Half the ICUs at Bangabandhu Medical are out of order

More than half the ICUs at Bangabandhu Sheikh Mujib Medical University (BSMMU) are out of order.  There is also a shortage of  staff to run the ICUs. As a result, children and elderly persons are deprived of this medical treatment during emergencies.

Intensive Care Units (ICU) are required for patients with serious health complications and in critical condition. There is an ICU crisis in the hospitals around the country. It is common to see relatives rushing around to avail ICU facilities for their patients.

ICU charges are comparatively lower at BSMMU. Daily charges for normal ICU are Tk 2,100. Another Tk 960 is required for life support equipment and monitors. That means a daily charge of Tk 3,010 at the most. For a newborn the daily cost is Tk 1,500. On the other hand, the daily ICU charge in any medium standard private hospital in Dhaka is Tk 15,000.

The driver of a private television channel was seriously injured in a motorcycle accident on Eid-ul Azha day at Akhaura, Brahmanbaria. He was first taken to the National Institute of Traumatology and Orthopaedic Rehabilitation (Pangu Hospital) in Dhaka.

Later he was taken to the National Institute of Diseases of the Chest and Hospital. At one point of his treatment it was said that he needed to be admitted to ICU, but there was no vacant ICU at the chest disease hospital. A search was made of almost the government hospitals in Dhaka for an ICU bed but to no avail. Later the driver was admitted to a private hospital in Mohakhali.

The managing director of that hospital in the evening yesterday, Thursday, told Prothom Alo that the patient's bill is coming to around Tk 20,000 every day.

According to information provided by an official of the BSMMU vice chancellor's office on Wednesday, there are 101 ICUs of different departments of the university. Of these, 20 are for newborn infants and 20 are for children. Of the total ICUs, 42 are out of order. And 20 ICUs have never been started up. In all, 62 ICUs lie unused. These ICUs are lying idle for month after month.

After recovering in the ICU, a patient is placed in a high dependency unit (HDU). After further recovery, the patient is transferred to a general ward or cabin. BSMMU has 14 HDU beds of which four are out of order.

When asked about the matter, BSMMU pro-vice chancellor (education) Prof. Md Atiqur Rahman told Prothom Alo that last March several news appointments were made to senior posts, including that of VC, at BSMUU. After the new administration took over, a list was drawn up of the unused ICU and efforts are being made to start these up. Arrangements are being made to train the staff. There has also been initiative to release funds to purchase equipment.

The neonatal department is on the first floor of BSMMU Block C. There are special ICU facilities here for infants aging from 0128 days. This is the neonatal intensive care unit (NICU). There are 20 beds here.

Speaking on Wednesday to the chairman of the neonatal department, Prof Sanjay Kumar Dey, it was learnt that there had been seven newborns admitted on the previous day and 13 ICU beds were vacant. These could not be used due to lack of equipment.

Sanjay Kumar Dey said there 20 ventilators would be required to keep all the beds functional, but there were only 2. A special machine called 'radiant warmer' is used to keep newborn infants warm in the ICU. There is need for 10 such machines, but only 8 are functional. Due to the shortage of all sorts of equipment, it is not possible to admit patients to all the beds.

It would require around Tk 30 million (Tk 3 crore) to keep all the beds functional, said Sanjay Kumar Dey. When asked if he had informed the university authorities about these problems, he said that these problems have been there for long. The vice chancellor had been informed in writing one year ago about all these matters.

The university does not have ICU facilities for children aged between 28 days to 8 years. The officials say that equipment has been purchased for 20 ICU beds for children and there is adequate space too. But the children's ICU is not being started up.

The university has a department called Anaesthesia Analgesia and Intensive Care Medicine for complicated cases. This department has 32 beds. There were 31 patients in the department on Wednesday. All the ICUs are functional in this department, but the problem here is different.

Professor Montosh Kumar Mondal, in charge of the ICU, told Prothom Alo that patients in ICU must be kept under 24 hour observation. A specially trained nurse is required for each and every ICU patient. There is a shortage of nurses. In the morning shift there is one nurse for two patients. In the evening shift there is less. Six to seven ayahs and word boys are required for every shift, but there are only two or three.

Speaking to the teachers and physicians of this this department, it was learnt that there is a pressure of patients throughout the year at the ICU of this department. Patients from other departments of the university are sent here too.

According to a senior official of BSMMU, that there are 10 ICU beds in the university's five-storey cabin block, two for each floor. Not one of these is functional. There are another 18 ICU beds for the respiratory emergency department, the cardiac surgery department and cardiology department, and the paediatric nephrology department, but these are out of order.

BSMMU is an autonomous institution. It runs on its own revenue as well as government grant. As the physicians do not face the risk of being transferred to any other institution, they can work comparatively independently. The government provided this institution with ample facilities and benefits so it can provide proper, humanitarian and quality service. The public expect a lot from BSMMU, but those expectations are not being fully met.

Patients waiting

In certain hospitals the authorities suddenly tell the patient's relatives that the patient needs to be admitted to ICU. As the charges at private hospitals are high, many opt to get admitted to government hospitals or BSMMU. ICU is not available in such emergencies. There are always four or five patients on the waiting list for the BSMMU neonatal department ICU.

The waiting list is long at the Anaesthesia Analgesia and Intensive Care Medicine Department too. An official of the department said that there are 30 to 40 patients on the waiting list. Many of them cannot wait and have to spend a lot of money to get admitted to a different hospital.

Public health experts feel that the ICUs at this medical institution, one of the best in the country, remain out of order due to lack of initiative and coordination. A culture of humanitarian and advanced services has not been created.

Speaking to Prothom Alo, public health expert Be-nazir Ahmed said, "A culture of humanitarian and advanced services has not been created here has yet. If the 101 ICU were functional and active, this institution would be able to play a significant role in saving innumerable persons' lives. Those earning a degree from here had the opportunity to learn a lot. Unfortunately, nothing of this is happening."