537 machines out of order at Rangpur Medical College Hospital

Nazir Hossain’s residence is in the Barabari area of Rangpur Sadar. The 75-year-old had a brain stroke on 9 September. On the same day he was admitted to the Rangpur Medical College Hospital. Doctors advised he take a CT scan in order to check whether he had blood clots in his brain vessels or if the bleeding occurred due to burst of blood vessels. The CT scan could not be carried out in the hospital as both the machines have been out of order for long.

On 10 September morning, Nazir Hossain was rushed to Central Laboratory, a private diagnostic centre located at the intersection of Jail Road. He was returned to the medical college hospital after the CT scan. Nazir’s son Mahubar Rahman got the CT scan report at 8 pm on that day.

Mahubar talked to this reporter while entering the hospital returning from Central Laboratory. He told Prothom Alo Alo “It was a big hassle to bring my father out of the hospital and he suffered a lot. We would not have faced so much suffering had the machines of the hospital been in order."

The CT scan machine is operated by the Department of Radiology and Imaging of the hospital. Nazmun Nahar, the head of the department, told Prothom Alo that there are two CT scan machines in the hospital but both of them are out of order since 2019.

Not only the two CT scan machines, but hundreds of other machines are lying out of order in this hospital. According to the health department, 537 small, large and medium machines are out of order in this hospital.

These include large machines such as MRI or CT scans, as well as the smaller machines like pulse oximeters. In mid-July Prothom Alo received the updates on Rangpur Medical College Hospital's machines in the fiscal year 2022-23 from DGHS where the number of out of order machines are mentioned separately.

Rangpur Medical College Hospital is a vital medical institution in North Bengal. It was established in 1968. Currently its capacity is 1000 beds. However, an average of 2,000 patients are being admitted every day. People from eight districts- Panchagarh, Thakurgaon, Dinajpur, Nilphamari, Rangpur, Lalmonirhat, Kurigram and Gaibandha- come to this hospital for treatment.

Established on 65 acres of land, this hospital is crowded with poor patients throughout the year. Many people, however, are disappointed when they come for emergency treatment for strokes or heart diseases or road accident injuries.  For year after year many emergency tests are not being done in this hospital. A section of doctors claim that there is no supervision in the hospital. They say influential business people often deliver machines that are not usable.

Be-Nazir Ahmed, Director, Disease Control, Directorate General of Health Services told Prothom Alo, this situation is more or less same throughout the country. This has been happening for many years. He said, on one hand hospitals lack necessary machines on the other hand the machines that are there, often remain unused as these are out of order. Some of the machines remain idle day after day due to minor glitches. Some machines are not replaced when needed and ultimately the patients have to pay the price.

This public health expert said, as the patients go to private centres to get their tests done, their costs rise manifold. The machines bought with billions of takas are basically a waste or unnecessary investment. This has been going on year after year as there is no proper planning.

Treatment of the patients with high risk and complicated heart disease is carried out in the intensive care unit (ICU). There are 10 beds in the ICU. During a visit to the ICU on 10 September, it was seen that eight electric stand fans were in service for the patients. The noise of these fans is unbearable even for the healthy. But in the ICU these fans run for 24 hours a day. There are eight air conditioners but only two were working.

Some machines were seen on the left side upon entering the ICU. Physicians said one of them was an echo-machine, one is a portable x-ray machine. The machines lasted one and a half to two months after purchase. Since then there have been accumulating dust.

Upon leaving the ICU, a lock is visible in a room on the left-hand side where C-arm is written on the door. The C-arm is a special type of machine. It requires a special type of table to be used effectively. But the machine suppliers did not supply the table with the C-arm. The C-arm has remained unused for more than 10 years.

In the cath lab, three nurses were seen gossiping and angiogram service was closed.  Physicians of the department said that the angiogram machine has been out of order since November 2019 before Covid outbreak. It was started about a couple of months ago.

After running for a month and a half it went out of service again. More than 1,500 angiograms were performed in that month and a half, more than 50 patients underwent stenting. But now the service is closed. No one could say when the machine would be fixed.

According to DGHS, the cardiology department has most out of order machines. In total including small, big and medium sized machines, there are 209 machines out of order. Some of them are cardiac monitors. 46 cardiac monitors are out of order in this department.

Chief of the cardiology department Haripada Sarkar told Prothom Alo, “If a heart disease patient requires an angiogram, we advise them to go to Dhaka.” Angiogram is not done even in any private centre in Rangpur city.

Health minister Zahid Maleque and DGHS Director General Abul Bashar Mohammed Khurshid Alam visited Rangpur Medical College Hospital on 16 February. During that visit the hospital authorities informed the minister that more than 400 machines are out of order. A list was also drawn up.

DGHS sources said that after the visit of minister and the DGHS Director General a letter was sent to Rangpur Medical College Hospital from the Hospital Services Management section of DGHS.

In that letter information regarding the inoperative machines were asked to be recorded in a certain form. According to the response of that letter by Rangpur Medical College, it is seen that the number of out of order machines is 537.

When asked about this, Mohammad Yunus Ali, director of Rangpur Medical College Hospital, said he had joined as director just a few days before the hospital visit of the minister. The list of out of order machines is not very clear to him. But a new list of machines is being prepared by examining each and every department separately.

Talking to several senior physicians, it was known that heavy equipment was bought in 2011-12 and 2012-13 fiscal year in various departments including the departments of cardiology, radiology and imaging, and urology. During that time all the hospital equipment was supplied by Lexicon Merchandise.

Lexicon owner Motajjerul Islam’s residence is in Rangpur but he has contracting business in the health sector throughout the country. With the connivance of high-ranking officials of the Ministry of Health, the contractor supplied Rangpur Medical College Hospital with machines worth over Tk 1 billion. The hospital could not use most of these machines even for a year.

Physicians of the cardiology department, seeking anonymity, said that the  contractor designed the cardiology department and the radiology department. Any physician or official showing slightest of dissent against this could not remain in the hospital.

A professor of the hospital told Prothom Alo, Motajjerul Islam is not active now but others are there. A team of four such persons are known as the “Four Caliphs’ in the hospital campus.

Businessmen said Motajjerul is at the US now. He could not be contacted regarding these allegations.

During visits to various departments of the hospital and talking to patients on 9 and 10 September, it seemed there was a lack of sincere initiatives or efforts to run the hospital properly. Initiatives to repair the machines are limited to correspondence. Some people are more interested in buying new machines than fixing the existing ones.

Meanwhile, the director of the hospital has sent two separate letters to the DGHS asking for new equipment. A letter asked for 219 types of machines and medical equipment for the fiscal year 2023-24. In another letter the number of machines is even higher. The demand for those machines is placed for the next five years.

But this correspondence will bring no benefit to Anwar Hossain or his son Rahim Hossain of Saidpur of Nilphamari district. Both the father and son work in a sawmill of Saidpur. Rahim's spine is bent and he must undergo surgery. He was admitted to Rangpur Medical three weeks ago. Physicians have kept changing the date of surgery. His father Anwar is also in hospital to take care of his son. Their earnings have come to a halt. Costs are high. Some tests including X-rays have to be done from private centres outside the hospital.

Anwar Hossain told Prothom Alo that while staying in the hospital, he and his son gradually seeing death looming large.

* Ariful Haque, Prothom Alo staff correspondent, Rangpur helped to prepare the article

** The report, originally published in the print and online editions of Prothom Alo, has been rewritten in English by Syed Faiz Ahmed