State of public hospital in Dhaka-I

Heart hospital NICVD cries for care

Overcrowding, highhandedness of middlemen among problems


Ismail Hossain | Published: December 01, 2017 00:46:09 | Updated: December 03, 2017 17:59:42


Patients along with their relatives staying on a floor at National Institute of Cardiovascular Diseases in the capital due to scarcity of beds. — FE Photo

Country's exclusive public cardiac hospital NICVD itself needs cure for debilitating problems, principally overcrowding by patients and irregularities.

The backhander or influential reference for getting seats or other services and being forced to buy life-saving medicines which were supposed to be cost-free also were alleged by patients.

The authorities say, in reply, they are trying to improve service in spite of facing unmanageable pressure of patients.

The National Institute of Cardiovascular Diseases (NICVD) treats more than double the patients than its seat capacity every day. 

The hospital has 414 seats in 18 wards, but 950 patients, on average, remain admitted every day. Currently, more than 500 patients take treatment lying on floors per day.

The patients and doctors both say the quality of treatments is compromised due to overcrowding of patients, as the hospital cannot refuse anybody coming for treatment.

The authorities have recently taken initiative to increase its facilities to cope with the increasing number of cardiac patients.

Modernization of emergency department, vertical extension of hospital to double the number of seats, and more free lifesaving medicines for all patients are some of the new facilities the hospital has added recently or is in the process.

In February this year, the Executive Committee of the National Economic Council (ECNEC) approved a Tk 880 million project for vertical expansion to make more rooms.

"The construction work of vertical expansion of NICVD building was set to start, and once the project is completed, the bed crisis will be over," said Director of NICVD Professor Dr Afzalur Rahman.

There is only one ward for women and children. The authority is now focusing on setting up more wards for them.

There will be 450 new seats, 33 cabins and special children and female wards in new three floors of vertical expansion.

"We hope new expansion will be completed by the end of 2018 and after completion severe crisis of accommodation will be eased, said Mr Rahman.

The hospital received 476 outdoor and 634 indoor patients daily in 2012, while 472 and 629 in 2013, 549 and 660 in 2014, 609 and 688 in 2015 and 618 and 738 in 2016.

The total outdoor patients were 170,466 in 2012 while 44,559 patients received treatment indoor during the same year.

The numbers were respectively 172,269 and 43,341 in 2013, 200,533 and 47,763 in 2014, 222,186 and 63,390 in 2015 and 226,138 and 64, 906 in 2016.

The patients have been increasing significantly each year but infrastructural facilities didn't as much as the hospital needed for increasing patients.

The revenue budget of the hospital also increased from around Tk500 million in 2012 to 837 million in 2016, hospital sources said.

Dr Afzalur Rahman said it is natural patients will come to the NICVD as this is the only full-fledged cardiac hospital in public sector.

"We are trying to increase facilities to accommodate as many patients as we can. The service quality is not up to the mark due to flocking patients, but we can't say no to anyone," he said.

In May last, the NICVD hospital started free supply of Streptokinase injection, which is used for dissolving coronary blocks. The supply was earlier limited to only 100 patients a month.

"Earlier, we used to provide the injection to maximum 100 patients every month. Now there is no limit to it. Whoever needs it will get it for free," said Prof Dr Afzalur Rahman.

The hospital also provides four Enoxaparin injections for two days for all patients.

"Besides we are planning to build to 10-storied building for staff housing and a 14-storied one for expanding hospital facilities further," Mr Rahman said.

But there are other sides of the coin too, as is alleged by many. Patients alleged it is almost impossible to get a seat in the hospital without under-table dealings or influential reference.

"I brought my father six days back here, and until the fifth day, I did not get a seat. I gave Tk500 as bribe yesterday and then I got a seat today," Mobasshera Yeasmin told The Financial Express.

Ms Yeasmin said many seats got vacant in the meantime, but she did not get one because she wanted a seat without an enticement. 

The patients also alleged all patients do not get the medicines they are entitled to get free of cost.

Sometimes ward boys and nurses force them to buy medicine from outside.

Admitting irregularities, Dr Rahman said yes there are some allegations but the authorities are trying to improve the situation.  "We take immediate action if any patient complaints to us," he said.

According to hospital administration, some nine hospital staff members were suspended during last few months for involvement in such activities. 

Some 484 new nurses have joined the hospital recently. The new addition allowed the authorities to appoint a nurse for one patient in ICU and CCU.

"Besides, a nurse was ensured for every three patients in ward," Mr Rahman said.   

There are also allegations brought by patients that hospital charges higher prices of stents even after government's fixation of stent price.

The Director said he welcomes recent government decision to fix the uncontrolled prices of stents that had been worrying patients and their families for years.

He said NICVD ensures the government-set prices.

The NICVD authorities have introduced a practice to avoid misunderstanding between patients and the hospital. A patient undergoing angioplasty or cardiac device implantation now has to fill in a form describing what sorts of medications and medical devices being used.

The form has to be signed by cath-lab sister-in-charge, cath-lab technologist-in-charge and consultant cardiologist.

The hospital provides one copy to the patient, one copy to the company authority and preserves one copy at the hospital.

"The measure has been taken so that the company can charge for only what it has delivered," Mr Rahman added.

The institute was established in 1978 with the aim of establishing modern cardiovascular-care services in the country and to develop trained manpower in this field for the need of the country.

Besides rendering the best possible services and care for the cardiac patients, postgraduate medical courses for the doctors were introduced in this Institute in July 1982.

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