Home ›› 14 Dec 2022 ›› Front
Masum Billah, a resident of Borhanuddin upazila in Bhola, started suffering from chest pain at midnight recently. His family waited till morning before taking him to a private hospital in the district town, a one-hour drive from his home.
The on-duty doctor referred the patient to Dhaka’s hospitals as they did not have the necessary equipment and cardiologists to provide treatment.
Due to the lack of cardiac treatment facilities in his district, Masum was then taken to Ibrahim Cardiac Hospital in Dhaka where the doctors conducted his cardiovascular surgery and provided further treatment.
Talking to The Business Post Masum Billah said, “I paid Tk 3.20 lakh under a 10-day package for open heart surgery at the Ibrahim Cardiac Hospital, in addition to the huge amount of money my family members spent for staying in Dhaka during the time.”
“If open heart surgery could be conducted in my district, our expenditure and sufferings would have been reduced a lot,” he said.
Like Masum Billah, numerous heart patients in 59 out of 64 districts of the country are not only suffering from the same problem but facing premature death also as the treatment for cardiac diseases is still Dhaka-centric.
Only 29 hospitals in five districts of the country have the necessary equipment needed to conduct cardiovascular surgery. Of those, 21 hospitals are in Dhaka city, four in Chattogram, two in Khulna, and one each in Sylhet and Sirajganj, according to the Cardiac Surgeons Society of Bangladesh (CSSB).
Hospitals in the rest 59 districts have no cardiovascular treatment facility. As a result, heart patients in those districts are suffering immensely, being deprived of proper treatment in time.
Lack of cardiac treatment facilities across the country is resulting in numerous deaths every year that could be prevented if the district-level hospitals could provide the necessary treatment, said experts.
They said although there are primary care facilities for heart disease at the district level, they are not up to the mark, so the patients rush to the capital for treatment. The number of full-fledged cardiac treatment centres as well as cardiologists and cardiac surgeons is extremely inadequate, resulting in many preventable deaths in the country, according to health sector officials.
Officials of the National Institute of Cardiovascular Diseases (NICVD), located in Sher-e-Bangla Nagar area in the capital, said at present an average of 400-500 patients come to the outdoor department every day, which is comparatively higher than the daily turnout during pre-pandemic times.
At the indoor wards, an average of 1,200 patients are treated every day. The government recently increased the number of NICVD beds from 400 to 1400 to provide treatment to the growing number of cardiac patients.
Bangabandhu Sheikh Mujib Medical University (BSMMU) Vice-Chancellor Professor Dr Md Sharfuddin Ahmed told The Business Post that decentralising the cardiac treatment facilities has become a must to reduce the number of deaths of cardiac patients.
The health expert said, “The government has undertaken projects, following the instructions of Prime Minister Sheikh Hasina, to set up modern hospitals in eight divisional cities with full-fledged cardiac, kidney and cancer units having skilled doctors and staff.”
“I hope that the heart treatment facilities will be decentralised once those hospitals are built and the heart attack patients would get proper care at the very beginning in their district,” said Prof Sharfuddin.
According to a study of NICVD, the prevalence of cardiovascular disease in Bangladeshis is 4.5 per cent regardless of the type.
Around 17 per cent of those who die due to various diseases in the country are related to heart disease, said experts.
They said the lives of many patients could have been saved if they had received proper and timely treatment at their nearest hospital in the country.
According to physicians, the treatment protocol for cardiac arrest patients is the same everywhere but doctors cannot give treatment without the necessary supporting staff and equipment, which is absent in district-level public hospitals.
The coronary care units of divisional-level hospitals are also not well-equipped and cannot even accommodate all patients due to the scarcity of beds.
The country’s public and private hospitals have 43 cardiac care units altogether.
According to the CSSB, 16 out of the 21 hospitals that conduct cardiovascular surgery in Dhaka are privately owned. These 16 hospitals carry out the majority of cardiac surgeries, conducting 12,000 surgeries annually on average.
The fees for cardiac surgery begin at Tk 1.10 lakh in government facilities, while the lowest fee at private hospitals is around Tk 3.20 lakh.
There are only 85 centres for conducting angiograms across the country and 58 of those are located in Dhaka.
Sources concerned said there are six public medical colleges in Rangpur, Rajshahi, Khulna, Sylhet, Mymensingh and Barishal that have coronary care units. But only angiograms and other related diagnostic facilities are available at these colleges.
However, these services often remain unavailable due to a shortage of doctors and technicians.
Talking to The Business Post, Tangail Civil Surgeon Dr Md Minhaz Uddin Miah said, “There are no angiogram or surgery facilities in the district for heart patients but we have cardiologists to provide primary treatment and prescribe medicines.”
He hoped that all kinds of cardiac treatments including surgery will be introduced in more districts in future.
Besides decentralising the cardiac treatment facilities, experts suggested strengthening the cardiac care units of the public hospitals of 64 districts by ensuring necessary equipment, staff and cardiologists to save lives of people.
A cardiac patient needs to get admitted to a hospital for treatment within eight hours of a heart attack, but currently, only one per cent of the total population of Bangladesh can enjoy the facility, said a doctor on condition of anonymity.
Meanwhile, there is still a huge shortage of cardiologists in the country compared to the number of patients.
Bangladesh currently has a total population of 16,51,58,616, according to the preliminary data from the “Population and Housing Census 2022” conducted by the Bangladesh Bureau of Statistics (BBS).
However, the numbers of cardiologists are only 1,100 while the number of cardiac surgeons is only 250 across the country, according to doctors.
The data shows that currently there is only one cardiologist for 1.50 lakh people while one cardiac surgeon for 6.60 lakh people in the country.
Mohsin Ahmed, associate Professor of the Department of Cardiology of NICVD told The Business Post, “Bangladesh has made significant progress in providing cardiac treatment and now world-class heart treatment is provided in the country.”
“The number of patients going abroad for heart treatment is reducing day by day because all modern treatment facilities except heart transplant facilities are now available in Bangladesh,” he added.
In 2020, the government approved the construction of eight full-fledged cancer hospitals with well-equipped cardiac units in all divisional cities of the country.
Although the government planned to strengthen the existing cardiac care units in the medical college hospitals and the district-level hospitals at the beginning of the Covid-19 pandemic, no significant progress is visible in this regard.
Health Ministry’s Additional Secretary (Hospital Wing) Nazmul Haque Khan told The Business Post that the government has taken various initiatives to ensure heart treatment facilities for the country’s people.
He also said the health sector achieved remarkable success in recent years and government efforts are continuing in this regard.
The country’s first open-heart surgery was conducted at the Cardiology Institute of Shaheed Suhrawardy Hospital in September 1981 led by Prof Nabi Alam Khan. Since then, over 50,000 people have undergone open heart surgery in the country so far, according to physicians.
They also said currently 10,000-12,000 bypass surgeries are performed every year while 15,000-16,000 angioplasty and 50,000 angiograms are performed at public and private hospitals every year.
According to the non-communicable disease risk factor survey 2018, some 15.5 per cent of Bangladeshis aged between 40 and 69 years are at risk of cardiovascular diseases.
