21 trauma centers: No treatment, only buildings are there

The Elias Ahmed Chowdhury Trauma Center has been built at Duttapara of Shibchar in Madaripur at a cost of Tk 120 million, but the facility remains closed since it was inaugurated on 8 November 2022. Picture was taken recently.
Ajoy Kundu

The Elias Ahmed Chowdhury Trauma Center has been built at Duttapara of Shibchar in Madaripur at a cost of Tk 120 million, for providing emergency treatment service to the road accident victims.

Health minister Zahid Maleque inaugurated the health facility beside the Bangabandhu Sheikh Mujibur Rahman Expressway in November last year, but it is yet to launch treatment service.

A deadly bus accident took place in Shibchar on Sunday, leaving 19 killed and 25 injured. The victims were taken to a private hospital and different upazila health complexes, instead of the nearby government trauma center.

The directorate general of health services have constructed a total of 21 trauma centers across the country. The government took initiatives to construct 10 of the trauma centers in the fiscal year 2004-05 and the remaining 11 in fiscal year 2010-11.

But,16 of them are currently lying defunct while two are running only outdoor services and two others are under construction. Another trauma center is being used as the orthopedics division of a district hospital.

The trauma centers were aimed at providing quick treatment to the road accident victims and saving lives. A proposal was made for recruitment of 34 officials, including 14 physicians, 10 nurses and pharmacists, to each of the trauma facilities.

But the authorities did not recruit manpower as per the proposal and provide medical equipment to the medical facilities in most cases.

As a result, the trauma centers could not serve the purposes. The health directorate could not say the exact amount of spendings on the facilities. However, the local health and public work authorities estimated the total costs at Tk 1.4 billion.

The infrastructures are getting damaged due to lack of use and maintenance while the equipment is being stolen. Sometimes, the drug addicts find the trauma centers as safe shelter for drug consumption.

Photo shows the trauma centre in Shahidnagr of Daudkandi upazila, Cumilla, but facility is yet to launch treatment service.
Abdur Rahman Dhali

Sheikh Daud Adnan, director (hospital and clinic) of the health directorate, said the trauma center concept is not realistic in the context of Bangladesh. The facilities could not be utilised due to weaknesses in planning. There is no manpower to run the centers.

“No more trauma centers will be constructed. It is being planned how the prevailing centers can be utilised,” he added.

The current trauma centers are situated at Atgharia in Pabna, Sherpur in Bogura, Sirajganj Sadar and Ullapara, Bhairab in Kishoreganj, Gopalganj Sadar, Shibchar in Madaripur, Shivaloy in Manikganj, Jazira in Shariatpur, Bhanga (Madhukhali) in Faridpur, Sreenagar in Munshiganj, Dhamrai in Savar, Elenga in Tangail, Lohagara, Hathajari and Raujan in Chattogram, Daudkandi in Comilla, Mohipal of Feni, Bhaluka in Mymensingh, Chatak in Sunamganj and Bahubal in Habiganj.

Political inauguration

There are four trauma centers in total along the Dhaka-Mawa expressway. Among them, the Shibchar trauma center was found closed on 15 March, with no health officials present there. Locals claimed that the medical facility is now a gathering place for the drug addicts.

Asked the reason behind the closure of the trauma center despite being inaugurated formally, Munir Ahmad, civil surgeon of Madaripur, told Prothom Alo that it was actually a political inauguration. There is no manpower, no logistic support (equipment facilities) to keep the trauma center operational.

He also said even the Shibchar health complex does not have required number of physicians and nurses. How the trauma center will be staffed!

The authorities constructed another trauma center in Sreenagar upazila of Munshiganj in 2020, at a cost of Tk 23 million. But the fans, lights and other valuable equipment from different rooms were stolen. Locals said the building is also a gathering place for drug addicts.

Photo shows the trauma centre in Dhamrai, Dhaka.
Shamsuzzman

Munshiganj civil surgeon Manjurul Alam blamed lack of manpower and necessary equipment for the non-operation of the trauma center.

Another trauma center was supposed to be open on the ground floor of Jazira upazila health complex in Shariatpur, but it wasn't eventually. A section of the floor is now lying unused.

The remaining trauma center along the expressway is being used as the orthopedics department of Bangabandhu Sheikh Mujib Medical College in Bhanga of Faridpur.

Buildings left abandoned

Construction of a trauma centre was completed beside Dhaka-Sylhet highway in Kamalpur area of Bhairab in March 2020 at a cost of Tk 190 million, but the centre is yet to start operation. However, the upazila health and family planning department locally opened an outdoor service on 20 February this year.

Bhairab upazila health and family planning officer Bulbul Ahmed told Prothom Alo the trauma centre is adjacent to the Dhaka-Sylhet highway, which sees a rise in road accident, so, it is very necessary to open the centre to ensure treatment to patients. Letters have been sent to authorities concerned for several times to open the trauma centres, but to no avail, he added.

The highway on the west side of Bangabandhu Bridge in Sirajganj has always been prone to road accident. The Sheikh Hasina Trauma Centre has been constructed in Mulibari of Soidabad union parishad in Sadar upazila of Sirajganj to ensure emergency service to victims of road accident. Construction of this centre ended in 2020 at an approximate cost of Tk 110 million. Sources at the Sirajganj civil surgeon office said the centres could not be opened due to a lack of manpower and equipment.

A trauma centre was constructed on Dhaka-Sylhet highway in Bahubol area of Habiganj in 2013 at a cost of Tk 31.8 million and, the centre is yet to be inaugurated. The trauma centre, which was constructed next to the Dhaka-Bogura highway on the premises of Sherpur upazila health complex at an approximate cost of 140 million, is yet to open even though the facility was inaugurated in April 2018.

A four-storied trauma centre was constructed beside the Dhaka-Khulna highway in Ghonapara area of Gopalganj’s Sadar upazila in 2018, at a cost of Tk 120 million, but no manpower was provided. District civil surgeon Niaz Muhammad told Prothom Alo power connection has been snapped since the centre has an arrear of Tk 400,000 in electricity bills before the opening.

Photo shows the four-storied trauma centre in Shibalai upazila of Manijganj.
Abdul Momen

A trauma centre was constructed near Dhaka-Chattogram highway in Shahidnagar of Cumilla’s Daudkandi upazila in 2006 at a cost of Tk 60 million. Yet it still remains closed. A trauma centre was inaugurated in Lohagara upazila of Chattogram in 2013 at an approximate cost of 40 million, and no manpower and equipment has been provided to the centre as yet.

The four-storied trauma centre in the upailza health complex of Manikganj’s Shibalai upazila was handed over to the authorities concerned in 2015 after completing the construction at a cost of Tk 15 million, but the centre is yet to receive any manpower and equipment. It took nearly 11 years to build the trauma centre in Dhamrai upazila of Dhaka and the centre has not been handed over to the authorities yet.

An outdoor department was opened at the trauma centre in Mymensingh’s Bhaluka upazila six month ago with four physicians and no arrangement for patient admission.

Though the government decided to build no trauma centre, construction of two centres is in progress – one is in Sunamganj’s Chatak upazila at a cost of more than Tk 130 million and another is in Chttogram’s Raujan upazila at a cost of more than Tk 120 million. People concerned said these two centres will face similar fate unless necessary physicians and equipment are provided after construction ends.

‘Waste’ of public fund

The matter of trauma centres left empty came to limelight following the rise in road accidents and fatalities in the country. Road accidents, according to Road Safety Foundation, claimed 7,713 lives in 2022.

According to people concerned, in many cases government agencies are interested in constructing buildings and establishments, because there is opportunity for financial gain during procurement as well in helping contractor secure the work, but there is no initiative on the use of those buildings and establishments to ensure service to people.

Projects like trauma centre are taken up when no accountability exists, Bangladesh Medical Association general secretary Ehteshamul Hoque Chowdhury observed. He told Prothom Alo that had accountability existed no one could have taken up such project at the expense of public funds and it was necessary to conduct feasibility study on the number and location of road accident, patients and required manpower before undertaking a project.

Ehteshamul Hoque Chowdhury said trauma centres are necessary and it is possible to open these centres by appointing manpower and providing required equipment.

(Prothom Alo’s Staff Correspondents and Correspondents from respective districts and upazilas contribute to this report.)

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