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Mizanur Rahman from Gabtoli of the city could not be able to get his ailing wife Mithila’s thyroid test done as they were late for 10 minutes to reach the National Institute of Nuclear Medicine and Allied Science, BSMMU, on Thursday.
They reached there just after 1pm as there was huge traffic congestion on their way to the hospital.
“We were late just for 10 minute. They said they couldn’t take samples after 1pm due to manpower shortage,” he said.
When he first got the sample tested three months back it took 10 days to get the result but when he did it for the second time it took only two days.
“So, I decided to get the test done from Ibn Sina that charged double the money. Private facilities charge about Tk2, 000 while it is only Tk800 at the BSMMU. Lab Aid even charges more,” Mizan, who is also a fruit vendor, said.
Due to lack of technologists in the government health care facilities in the country, majority of the people, especially from the poorer section, are being deprived of low-cost health services, say health experts.
The machinery worth crores of taka provided to the government tertiary, district and upazila level hospitals have remained idle for a long time resulting in damage to such machinery.
In Bangladesh due to higher medicine and testing prices, almost 67 per cent of the total health care costs are paid out of pocket, Hossain and Ahmed mentioned in their research ‘Stronger Health care System in Bangladesh.’
As a result, the number one cause of personal bankruptcies in Bangladesh is catastrophic healthcare cost, the research said.
Former Vice Chancellor of BSMMU Prof Dr Kamrul Hasan Khan, also a laboratory expert, said if government facilities ensure quality clinical diagnostic services round the clock, people, especially the poor and middle-income families, will be the major beneficiaries.
Bangladesh scenario
Almas Ali Khan, also the President of Bangladesh Medical Technologist Association (BMTA), said he had worked in the lab since 1983 and could rarely manage leaves during the service period.
There is only a seven-member team in the Biochemistry Laboratory of BSMMU that provides services to around 3,000 cases daily round the clock.
Among them, two members have already gone on Leave Preparatory to Retirement (LPR).
According to the senior technologists, a position where a rare number of these professionals can reach, they need over 50 members to make the tests round the clock comfortably and more efficiently.
There are some 140 technologists working in different departments in BSMMU. As there is a scarcity of technologists in the hospital, many departments even cannot run their services round the clock. To make it possible at least 2,000 technologists are required here alone, he added.
World Health Organization (WHO) guidelines suggested the doctors and medical paramedic ratio of 1:5. But the situation is almost reverse in Bangladesh. In Bangladesh, the ratio is 4:1.
For example, in Dhaka Medical College Hospital, only 26 radiology and imaging technologists are conducting over 1200 x-rays, over 100 CT-scans and around 100 MRIs.
The number is several times higher in BSMMU as they have two outdoor and emergency facilities, more than DMCH, although they have some 24 members in Radiology Department.
According to DGHS bulletin-2019, a total of 2,736 posts (out of 7,920) are lying vacant in the country. Some 6,500 medical technologists have been recruited till now. Of them, some have already retired.
Of the total, only 2500 are lab technologists, said the BMTA President.
DGHS has published an announcement on April 12 to recruit 2698 medical technologist under 14 categories.
BMTA President Almas Ali said: “An upazila health care centre needs some 45 technologists right now to operate round the clock whereas only one technologist has been appointed in the facility. Sometimes, a technologist is given responsibilities for two thanas as well.
To make all the government hospitals’ diagnostics run round the clock, more than 22,000 recruitments, apart from the 7,920 posts at the DGHS, are needed.
Bekar (unemployed) and Private Services Medical Technologists Associations (BPSMTA) said some 25,000 medical technologists who graduated from the institutions under the Health Ministry are unemployed at present.
Shah Alam Khan Parvez, President of Bangladesh Association of Radiology and Imaging Technologists (Barit), said if the government recruited minimum number of technologists in every facility, all these people would be employed, he added.
Better government services can lower cost for the poor
BMTA President Almas Ali said in government facilities they are testing blood sugar for Tk50 whereas the test costs Tk350 to Tk500 in private facilities.
Shah Alam Khan Parvez says DMCH conducts CT-scan ranging from Tk1500 to 4,000 whereas Tk5500 to Tk12, 000 are charged at different private facilities.
It is true in case of MRI and x-ray as well, he added saying that diagnostic centres near government facilities are forced to lower the price as a patient gets the same services at the prices four to seven times lower depending on services at government hospitals.
Prof of Institute of Health Economic under University of Dhaka, Dr Abdul Hamid said although there is no large-scale research on treatment expenditure in recent years, out-of-pocket expenditure could be 33 per cent less if government could ensure 24-hour diagnostic services in every upazila at tertiary level hospitals through recruiting medical technologists, he said.
