharmaceutical companies in the country, which made some 1,455 generic medicines but the Drug Administration fixed the prices of only 177 generic medicines listed as ‘primary healthcare medicines’.

The pharmaceutical companies were left at their liberty to fix the prices of the rest of the generic medicines.

The Awami League in its 2018 election manifesto promised to set up specialised treatment facilities for kidney, heart, cancer at the existing medical college hospitals and a 100-bed cancer and a 100-bed kidney hospital at each divisional headquarters.

In 2019, plans were taken to set up only the proposed cancer hospitals at the divisional cities.

Health Services director general Abul Kalam Azad told New Age that in 2020 a Bangabandhu Help Desk would be opened at all hospitals to help people find the available services at the hospitals.

Besides, about 20 hospitals, which were upgraded to 250-bed facilities from 100-bed ones, will be opened with increased manpower and equipment, he said.

Besides, he added, 5,000 more doctors will be recruited, vacant posts filled up and new posts created to provide health services to the rural and marginalised people.

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