But who’ll run the tests?

With coronavirus positive cases increasing in the country, many are expressing dissatisfaction over the small number of tests being conducted every day and wondering about the possible reason behind this.

The reason is quite shocking.

No medical technologists (MT), entitled with the duty of testing and analysing body fluids at laboratories, were appointed at government hospitals in the last 11 years.

According to health professionals, due to the shortage, the number of coronavirus testing in the country is still low compared to other countries. Even those working as MTs at laboratories are not well trained, they added.

There is only one MT against four doctors in Bangladesh whereas at least five should be appointed against each doctor, as per World Health Organization guidelines.

Also, against every 10,000 people, there are only 0.32 MTs, which means only one MT is in charge for over 30,000 people.

The latest health bulletin of Directorate General of health Services (DGHS), published in November 2018, reported that a total of 2,736 MT posts (of the total 7,920) are lying vacant at the country's medical college hospitals.

'FEUD DELAYING HIRING'

A feud between the Medical Education and Family Welfare department under the Ministry of Health and Family Welfare and the Board of Technical Education is allegedly delaying the recruitment for the past 11 years.

A series of inter-ministerial meetings were held, new laws were introduced, two writ petitions and an appeal were filed with the High Court and a verdict was also delivered, but still the process of recruitment remained halted.

As a result, despite the 17 laboratories in and outside Dhaka having the ability to conduct more than 4,000 tests a day; they could test only 1,000 samples, said health officials, seeking anonymity.

"It is not possible to collect samples from community clinics with the least amount of manpower and test those," Selim Molla, former secretary general of Bangladesh Medical Technologist Association, had said in a statement recently.

In this situation, it will be easier to appoint unemployed MTs who passed from various public-private institutions under the health ministry to collect and test the samples, Molla told The Daily Star.

The health ministry has no such plans.

Additional Secretary (Administration) Habibur Rahman Khan said, "We have manpower crisis, challenges in collecting samples. That's why we are providing online training to health workers. But we need more medical technologists who can run the testing machines," he added.

WHY THE HOLD-UP

In November last year, an eight-member inter-ministerial committee was formed to resolve the appointment-related problems. It was headed by Rois Uddin, an additional secretary to the public administration ministry.

On December 2, the committee in its report asked the Technical Education Board to stop new admission to MT courses and make an amendment to their laws.

The committee said "Bangladesh Allied Health Education Board" will be formed after amending the Technical Education Board's law and all health educational institutions would be brought under the board to implement its "One Umbrella" concept.

On February 10 this year, the Technical Education Board suspended enrolment by issuing a notice, and Morad Hossain Mollah, chairman of the board, sent a letter to the education ministry to amend the laws, but the gazette in this regard is yet to be published.

"A feud between the ministries [of education and health] started after the Technical Education Board started teaching medical technology courses at different educational institutions back in 2005," mentioned the committee in the report.

The course has been taught by the State Medical Faculty of Bangladesh under the health ministry since 1983.

To resolve the conflict, another inter-ministerial meeting was held in 2007 and it was decided that all health education-related courses will be conducted by the health ministry under the "One Umbrella" concept.

"In that meeting, delegations from the education ministry, Technical Education Board, health ministry and health education department decided that students enrolled in the course under the board, who will fulfil the criteria of state medical faculty admission will be brought under the umbrella." said the report.

"But the health directorate issued a recruitment notification in 2013, setting a three-year-long diploma course under the state medical faculty. Aggrieved by this notification, some students who passed the course under the technical education board filed a writ petition," said the report.

The report also said the High Court issued a rule in 2016 directing the health ministry to coordinate with the Technical Education Board and ordered swift implementation of the umbrella concept.

But that too seemed to be stuck in limbo as some students under the state medical faculty filed a leave-to-appeal petition with the HC the same year.

The HC again asked the authorities concerned to implement its previous rules, which never happened.

Asked, Additional Secretary (Admin) to the Ministry of Health and Family Welfare Habibur Rahman Khan said they have to follow up on this.

"Emergency appointments are not a decision of the health ministry alone, it needs recommendation from the public administration, finance ministry and the intervention of the prime minister," he told The Daily Star recently.

When mentioned about the ongoing crisis, he said, "We can list medical technologists who are working in private hospitals. But we have to think about how they can be adjusted."