High-interest loans, land sales, assistance: Families struggle to pay medical bills

On 19 September, teenager Toma Akter suddenly developed severe abdominal pain. Her parents first took her to an upazila health complex and then admitted her to Manikganj Medical College Hospital. On 13 October, she was transferred to the urology department of Dhaka Medical College Hospital, where she was diagnosed with kidney complications. Her blood creatinine level was 22 times higher than normal. Since Sunday, she has been receiving dialysis in the hospital’s intensive care unit (ICU).

At 10:30 am on Wednesday, Toma’s mother, Lipi Akter, was seen waiting anxiously outside the ICU. The family lives in Atigram union in Manikganj Sadar upazila.

She said Toma was the eldest of their four children. Leaving the other three with their grandmother, she and her husband had come to the hospital with Toma.

As her condition deteriorated, Toma was transferred to the ICU from Ward 310. Her parents have been sleeping on a mat beneath a hospital staircase.

While speaking to this correspondent, Toma’s father, Toraf Ali, arrived carrying a receipt for a blood test costing Tk 350. He had paid Tk 400 for another test earlier that morning.

A painter by profession, Toraf Ali said the family had spent Tk 72,000 on their daughter’s treatment in a month, using money received as help from others, loans and proceeds from the sale of land. He said he could think of nothing other than his daughter’s recovery.

At Dhaka Medical College Hospital on Wednesday, four other families were also found struggling to meet the cost of treating their children.

Brigadier General AKM Farhad Hossain, director of Dhaka Medical College Hospital, told Prothom Alo in his office that patients often have to pay out of their own pockets because of overcrowding, long waits for surgery, prolonged hospital stays and the cost of accompanying family members.

The hospital has 2,600 beds but accommodates more than 4,000 patients. No patient is turned away without being admitted, he said, leaving the hospital under far greater pressure than its budget allows. Nevertheless, the hospital supplies most medicines and provides a sufficient quantity of food to patients.

He added that the budget for patient care was being increased, which could help reduce out-of-pocket expenses.

Toma’s father, Toraf Ali, said the family spent Tk 6,500 on a CT scan and other tests on the first day of her illness. After physicians identified her kidney complications, they advised the family to travel to Dhaka for an MRI. On 6 October, they paid Tk 12,000 for the scan at a private diagnostic centre in Dhaka.

After returning to Manikganj, Toma’s condition deteriorated, and she was admitted to Dhaka Medical College Hospital on 13 October. She has undergone three dialysis sessions so far, each costing Tk 400. The hospital provides some medicines and supplies, but the family must buy others from outside. They were told on Wednesday that assistance would be provided from the hospital’s poor patients’ fund.

Toma’s mother, Lipi Akter, said her husband did not even own a homestead in their village, and the family lived in someone else’s house. She had inherited a share of land from her own family. Burdened by debt and facing persistent pressure from creditors, she sold the land to a cousin for Tk 100,000 five months ago.

After repaying their debts, they had Tk 15,000–20,000 left. That money, too, has now been spent on Toma’s treatment.

To cut their own expenses, the couple eat two pieces of bread in the morning and only rice and dal (lentils) for lunch.

Bursting into tears as she spoke about her daughter, Lipi said, “My daughter is so beautiful! She looks like the daughter of a wealthy family. If someone took responsibility for her treatment, I would work as a maid in their house!”

Jewel Sardar, 36, has been receiving treatment for nearly four months in the corridor of Dhaka Medical College Hospital’s burn unit, in an additional bed in the Red Unit.

He is from Kata Khali union in Dashmina upazila of Patuakhali, and works as a fisherman. Four months ago, while fishing, he fell from a trawler, which hit him, severely injuring his right leg.

Jewel said he had spent Tk 300,000 on treatment over the past four months, including Tk 250,000 borrowed at an exorbitant interest rate. He must repay Tk 375,000, including interest, within a year.

He is staying at the hospital with his wife, Shahana, while their three children remain at home. Jewel has undergone surgery on his leg. Ten days ago, he had to take 15 medicines a day, 10 of which he had to buy himself. He also needed two injections costing Tk 850 each.

He said the injections had run out 10–12 days earlier and the number of medicines had since been reduced. Of the five medicines he now needs, the hospital provides four.

Kajol Rani lay in the orthopaedic ward of Dhaka Medical College Hospital with her left leg held in traction using bricks, groaning in pain. She and three family members accompanying her said she was from Louhajanj upazila in Munshiganj.

Last Thursday, while standing by the roadside, she was hit by a motorcyclist. Kajol said her husband was currently unemployed and that she had two daughters. She was struggling to pay for her treatment.

Over the past week, she had spent Tk 20,000 on nine medical tests and medicines.

Four-year-old Tahmid has been admitted to the children’s ward of the hospital’s burn unit, in the Red Unit, for surgery. He is the youngest of three children of Shoriful Islam and Rabeya Khanam, who live in Kalia upazila, Narail.

Rabeya Khanam said that on 28 November last year, a large cooking stove had been set up in the courtyard of a neighbouring house to prepare food for a kulkhani gathering. Tahmid fell into the stove, burning his left hand and leg. Three of his fingers have fused together, and surgery is needed.

Tahmid’s father works as an office assistant at a company. Despite financial hardship, he is trying to arrange the money needed for his son’s recovery.

Mohammad Harunur Rashid, resident surgeon in the hospital’s burn and plastic surgery department, told Prothom Alo that treatment and surgery were provided free of charge and most medicines were supplied by the hospital.

He pointed out that patients admitted to the department often require lengthy treatment and need nutritious food.

“Several family members also stay with them. As a result, families frequently end up spending far more on their own living expenses than on the patients themselves,” he added.