Bangladesh's healthcare system suffers from an acute shortage of anaesthesiologists even though their service is required in surgical and emergency care.

Health experts say low pay, lack of recognition compared to surgeons, and the government not recruiting enough anaesthesiologists are the reasons why many doctors do not specialise in the field.

According to the Bangladesh Society of Anaesthesiologists, Critical Care and Pain Physicians (BSACCPP), there are approximately 2,400 anaesthesiologists in the country.

The World Federation of Societies of Anaesthesiologists, a global alliance, says there must be five anaesthesiologists for every 1 lakh people. There are fewer than one in Bangladesh.

"The field has always been neglected in the country. Compared to surgeons and other specialist doctors, anaesthesiologists earn very little. But the job they do involves a great deal of risk," Prof Kawsar Sardar, secretary general of the BSACCPP, told The Daily Star yesterday, adding that anaesthesiologists were highly paid in the developed countries.

"Compared to surgeons and other specialist doctors, anaesthesiologists earn very little. But the job they do involves a great deal of risk."

— Prof Kawsar Sardar secretary general of the BSACCPP

Operation theatres at most of the hospitals in Dhaka lack proper equipment and management, but the ones outside the city do not maintain any standard at all, he added.

"For most surgeries, an anaesthesiologist is engaged at the very last moment, when the patient is already on the operating table," he said, adding that that's why fatalities related to anaesthesia use are not uncommon.

The standard protocol is a patient must go through pre-anaesthesia check-ups so that doctors can identify the risks, he said.

Experts also say that in many countries there is a tradition of creating professionals based on the demands and needs.

The government can introduce a quota to ensure that the number of medical students specialising in anaesthesiology and the other branches are proportional.

However, Prof ABM Khurshid Alam, director general of the Directorate General of Health Services, said such a step by the authorities may not be popular among the medical students who may wonder whether "they would be allowed to choose their career path."

He added that students factor in the social recognition, financial benefits, and social security when they decide what they want to study.

"It must be ensured that the anaesthesiologists get paid well," Alam, also a renowned surgeon, said.

According to BSACCPP, from assistant professor- to professor-level there are 213 posts for anaesthesiologists at the government facilities. At least 107 of the posts are currently vacant.

Anaesthesiologists say they face serious pay inequality at private hospitals and clinics.

At most of the private health facilities, an anaesthesiologist has to depend on a surgeon to earn money.

"But no one wants to be dependent. The way a surgeon is celebrated in society, an anaesthesiologist is not," said Prof Khalilur Rahman, honorary consultant at BIRDEM.