DMCH Outpatient Dept: An ordeal of unending queues

On the night of October 14, Sanjida Begum fell off the stairs of her Azimpur New Colony residence, and hurt her leg.

As her pain showed no signs of easing till the next morning, the 38-year-old’s family members decided to take her to the outpatient department of Dhaka Medical College Hospital around 11am.

Once there, a family member of hers stood in a line to get a token from the counter and be referred to the specific department.

All the queues for the counters moved at snail’s pace as the room, filled to the brim with patients and attendants, became suffocating in the heat and humidity. Ceiling fans overhead could not keep up to the number of patients.

About 40 minutes later, the family got a ticket and was told to go to the orthopaedic section, where another long queue awaited them. An hour went by waiting, before Sanjida was referred to a doctor.

The family had to stand in a queue once again as Sanjida’s pain escalated. After one more hour, a receptionist sent her to the doctor’s room.

The doctor told her to get an X-ray done on her leg and prescribed some medicine.

Sanjida and her family went to the outdoor’s pathology department for the X-ray.

There at the pathology department, unsurprisingly, was another long line of people waiting to be tended. By the time Sanjida limped to the counter, it was almost 2pm.

“We are closed,” said the person behind the counter nonchalantly.

“He told me to come back the next day,” Sanjida told this newspaper at the outdoor recently. “We requested him many times but to no avail.”

The family went back home tired.

The next day (October 16), they came back around noon. “This time, we went straight for the X-ray,” said Sanjida’s daughter, who accompanied her.

But there was a long queue there  that day too, with over a hundred patients and their attendees.

Meantime, a person walked up to them and said if they paid him Tk 200 they would not have to wait in line. Sanjida was in too much pain and paid him the money.

He quickly took her to the X-ray room, helped her get the X-ray done and gave her the report -- all in less than 30 minutes.

After looking at her report, the doctor said she had a fracture and needed to plaster her leg.

It was done in a separate room, which meant another long queue, more chaos and above all, more waiting. Sanjida sighed and waited for another hour.

“When my turn came, it was around 2pm, and the staffers said they would not be able to plaster my leg,” she said. “I left the place frustrated, and did not want to come back the next day [October 17].”

But the day after, the pain in her leg escalated and she went to DMCH once again, to get her leg plastered. And once again they had to go wait in line amid staffers screaming that many, including her, did not have all reports or necessary documents.

Amid the commotion, a man approached her and said he could manage everything for Tk 300. Sanjida paid him the money.

“He took me to a room right away. Surprisingly, he did not have to buy or get anything the staffers were telling everyone to get,” she said. “Finally, they put my leg in a plaster cast,” she added. “I have to come back after two weeks for check-up. Who knows what’s in store for me?”

A RECURRING SCENE

Sanjida is not the only one who had such bitter experience at the outpatient services. During visits to the department in the last two weeks, many patients shared their ordeals with this newspaper.

They spoke of mismanagement, long queues, crammed and humid rooms, and insufficient seating arrangements. Many also alleged of mishebaviour by staffers, and how patients are held captive in the hands of “brokers or middlemen”.

One of them is Mohammad Dulal, 50. The Bogura resident came to the outdoor on October 18 around 9:30am with pain in his head and left arm. These correspondents saw him in a line to see a doctor in the afternoon.

“So far, I had to stand in three lines. Now I’m waiting to see a doctor. Who knows how many more queues I have to take?” said Dulal as he perspired profusely. “It’s very humid. People will get sick just standing here.”

In a separate queue not far from Dulal, was Tumpa Begum. The Nimtoli resident with a child in her arms was waiting for medicine. “I came here around 10am. My husband could not get the day off, so I had to bring along my six-month-old,” she told this newspaper around 1pm, as the baby in her arms kept crying in discomfort.

Wishing anonymity, a medical officer said the number of doctors and staffers are severely inadequate to handle the rush of patients. “It gets stuffy and humid here due to the huge number of people. We have to step outside from time to time just to catch a breath of air.”

The DMCH outdoor service, located beside Central Shaheed Minar on Dhaka University campus on the first and second floors of a three-storey building, has been at the same place since the 1960s. The number of patients has increased sharply in the last 20 years, but the outdoor department has seen no expansion.

INITIATIVES

Contacted, Brig Gen AKM Nasir Uddin, director of DMCH, was at first surprised to hear about Sanjida’s experience.

After he was told about other allegations and complaints, he said, “We do have some crisis and some people exploit the situation. We are trying to take care of those. Whenever someone complains of mismanagement or misconduct, we take steps right away.”

Regarding middlemen taking money from patients for quicker service, the director said, “Whenever we hear anything of that sort, we catch that person and hand him over to police. The outdoor is a busy place; that’s why they take advantage of that.”

“The outdoor sees around 4,000 patients every day who visit with their family members; it’s hard to handle such a large number of people with the current manpower and infrastructure,” the director added.

The hospital is planning to upgrade services, he said.

“To start with, we need more space. We are planning to expand the outdoor. There is an open space behind the Shaheed Minar between the Nursing College and the medicine store. We’re thinking of constructing a shed there, to shift the ticket counters,” the director said. “We will shift some departments there as well to ease the pressure.”

He said they also need to increase the number of doctors, nurses and staffers. “We will send a proposal to the health ministry in this regard soon,” the director said.