The Directorate General of Health Services (DGHS) has had the ironic misfortune of suffering from ill health. Its illness has only been in sharp contrast to the robust financial benefits - earned or unearned - derived by the majority of its bosses and some of his cohorts down the ranks. In charge of overseeing the public health of the nation, the DGHS ought to play a pivotal role even in normal time. But in time of an unprecedented pandemic like the Covid-19 that has brought almost all nations on this planet on their knees, the services such organisations render assume the importance at its maximum.
Clearly there was need for honest and steadfast leadership at the helm of the organisation in order to respond positively and effectively to the health crisis created by the cronavirus. Instead, right from the beginning the DGHS faltered and failed to apprise the political leadership of the health risks posed by the virus. When the overriding need was to assess the situation dispassionately and marshalling all the available resources to fight the virus in a systematic and coordinated manner, it was, as it now comes to light, busy feasting on perverse opportunities.
Physicians from Mugda Hospital complained of supply of substandard personal protection equipment (PPE) in early days of admission of Covid-19 patients to that hospital. Intriguingly, those physicians who complained were transferred. This shows where the malady lies. The investigation has not been concluded yet. Why? Now with the exposure of the scandalous agreements signed with Regent Hospital, JKG Health Care and Sahabuddin Medical College and Hospital there is the confirmation of the irregularities and malpractices that have sapped over the decades the energy and efficiency needed by an institute or organisation like the DGHS to rise up to the challenges thrown by the pandemic.
While the nation eagerly awaits what follows the DG's resignation and removal of a director, the comment coming from the information minister gives a positive sign. He states that here is an opportunity for reorganisation of the DGHS, now that the DG has resigned. Sure enough, the organisation must look forward and start a fresh journey on its mission. But what the minister means by reorganisation is not clear. Can it be transformation of its organogram or transfer and replacement of key positions in the organisations?
The country's health sector's malaise cannot be cured simply by skin-deep surgery. Hospitals -both public and private, diagnostic centres have long failed to live up to an above average standard. A lot of those have either indiscriminately violated medical ethics or simply faked their genuine versions and even run with impersonated doctors. Manufacture, marketing and sale of spurious and time-barred medicines have only put public health at further risks -in certain cases causing health complications or even death.
The extent and depth of the problem are so vast and unfathomable that the sector warrants a comprehensive reform. In government hospitals, drugs prescribed are not available in their stores. Patients -no matter if they are very poor -are compelled to buy them from pharmacies outside. Patients seeking admission to some of the government hospitals are either persuaded or coerced to get admission to private clinics run by doctors of the same hospitals. What happens in the name of private practice is mostly a disgrace. No wonder, those who can afford go abroad for treatment.
With such mismanagement and corruption taking a heavy toll of the healthcare system, it is simply unprepared to meet the challenges coming from a pandemic like this. The pandemic has overwhelmed the capacity of medical facilities even in countries boasting the most advanced of the kind. In countries like Bangladesh, there was need for most sincere and prudent use of every bit of resources to fight the disease. But it now gets blatantly revealed how funds have been misappropriated and health protocols including the quality of PPE supposed to protect physicians treating patients have been compromised. Perhaps a thorough investigation may conclude if death of so many doctors was unavoidable.
Procurement of hospital machines and equipment as also expenditure on construction, extension or renovation of buildings has ever remained a grey area. Machines and apparatuses worth millions of takas are never even opened or they get rusted because there are no technologists to operate those. In a number of cases last year and before the arrival of coronavirus this year, chiefs and other staff members of a few government hospitals were sued for misappropriation. A classic case involves the mafia reign established by a supplier of medical equipment to a government hospital, who fled the country before reinstating his niece there to oversee his vicious empire.
All this could happen because of the malady the DGHS suffers from. Now this has to be addressed in a systematic manner. Modern concept of hospital management is radically different from what is traditionally practised here. Doctors with MBBS, FCPS, FRCS degrees do not necessarily have to run hospitals. Those who pursue advanced public health study preferably with hospital management as a specialty are better suited to be the chief executive of large hospitals. It is them who know what to do and how and when, so far as hospital or healthcare management is concerned. The highly experienced among them should be in charge of the DGHS.
Now the term public health sounds abstract but it is the nation's health that concerns the population's physical and mental well-being. It should be visualised in terms of a prerequisite for national progress. So, more funds than has been allocated in the budget this year will be required to develop an advanced healthcare system. A national health policy should be formulated keeping an eye on introduction of health insurance for every citizen in phases beginning with those at the bottom.
