Jahangir Alam, 65, suffered a brain stroke on Friday and was admitted to the Neuro Medicine Ward of Chittagong Medical College Hospital.

Doctors advised his family to get a Magnetic Resonance Imaging (MRI) test.

However, the lone MRI machine at CMCH has been non-functional for two years, leaving the family in a dilemma about how to afford the expensive test elsewhere.

Many poor patients like Jahangir come to CMCH for treatment, only to find themselves unable to afford the costly MRI tests at private diagnostic centres, which range from Tk 9,000 to Tk 20,000.

Before the machine broke down on May 16, 2022, CMCH provided MRI services for Tk 3,000-5,000.

"I am retired and spent most of my savings on my daughters' marriages while another daughter is still studying. I am struggling to collect money for this expensive test," said Jahangir from his hospital bed.

Md Nasir, 32, a vegetable vendor from Fatikchhari upazila in Chattogram, faced a similar ordeal after suffering a spinal cord injury.

"If CMCH's MRI service was available, it would have benefitted us. Now, we had to do the test from outside spending much more than we can afford," said his wife, Mamtaz Akter.

"MRI is a modern diagnostic test that takes very clear images of internal organs to detect specific diseases or abnormalities," explained Pradip Kumar Kayasthagir, a professor at CMCH's Neuro Medicine Ward.

He said around 120 patients are admitted to his ward daily, and at least 10 percent need an MRI.

HOW THINGS UNFOLDED

The health ministry allocated a Tk 9.84 crore new MRI machine of the Japanese Hitachi brand to CMCH in 2017 after the old one failed in 2014, according to Dr. Rajib Palit, CMCH's deputy director. The machine was installed in the hospital's cardiology building.

After its inauguration on October 24, 2017, it couldn't be fully utilised due to a lack of films. Full service began in January 2018, but the machine faced a technical glitch in October 2020, halting service for seven months until May 2021.

The machine kept having glitches until it finally stopped working on May 16, 2022.

"There is no post of biomedical engineer at the hospital, so medical equipment are not being properly maintained," said Dr Subas Majumder, head of CMCH's radiology and imaging department.

CMCH PAYING FOR HIS OWN DECISION

Since the machine's warranty expired in August 2020, it will now take Tk 7 crore to repair it.

CMCH could have repaired it for Tk 1 crore with a maintenance contract with the supplier company, but the hospital only wanted to pay Tk 65 lakh, according to sources.

"I have informed the health ministry about our requirements, including the need for an MRI machine. We need Tk 7 crore to repair the existing one and Tk 17 crore to buy a new machine," said CMCH director Brig Gen. Shamim Ahsan.

Health Minister Dr Samanta Lal Sen in  a recent visit to CMCH said, "I feel bad knowing that the MRI machine in the hospital is out of order. Chattogram is the second largest city after Dhaka. I will do whatever is necessary to fix the problem."

EMPHASIS ON FINANCIAL AUTONOMY

At least 20 MRI tests were performed daily when the machine was operational between 2018 and 2020. With each test costing a minimum of Tk 3,000, CMCH could collect at least Tk 60,000 daily, amounting to Tk 5,18,40,000 over three years.

"We deposit all the money realised from patients' diagnostic tests to the government fund," said the CMCH director.

Dr Faisal Iqbal Chowdhury, general secretary of the Bangladesh Medical Association's Chattogram chapter, said government-run hospitals need financial autonomy to get urgent repairs done.

The current system requires hospital directors to request funds from the health ministry even for minor emergencies, leading to unnecessary delays in providing essential services, he added.