Health sector rife with mismanagement, corruption

Mismanagement and irregularities have become the norm at the Directorate General of Health Services (DGHS), but officials of the directorate remain complacent. This is having an impact on the coronavirus tests and treatment. Experts say, the situation has reached this state due to lack of any monitoring and evaluation.

DGHS additional director Nasima Sultana, at Thursday’s regular news briefing, said that two private medical colleges had been given permission to run coronavirus tests. One of the colleges was taking time to start the tests as there was a delay in the arrival of certain equipment.

Investigations later revealed that the medical college in question didn’t even have the appropriate RT-PCR machine. DGHS simply issued permission without even checking whether it was actually qualified to conduct the tests.

Prior to this, the law enforcement agencies uncovered fake sample testing by a company called JKG. On the heels of that scam, the Regent Hospital fraud came to light. The agreement with Regent was signed by the director general of DGHS Abul Kalam Azad.

An official of the hospital division of DGHS told Prothom Alo that the directorate has formed an inquiry committee to look into the Regent Hospital incident. Nothing had been done about the JKG matter. Sources in the health directorate have said that permission for sample testing has been given to a number of other establishments without carrying out any inspection of the laboratories.

Public health experts and several officials of the health directorate have said that it is not just about permission for the laboratories or hospitals. There are several other areas where there is a glaring lack of accountability among the officials of the directorate.

The health directorate has taken no initiative to inquire into the several deaths resulting from hospitals failing to admit patients in the capital city. Over 5000 physicians, nurses and health workers have been infected with coronavirus and many have died. The risks faced by the health workers were to be looked into and directives were to be drawn up as to what was to be done. These tasks have not been carried out.

DGHS lacks the standard epidemiological information, data and statistics required for research, planning and policy making. Even after writing to the concerned office, members of the directorate’s public health advisory committee have not received the required information.

Meanwhile, there have been allegations of corruption in the procurement of medical equipment. Two government officials, of Mugda Medical College Hospital and Khulna Medical College Hospital, protested about the low quality of the masks supplied. One of them was transferred and the other was made officer-on-special-duty (OSD). No one is speaking openly about these matters. However, at a virtual meeting on ‘Corona in Bangladesh: A Six-Month Review’, organised by the Bangladesh Health Reporters Forum on 26 June, the DG, DGHS Abul Kalam Azad said and anti-corruption commission (ACC) was looking into the matter of corruption. The health directorate was cooperating with them.

The walls inside the DGHS office are plastered with posters declaring, ‘My organisaton and I are corruption-free.’ Over the past one month the law enforcement has revealed several incidents of large scale corruption and irregularities. ACC also has published a list of 14 companies involved in corruption in the health sector. Many are of the opinion that certain officials of the health sector are also involved in this corruption.

Many decisions have to be taken hurriedly during the coronavirus pandemic. However, it is globally being said that certain fundamental issues must be maintained in decision-making. This includes legality of the work as well as experience and capacity of those being given the work.

Executive director of the anti-corruption organisation, Transparency International, Bangladesh (TIB), Iftekharuzzaman, speaking to Prothom Alo, said that many persons have taken the coronavirus outbreak as an opportunity to make money for themselves. Regent and JKG have been carrying out such corruption in collusion with officials of the health directorate. The agreement between Regent and DGHD was no legally proper.

No senior official of DGHS was willing to comment on these matters.

The health directorate has two positions concerning coronavirus tests. Initially the government Institute of Epidemiology, Disease Control and Research (IEDCR) was in control of the sample testing. Several organisations, including icddr,b, had come forward to help in carrying out the tests. However, DGHS did not take them in. IEDCR director Meerjady Sabrina several times has said that each and every lab must be of a qualified standard. Permission for tests will not be given if the lab is not equipped with proper equipment, trained technologists and proper security.

On 4 May the responsibility of testing was removed from IEDCR. Various government and private institutions were given the task. Presently 77 institutions are involved in coronavirus testing, but DGHS has not verified the competence and standard of all of these institutions. There are many complaints about the results and certificates given by several of these institutions. The common people have been given incorrect certificates and have been cheated. The health directorate has not even looked into these complaints.

Speaking at the DGHS press briefing on Thursday, additional director general Nasima Sultana said that they had issued letters to two private medical colleges asking why they were not conducting tests even after being granted the permission. One did not reply, the other sad that there was a delay in arrival of the required equipment.

Prothom Alo in Friday contact the owner of the medical college which claimed the equipment hadn’t arrived as yet. He said that the RT-PCT machine for testing coronavirus samples would reach the country on 12 July. That means DGHS gave permission to an establishment which didn’t even have the required machine. One what basis was the permission issued? Wasn't any inspection carried out of the laboratory?

Nasima Sultana said that no inspection had been carried out. She said that permission had been granted based on the papers submitted by the institution. No one was sent to inspect the premises as their as a shortage of workforce at the directorate.

Sources in DGHS said that there are at least another 5 institutions which had been given permission but which had no started testing.

The media and the social media are rife with reports about the sufferings people have to face in getting tests done, various irregularities and discrepancies and also the standard of the hospitals. This had had a negative impact in people’s minds. The number of patients in Covid hospitals is lessening. Around 72 percent of the beds are empty. Public health experts say that people are not going to the hospitals for treatment as they do not have confidence in the health system and the hospitals.

Public health expert and former director of disease control at DGHS, Be-Nazir Ahmed, said that many incidents have discouraged people from going to have their samples tested or from going to hospital. This may lead to an increase in transmission of the virus.

Speaking about what can be done in this situation, the TIB head Iftekharuzzaman said, “No improvement in the situation can be expected unless there are political directives from the top most level and implementation of those directives. When the directives are issued, a taskforce can be formed to ensure implementation.”

Public health expert Be-Nazir Ahmed feels that there are others things required along with accountability and responsibility. Speaking to Prothom Alo, he said that this situation has been created due to a lack of planned monitoring and surveillance. It will be possible for the situation to improve if a third party is assigned for regular evaluation of the situation.

* This report appeared in the print and online editions of Prothom Alo and has been rewritten in English by Ayesha Kabir