Little care for the living and the dead

The Daily Star May 11, 2020

Deluged with suspected Covid-19 patients, hospitals struggle to ensure emergency treatment; dead too are often left in neglect

Time is of the utmost essence in emergency care. But in this pandemic, as hospitals take on the challenge of a rising number of patients, emergency care is denied to many, resulting in fatal consequences.

Abrar Hossain’s mother needed emergency assistance when she was brought to Dhaka Medical College Hospital’s newly inaugurated coronavirus unit at 10:35am yesterday.

Abrar, who is a subeditor at this newspaper, narrated the incident to this correspondent.

“Two weeks ago, my mother started feeling feverish. All of us had flu-like symptoms but recovered fast, so we didn’t worry too much. In fact, in the last few days, her fever was coming down. This morning she woke up, gave directions to the domestic help to cook for the day… and then all of a sudden, she started having breathing problems. She was sitting in a chair, experiencing laboured breathing and within 10-15 minutes she stopped breathing completely,” described Abrar.

He called an ambulance immediately to their home on Tajmahal Road, but the vehicle took a further 40 minutes to arrive.

“At 10:35 am, we entered the DMCH emergency and I was looking for a doctor or a nurse to attend to her, but a nurse told me to stand in line and take a token.

“I went to the admission counter, bought a token and came back. Then the nurse told me to go inside a room and talk to the receptionist. There were four booths and all had long lines. I started screaming and shouting, saying this is an emergency, cut to the front of the line. They listened to my complaint and told me to take her up to the fourth floor to the isolation ward,” Abrar narrated.

“I pushed her to the fourth floor where a nurse put an oxygen mask on her, but it wasn’t working because she was not able to breathe properly on her own. Then, the nurse checked her file and said that I did not have a prescription for an echocardiogram, without which they cannot give any medication. The nurse then told me that there were no doctors around who could give such a prescription.”

He added that there were doctors on the far side of the floor, but the nurse attending his mother said they could not give a prescription.

By the time Abrar managed to get an ECG prescription, two hours had passed. At most private hospitals, an ECG is one of the first and immediate procedures done when a patient is brought into the emergency.

“All this time they did not try to resuscitate her or give her CPR. They gave her oxygen but she was not moving, or able to take the oxygen on her own,” he said. When asked, he agreed that his mother probably needed intubation.

When she was taken into the ECG, the report said that she passed away. “I think she passed away before that, while on the bed,” said Abrar.

The DMCH director could not be reached over phone despite several attempts, but a senior doctor said that there were no ICU beds available yesterday for patients like Abrar’s mother.

“These patients arrive to the hospital in a critical stage. Unless there is a bed empty, I cannot give any useful treatment other than oxygen,” he said.

A similarly futile search for emergency care took place before Habiba Memi’s maternal uncle died.

He had been suffering from a fever for five days prior to his death.

Habiba’s uncle was taken to Mugda Medical College and Hospital on May 8 with laboured breathing. “My aunt and her son were with him. They were told that the machine was out of service and they cannot test.

“They then went to two private hospitals but were turned away because he had breathing difficulties and flu-like symptoms. They finally took him to DMCH but he passed away while being transported from the CNG to the stretcher. The whole search for emergency care took over three hours,” she said. Three valuable hours that could have been crucial in saving his life.

The Principal of Mugda Medical College Dr Golam Shah Tuhin explained that the machine is not out of order but has been going through periodic disinfection for the last few days.

“We are still testing by sending samples to other laboratories, but we are giving out 200 tickets per day. I have over 500 patients showing up to get tested, what am I supposed to do? My entire hospital is filled to the brim with patients and there are no empty seats left,” he said.

On May 9, Gautum Aich Sarkar, the additional secretary of the Ministry of Food died after being denied emergency care at eight hospitals because he had a fever, media reports state.

Sarkar was receiving dialysis from a private hospital when he started showing signs of respiratory distress and his family was asked to move him.

Sarkar’s daughter Dr Sushmita Aich was contacted by this correspondent, but she requested privacy following her father’s demise.

EVEN AFTER DEATH, MISMANAGEMENT

As overstretched hospitals reel from trying to provide care to the large volume of patients, the dead are sometimes being left for the last, patient accounts suggest.

Snigdha Surovi’s father died in Kurmitola General Hospital in the early hours of April 20.

“He was in the Intensive Care Unit (ICU). Around 3:30am, he started having intense chest pain and laboured breathing. My mother was with him inside the ICU, and tried to get a nurse or a doctor but nobody was around, and he expired. A whole hour after his death, a ward boy came to see why my mother was crying so loudly and told my mother to leave the ICU since my father is already dead,” explained Surovi.

Her mother spent the rest of the night waiting outside, and she was finally allowed back into the ICU at 10:00am in the morning, Surovi stated.

“My father had died while sitting up, on his bed, propped against pillows. When my mother went inside, several hours after his death, he was still in the same position. Nobody even bothered to pull a sheet over his face, or lay him down on the bed. This was horrifying,” narrated Surovi.

“The ward staff then asked my mother to help him lay my father down on the bed. There was another patient, who had died at 2:00am, a few hours before my father died, and he was also left in the same position as my father for the duration of the entire night. The staff member asked my mother to help him fix up that patient too, but my mother was afraid of the dead body and declined to do it,” said Surovi.

During the early hours of April 26, Uttam Kumar Nandi passed away at an unknown time at the same hospital. He was alone at the hospital, without any attendants, since he tested positive for Covid-19.

None of his family members however were informed of his death. “There are no phone numbers you can call. We used to ask about him by calling his phone, but when his situation worsened on April 25, he was unreachable,” said his nephew Uzzal Nandi.

At 10:00am on April 26, they finally got through with the help of someone who had a personal connection with a doctor only to learn that Uttam Kumar Nandi was dead. “We were told that something bad has happened and we have to come to the hospital immediately. When we arrived at the hospital around noon, they had already cremated his body,” said Uzzal. “None of us got to see him for a last time, we have no idea what his final hours were like.”

The director and deputy director of KGH were called several times yesterday, but could not be reached for comments.

At DMCH, Abrar and Memi suffered a similar ordeal.

“When my mother died at 12:30 pm we wanted to leave immediately, but then they said that I needed to wait for paperwork,” said Abrar. It took a further six hours and going from desk to desk to get her body released.

Memi’s uncle died at 11:30 am — she could not get the body released before 5:00pm. “The body was on a stretcher on the floor of the ward the entire time. There was not a single doctor present who could process the paperwork. Around 4:00pm a ward boy came over with a paper and said, we can take the body away.”

Shaheen Mollah contributed to this report

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