Hospitals are supposed to be a place where patients to be treated in a comfortable home atmosphere as it is done in many countries of the world, no matter rich or poor, but in Bangladesh patients get even sicker when they step into a hospital thanks to a filthy, unhealthy and chaotic environment.
Health experts said faulty designs of the buildings, mismanagement, shortage of manpower and space, poor waste management system, widespread corruption and irregularities, staff’s insincerity and lax monitoring and regulation by the authorities concerned are the major obstacles to ensuring a healthy and patient-friendly environment in the country’s almost all public and private hospitals.
Despite having many world-class and specialist physicians in the country, they said a substantial amount of foreign currency goes down the drain as many rich and middle-class people are going abroad every year for treatment for lack of their faith in the local healthcare system alongside the poor condition and services of the hospitals.
Contacted, President of Swadhinata Chikitsak Parishad Dr Iqbal Arsenal said the healthy atmosphere of a hospital mainly depends on its architectural design, management and service delivery.
“No attention is paid to the design of hospital buildings in Bangladesh to ensure technical and functional requirements. We don’t have hospital architects in our country. Our hospital buildings are designed like other ordinary offices, houses and institutions without any focus on ensuring a healthy atmosphere. So, not only the patients but also the visitors to hospitals feel very uncomfortable there,” he observed.
Dr Iqbal said a new building of Dhaka Medical College Hospital (DMCH) has been constructed recently which apparently looks like a warehouse. “What’s the point of constructing such a hospital building where patients don’t feel relieved?”
When it comes to hospitals, he said healing starts with the architect as the right design and environment can speed up recovery. “But those who design hospitals in our country don’t think about a patient-centric atmosphere from the medical point of view. A hospital needs to have a well-planned system of sanitation, ventilation and effective waste management to ensure a clean and healthy atmosphere, but our hospitals lack those.”
Besides, the noted doctor said the distribution of different departments and units should be done following a good-design and plan. “If you go to BSMMU, you’ll find the nephrology department in one block while the urology in another. Other services are also not well-ordered as per necessity, causing sufferings to patients.”
He said mismanagement and lack of adequate manpower are also major obstacles towards improving the quality of healthcare services.
“It’s a fact that we don’t have an adequate number of doctors and nurses and other health workers. But we also don’t get desired and responsible services from the hospital staff as they get jobs in exchange for money. How can you expect proper services from an unqualified staff who managed the job through bribes? A person who doesn’t clean his or her own house or the bathroom, how will he or she keep the hospital or its washrooms clean as a cleaner,” Iqbal observed.
“The government is allocating huge taxpayers’ money for the improvement of the health services, but different syndicates and unscrupulous people are indulging in massive plundering. They buy a curtain at over Tk 35 lakh. So, corruption and plundering should be stopped. We need to check mismanagement,” the expert said.
He said there are some private hospitals offering quality services and a healthy atmosphere. “These hospitals are well-designed by architects and run by efficient management.”
But, he said, many other private hospitals have been built whimsically without any good design and adequate spaces and suitable locations. “Many houses have been turned into clinics. We need to have an effective policy and set standards to establish hospitals. Many hospitals and even medical colleges don’t have service rules.”
Iqbal said the Prime Minister has recently asked the authorities concerned to modernise the Dhaka Medical College Hospital (DMCH). “The authorities should make its new design by an efficient architect.”
Prof Muzaherul Huq, a former adviser to WHO South-East Asia region, said hospital architectures are very important to build a patient-centric healthcare establishment.
“The designs of hospitals are different from other buildings. A calm and quiet location, adequate space and a good design are imperative for a hospital. Ventilation is very important alongside infection prevention control for any hospital,” he said.
Apart from faulty designs, Muzaher said most public hospitals, including the DMCH, are always forced to admit patients several times higher than their capacities. “That’s why the hospital authorities can’t ensure a healthy atmosphere and proper service there. Even many patients receive treatment staying on their floors and corridors.”
He said the country’s healthcare system needs a complete overhauling with poorer plans and steps to ensure a healthy and quality treatment both at the public and private hospitals.
Contacted, Health Secretary Md Abdul Mannan said they are taking various steps to improve the environment and services at the public hospitals.
“We’re also thinking about making important structures of the public hospitals following modern designs by expert architects in the days to come. It’s the demand of time. Now we’ll surely focus on well-planned architectural designs in constructing hospital buildings to turn those into patient-friendly ones.”
As per the Prime Minister's directive, Mannan said, they are also taking a project to modernise the DMCH. “If everything goes as per our plans, The DMCH will have the best and sophisticated structure in the subcontinent. Professional health architects will design the hospital to ensure a comfortable and healthy atmosphere there,” he added.