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ICU in Public Hospitals

Just 12 beds for entire Ctg region

ARUN BIKASH Dey, Chattogram
Twenty-two-year-old Abu Taleb underwent an operation in a private hospital in the port city two days after being injured in a road accident at Chakaria upazila in Cox's Bazar on September 3. Due to post operative complications, Taleb required intensive care support. The hospital, however, lacked this facility.
Taleb's family wanted to shift him to the Intensive Care Unit (ICU) of Chittagong Medical College Hospital (CMCH). As the hospital had all 12 of their ICU beds occupied, Taleb, a tea-seller at Chiringa in Chakaria, was shifted to the ICU of another private hospital.
Taleb's brother Muslem Uddin said their family had to pay Tk 1.76 lakh to the hospital.
“We had to sell a cow and two decimals of land to pay the hospital charge, “ Muslem said while speaking to The Daily Star.
After a week, Taleb was lucky enough to get a bed in the ICU of CMCH and was shifted there.
“In CMCH, our daily expense was around Tk 1,000 per day for medicines. There were no other charges to be paid, “ said Muslem.
Patients from Noakhali, Feni, Rangamati, Khagrachhari, Bandarban, Cox’s Bazar, and Chattogram come to CMCH for ICU services as it is the only government hospital in the region that provides the service.
But not everyone is as lucky as Taleb to get a bed in the ICU of the hospital, due to its limited number of beds.
CMCH introduced ICU services in 2005 with six beds. The number of beds was increased to nine in 2011 and then to 12 in 2016, sources said. However, the logistical support was not increased as per the requirement, they added.
Some 10 private hospitals in the city have their own ICUs with the number of beds ranging from between five to
Experts said around 2,500 patients in the region need intensive care support every year, but the number of ICU beds in the hospitals is inadequate compared to the number of patients. Moreover, patients from the middle and lower income groups cannot afford private hospital ICU services which cost Tk 15,000 to Tk 20,000 per day, sources said.
"The main obstacle in increasing the number of ICU beds in hospitals is the lack of trained manpower and the high cost of equipment and medicines," said Maswood Ahmed, former professor (2011-2017) of Anaesthesiology and ICU ofCMCH.
Ideally, one trained nurse is required for each ICU bed and one trained doctor is required for every two, he added.
Since ICUs of private hospitals are unaffordable for many patients, CMCH should increase the number of beds in its ICU, he said, adding that there should be at least 50 beds in ICUs of government hospitals.
About the shortage of manpower and equipment in the 12-bed ICU of CMCH, associate professor of
Anaesthesiology and ICU of CMCH Pranoy Kumar Dutta, said, "We have no spare ventilators. All 12 of them are under constant use and often go out of order and sometimes, when a ventilator malfunctions, services in four to five beds remain halted for days."
He added that at least two spare ventilators are needed in the unit.
"Air cooler is a vital equipment for this unit. Our one has a capacity of 25 tonnes, against the requirement of 30," he said.
Pranoy also said the unit does not have a post for consultants and only two anaesthesiologists are currently posted there. “We need at least six consultants," he added.
"One assistant professor is posted but we need four more," Pranoy said, adding, that, along with their 32 nurses, the hospital was in need of eight more.
CMCH director Brig Gen Mohsen Uddin Ahmed, when contacted, said expansion of the ICU was under their consideration but it would take time.
"It is not possible to expand the ICU as we have a shortage of manpower and the present building cannot accommodate an expansion," he said.
He added that a new hospital building was under construction and that they would initiate expansion of the ICU provided that they get adequate assistance from the government.