Beds tripled, not staff – Dhaka Mohanagar General Hospital services in disarray

Infographic: TBS

It was a 50-bed hospital; the capacity at Dhaka Mohanagar General Hospital was increased to 150 beds in 2020, but regular surgery, ultrasonography, ICU and dental services have remained unavailable due to severe staff shortages.

Hospital authorities said many beds are even unused as only 56 people are working against 166 approved posts under the 2016 organogram.

They said the hospital should have at least 185 employees under the government staffing standard. However, the standard has yet to be implemented.

The hospital run by Dhaka South City Corporation was prepared as a 150-bed specialised Covid-19 or isolation hospital in March 2020, following instructions from the Directorate General of Health Services.

Its building, wards, cabins, operating theatres and equipment were developed for a 150-bed facility. Hospital officials said the current workforce was, however, insufficient to operate even 50 beds properly.

Consultant, doctor shortages disrupt services

Hospital authorities said the facility has no surgery consultant, leaving regular operations suspended.

Only two of its seven consultant posts are filled. The medicine and gynaecology departments each have one consultant, although officials said a full department requires at least two or three.

The hospital director's post has also remained vacant for a long time, with a consultant from the gynaecology department performing the additional duty.

One of the two resident surgeon posts is vacant. The resident physician post also has no permanent appointee, with another doctor temporarily performing the duties.

Of the 19 approved medical officer posts, 11 are filled. Some of the doctors are serving on deputation or performing additional duties.

The nursing shortage is more severe. Only 12 of the 31 staff nurse posts are filled.

Both operating theatre nurse posts are vacant, while the matron's post has no permanent appointee.

Equipment remains unused

Hospital authorities said the pathology and radiology consultant posts remain vacant after the previous consultants retired and were not replaced. Ultrasonography services have also been suspended.

The hospital's only dental surgeon post is vacant. As a result, a modern dental chair and other equipment remain unused.

They said some operations, including caesarean sections, are still being performed in the gynaecology department with support from a project, although the normal delivery service launched last year was later suspended.

Five ICU and high-dependency unit beds introduced during the Covid-19 pandemic could not be maintained because of staff and funding shortages, according to the authorities.

After four to five years, the beds were removed and allocated to hospitals in Narsingdi and Naogaon. The hospital currently has no ICU bed.

A liquid oxygen tank installed for intensive care services remains unused on the hospital premises.

During a recent visit, a large pile of waste was found in an open area of the hospital compound. The smell of rotting food and plastic had spread through the hospital and nearby areas.

Around 300 outpatients daily

Dhaka Mohanagar General Hospital Acting Director Dr Sakila Khatun said around 300 patients visit the outpatient department each day, but many beds remain unused because of the staff shortage.

"It is difficult to operate even 50 beds with so few nurses, let alone 150. If adequate staff are not provided despite the expansion of infrastructure, the project will effectively remain meaningless," she said.

We have submitted staffing demands many times, but we do not know why the appointments have not been made. However, the authorities have assured us that staff will be appointed this time, she added.

Dhaka South promises phased recruitment

Dhaka South Chief Health Officer Jahane Ferdous Binte Rahman acknowledged the shortage of doctors, consultants and nurses.

She said recruitment had been suspended during the interim government's tenure, but the relevant files were approved after the new government took office.

Recruitment of cleaners has already begun, she said, adding that doctors, nurses and other employees would be appointed in phases.

Dhaka South Chief Executive Officer Md Zahirul Islam said medical equipment could not be used without doctors and technicians.

"The corporation was considering operating its hospitals in partnership with private organisations alongside direct public management," he said. 

On the waste problem, Zahirul said keeping the hospital clean was a shared responsibility and the corporation was working to improve the situation.