Published in The Independent, July 23rd., 2010
M. Serajul Islam
A picture and a news item in The Independent’s issue of July 21st should jolt the conscience of people in charge of health care system of the country, if of course they have a conscience to jolt in the first place. The picture shows dangerous waste from Dhaka Medical College (DMC) dumped in the road in front of the hospital. In simple parlance, this is the equivalent of a prostitute quarter and a gambling and drinking place near the gate of a premier educational institution of the country because Dhaka Medical College and hospital has been established to be just that.
The deterioration in the affairs of Dhaka Medical College is nothing new. These days thanks to the influx of private TV Channels, we have visited the inside of Dhaka Medical College many times in virtual reality of course. The inside of the Medical College is in fact is worse than what the picture in The Independent has revealed. Those of us who have had the misfortune of visiting Dhaka Medical College physically have wondered whether anyone ever comes out of this place alive once entering it as a patient.
The Independent story has mentioned that there are 1000 hospitals, clinics, diagnostic centers that dump dangerous wastes regularly in the roads in front of their premises. In 1998-1999, I watched such pollution everyday from my apartment adjacent to the Bangladesh Medical College on Road 14 A Dhanmandi Residential Area. In the first place, the hospital has no business being there right inside a residential area. In course of time, I have moved out of the apartment for my family’s safety. It was not just that the Medical College was polluting the environment; it has also violated building by-laws and has turned the lives of those living on Road No 14 A upside down.
Coming back to The Independent story, Dhaka Medical College has defended itself on the issue of the wastes and has explained that clinics in nearby areas dump wastes in front of Dhaka Medical College to avoid paying money that is involved in the professional disposal of wastes that DMC carries out. The defense is a strong one by the DMC. However, it still does not resolve the fundamental issue; that dangerous medical wastes are dumped in front of the DMC which is a big institution and has enough security guards to ensure that such dangerous wastes are not dumped anywhere near it . Why can’t the DMC’s security deal with such illegal waste disposals that are just not causing great harm to people in the vicinity but also earning the DMC a bad name? Is there an evil nexus between some people in DMC and the clinics in the nearby areas?
It is no doubt that the large number of private medical clinics and diagnostic centers are playing a valuable role for providing medical services to the people of the country, particularly to Dhaka’s teeming millions. Unfortunately, barring a handpicked few, the majority of these clinics and diagnostic businesses are carrying out their functions and activities in a largely unregulated fashion. It is now a frequent story in the newspapers to read that one clinic or another has been ransacked because a patient has died due to the negligence of the attending doctor. Incredible as it may sound, there has been news in the papers lately that has mentioned such clinics appointing fake doctors! In the good old days, we knew there were doctors in the villages of Bangladesh that we called quacks. Fortunately those quacks seldom killed people because they did not have the benefit of the drugs that are in the market today; drugs when administered professionally save a patient but when served by others, call them quacks if you want, kill patients.
A country with such a large population as Bangladesh with such poor infrastructure and resources will never be able to provide medical attention to its people at the expense of the Government. The gap has to be provided by the private sector. It is gratifying that we are seeing the private sector come up to fill the gap. Unfortunately, in filling the gap, the private sector is not entirely motivated by the service elements of the medical needs of the people. Greed has been a major factor in the large number of such clinics and diagnostic centers coming up like mushrooms. Thanks again to the media, particularly the electronic media; we now know how patients are lured by professional goons from government hospitals to these clinics, a criminal process in which the doctors themselves also play a major role for reasons of greed.
All these factors point to a very dangerous situation existing all around us concerning the state of affairs in the medical profession of the country. There are very few in this country who have not suffered tragedy in personal lives because of wrong treatment in the hospitals, both government and private. For some strange reasons, such tragedies have always been allowed to remain at the personal level and have never been brought to the national level although the problem is serious enough to deserve national attention. We often hear of one doctor or another as being brilliant in Dhaka and commended for saving patients with their professional ability. It is good to hear when our doctors are praised this way. But while we praise our doctors, we often do not consider that Bangladesh is perhaps one of the few places in the world where the doctors can literally treat patient and experiment with them without anyone in the patient’s family being told anything about what the doctor is doing. In such experiments, patients die frequently with little or nothing that can be done against the doctor. There is very little legal recourse available to a patient’s family to take action against a doctor when a patient is killed either while experimenting or due to professional incompetence of the doctor. If doctors elsewhere had such liberty to treat patients as guinea pigs, they would have achieved wonders.
It is time for the Government to look seriously in regulating the medical profession, particularly the mushroom growth of private medical institutions. In the developed world, doctors can only dare deal with a patient with nothing short of the highest professional attention and devotion if he is not afraid of losing his license or going to jail. This is why doctors in the developed countries pay through their nose in taking personal insurance, something from which our Government blissfully protects the doctors. Our legislature should look into the laws that exist in the medical profession of the developed nations and replicate some to save patients from the mercy of the doctors. It is past time that there should be something called patients rights in the medical profession in Bangladesh and pasted boldly in all medical institutions that doctor should read every day while going to their places of work and coming out of it together with the Hippocratic oath that our doctors have very well forgotten.
On the issue that motivated me to write this piece, the story in The Independent, let something be done as a starter in cleaning the medical waste in front of private and government medical hospitals, clinics and diagnostic centers as a beginning in regulating the medical institutions of the country. The explanation by the DMC that the wastes belong to nearby private clinics is not good enough for it is also its duty to stop those who are disposing such wastes in front of its premises. Let the Government come with a prohibitive fine to stop this criminal menace for it is money that can bring some sense into these unethical businessmen who are giving such a bad name to the noblest of human professions.
The writer is a former Ambassador to Japan and Egypt and has a blog www.ambassdorseraj.blogspot.com