Around two hundred private hospitals and diagnostic centres have mushroomed in the Charpara area of Mymensingh city, but only eight hospitals and 17 diagnostic centres have legal papers, according to the Mymensingh Civil Surgeon's office. The others are running without a license, thereby posing a threat to public health. They do not have environmental clearance certificates from the Department of the Environment in the district either. Even the secretary of the Private Clinic Owners'Association of Mymensingh is running his clinic on an expired license. Charpara has become a medical hub because the area is adjacent to Mymensingh Medical College and Hospital.
Dr ABM Moshiul Alam, civil surgeon of the district, said, "I do not know exactly how many private hospitals and diagnostic centres there are in the city right now because I joined the office only recently. However, there may be more than 150 of them. A committee has been formed to find out the exact number."
Shibbir Ahmed Liton, coordinator of the Bangladesh Human Rights Commission's Mymensing wing, said, "Many new private hospitals are being set up in the city, and most of them do not have a license. There may be around 200 of them. People are being cheated by such illegal clinics and diagnostic centres. In the name of providing private healthcare facilities, these organisations are doing businesses only. Despite knowing the facts, the local administration is not doing anything about it."
Dr Towfiq Hassan, medical officer at the Civil Surgeon's Office, said, "We do not find a hygienic environment when we go to inspect a private hospital. The condition of the operating theatres in most of the hospitals is very poor, and the surgical tools are rusty. In such cases we take action through mobile courts."
The owners of the private clinics refused to talk to our correspondent on this issue. However, Dr Hossain Ahmed, secretary of the Private Clinic Owners' Association, did talk to The Business Standard on their behalf. He said, "The hospitals that do not follow the rules, do not run with valid licenses or do not renew their licenses should be sealed off."
When asked why his own clinic, Bashundhra Hospital and Diagnostic Complex, is running without a valid license and without an environmental clearance certificate, the doctor, after an embarrassed silence, said he could not renew the license due to some problems. "I will renew it very soon," he said.
Nazmul Haque, a resident of Gafargaon upazila of the district, had a blood test done at a private diagnostic centre in Charpara. He was diagnosed with Hepatitis B through the blood test, and was given treatment on the basis of that report. However, he fell ill again after a few days. He then had the blood test done in two different labs, and both the reports said that he had tested negative for Hepatitis B. Nazmul said, "I complained to to Kotwali Police Station in the city about this."
There have been numerous allegations of misdiagnosis at these diagnostic centres. During a recent visit to the Redium Diagnostic Centre in Charpara, this correspondent found a price list for pathology tests, where it was written that 'Chikungunya test – Tk1,200'. He asked the Lab Technician Mohammad Akash what disease was diagnosed with this Chikungunya test. Akash replied that the test was for the diagnosis of Black Fever (Kalajor). He actually had no idea what the test was for, but he is working in the lab. Though he does not have any educational certificate, he works there for Tk5,000 per month.
No rules followed in storing pathology reagents
A reagent is a substance that is used for chemical analysis of samples at a laboratory, and are essential for doing pathology tests. There are particular rules for storing them, such as at specific temperatures and humidity. But the private diagnostic centres do not keep the reagents under the specified conditions.
Executive Magistrate Mohammad Aktaruzzaman, who conducts the Rapid Action Battalion's mobile courts, said, "During our drives at diagnostic centres, we have found that reagents are kept in domestic refrigerators in an unhygienic environment. Sometimes, the diagnostic centres even use expired reagents. They do not follow any rules for storing the reagents."
Dr Sadequl Islam Talukder, head of the Pathology Department at Mymensingh Medical College, said, "A reagent is one of the most important things for doing a pathology test. If a reagent is not stored at the proper temperature, the result of a test will be wrong. A physician prescribes treatment for a patient on the basis of a pathology report. So, if the report is wrong, the patient will receive wrong treatment."
When asked about the low quality and unregulated private healthcare services in the city, Dr Mohammad Abul Kashem, director of the district's health department, said they were aware of the issues. "We are monitoring the situation. We hope it will improve soon," said the director.
Civil Surgeon Moshiul also said they were monitoring the private hospitals. "Whenever any clinic breaks rules, we seal that clinic," he said. But he could not show any record of sealing a private clinic over irregularities.
Farid Ahmed, director of the Department of the Environment in Mymensingh, said the private hospitals did not maintain a hygienic environment. "The owners do not want to follow rules. So, though they apply for environmental clearance certificates, we cannot give it to them after we inspect the clinics," he said.