Low allocation, low-quality diet for patients at 6 public hospitals in Dhaka

A nurse provides treatment to a dengue patient at the Shaheed Suhrawardy Medical College and Hospital in Dhaka, Bangladesh, 26 July 2023.Reuters file photo

Nripiti Das form was admitted to the Sheikh Hasina National Institute of Burn and Plastic Surgery in Dhaka in January. As he had surgery on his tongue, he had to take liquid through a tube, but he was served with coarse rice, vegetables and lentils and a piece of fried fish tail.

Why he was served solid foods instead of soup or liquid food? Later it was learned physicians prescribed him a normal diet. So, he was served with solid food. His daughter Srabonti said they spent more than Tk 15 to buy soups and other foods as his father cannot eat the foods provided by the hospital.

This correspondent visited six public hospitals in the capital recently to look into the overall situation of food provided to the patients. These hospitals are Dhaka Medical College Hospital, Bangladesh Shishu Hospital and Institute, National Cancer Research Institute and Hospital, Shaheed Suhrawardy Medical College Hospital, National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR) and Sheikh Hasina National Institute of Burn and Plastic Surgery.

There are several common allegations from all of these hospitals. There are several common allegations against all of these hospitals. The rice is coarse and smells bad, lentils are like water and curry is tasteless. There is no arrangement to serve food by measuring calories in proportion to age, weight and diseases of patients. Dieticians are just for formalities and the hospitals lack overall monitoring in this matter.

According to hospital officials, food allocation was at Tk 125 per patient at public hospitals two years ago, which increased to Tk 175 after the coronavirus pandemic broke out in 2022, while food allocation is at Tk 300 per patient at the intensive care unit (ICU) and the high dependency unit (HDU) of the Sheikh Hasina National Institute of Burn and Plastic Surgery.

Government officials said it is very difficult to provide a balanced diet. Directorate General of Health Services director (hospital and clinic) Abu Hussain Md Moinul Ahsan said it cannot be said randomly that patients are not having the foods provided by hospitals. Had the patients not eaten the hospital foods, their relatives would have not waited in long queues for food, he added.

Many patients eat outside food

Masud Rana, from Jamalpur, was relaxing on his bed at the National Institute of Cancer Research & Hospital (NICRH) after having his lunch on 8 February. He, however, did not have the lunch that the hospital served him on that day. “If the quality of food quality was really good, why would I not eat the free food provided by the hospitals?”

Masud Rana’s wife brought rice from home. He took the rice pot and said, “Check the taste and smells of this boiled rice, as well as the boiled rice provided by the hospital. Then you will understand why I do not eat it.”

Relatives of the patients rented rooms at various apartments near the cancer hospital and there are arrangements for cooking rice and curry for a cost of Tk 10.

Directors, stewards and cooks of several hospitals said it is not possible to provide three meals and some snacks daily for Tk 175. Previously, fish or meat pieces weighing 70 were allocated per patient at the cancer hospital, which has been reduced to 55 grams now. A cook at Shaheed Suhrawardy Medical College Hospital said pieces of pangas fish are slightly larger since their price is low and pieces of rui fish are usually smaller. However, pieces of fish and meat are processed based on estimation.

Fifty-four kilograms of mutton was cooked for the lunch of 993 patients at NITOR on 12 February and a piece of meat weighing 55 grams was allocated for each patient. Each patient was provided with a piece of meat weighing 60 grams at this 1000-bed hospital in the 2022-23 fiscal.

A patient is served breakfast for Tk 53.67, lunch for Tk 52.79, afternoon snacks for Tk 30.87 and dinner for Tk 37.67 at the Dhaka Medical College Hospital, totalling Tk 175 a day.

Farmer Abul Hossain along with his daughter from Rajshahi has been at the Dhaka Medical College Hospital for two months. He simply admitted that the cooking of the hospital does not taste good. Another patient said the banana that the hospital provides cannot be eaten, and lentils taste like water.

Dhaka Medical College Hospital director Brigadier General Md Asaduzzaman told Prothom Alo nobody complains about food. Nobody places such information in the complaint box either, he added.

According to a 2013 report ‘Dhaka Medical College Hospital: Advancement of good governance, challenge and way out’ by Transparency International Bangladesh, 200 patients on average per day do not take the foods provided by the hospital.

Dietitians just a formality

Diet is important for a patient as much as medicines. A patient’s diet is fixed based on many things including whether the patient has diabetics or kidney problems. In some cases, the diet amount is fixed based on the age and weight of the patients. Dietitians are responsible for advising diet charts for the patients.

Samiul Islam has been a dietitian at the national cancer hospital for four years. He completed graduation in business studies. He was a steward at another government office but was promoted to the cancer hospital. He completed a week-long training on nutrition. Replying to a query on how he measures calories and carries out other duties, he told Prothom Alo this is a matter of practice and he is not facing any problems.

Shaheed Suhrawardy Medical College Hospital dietitian Marzia Sultana said she monitors the diet chart that physicians prescribe.

The post of diet officer remains vacant at the Sheikh Hasina National Institute of Burn and Plastic Surgery. Dhaka Medical College Hospital director Brigadier General Md Asaduzzaman told Prothom Alo there is one dietitian at the hospital, it is difficult to distribute foods by measuring the calories of 4,000 patients daily.

Children's diet

This correspondent spoke to patients and their parents at the Bangladesh Shishu Hospital and Institute. The hospital provides free food for the patients. People concerned about the hospital said the food amount is slightly more so that mothers of the child patients can eat this too. However, the mothers said the amount of food is less.

Tania from Bagherhat has been in this hospital for a month as her two-year-old son is undergoing treatment. She said there was no taste in the hospital’s food. The amount is also less. The food looks bad. But they have been compelled to eat it. She often has to buy food from outside.

Hospital director professor Md Jahangir Alam told Prothom Alo that 40 per cent of this 682-bed hospital is for free treatment. Milk is provided for children over six months, if necessary, and foods are being provided for children suffering from malnutrition marinating diet chart.

Boiled rice of course variety, a small piece of chicken and mixed vegetable lentils was served on that day. Professor Md Jahangir Alam said it is not possible to provide basmati rice, but khichuri rice is provided in the morning.

However, foods are not cooked in a hygienic environment all the time. The kitchen of Shaheed Suhrawardy Medical College Hospital is very old and is outside of the hospital premises. Foods covered with clothes are brought on the trolley to the hospital. This correspondent visited the hospital kitchen on 13 February. The kitchen was nearly dark and emitted odour. Water gathers in small holes on the kitchen floor.

Shaheed Suhrawardy Medical College Hospital director Md Shafiur Rahman told Prothom Alo, “I admit the hospital kitchen is in a dire state and it is not also possible to mend such an old kitchen. However, the process is on to construct a modern kitchen at a new building soon.”

Way out

Allegations about food at the public hospital by patients are very old. Foods are not up to the standard and almost similar foods are provided at all hospitals. Many people are not habituated to see the patient’s diet as part of the treatment. Less debate and discussion is held on the patient's diet.

Bangladesh Medical Association former president professor Rashid-e-Mahbub said there was concern over the patients’ diet at public hospitals. Only an increase in budget will not work, adequate and competent manpower will have to be recruited in overall food processing management. Besides, it is also necessary to prepare patients’ diet charts by measuring calories by physicians and dietitians together, he added.

This report appeared in the print and online editions of Prothom Alo and has been rewritten in English by Hasanul Banna