Patients suffer as essential medical equipment remain out of order at CMCH

Four heavy healthcare equipment, including the mammography and MRI machines, at the Chattogram Medical College Hospital (CMCH) have been out of order for a long time, compelling patients to opt for expensive services in private clinics and diagnostic centres.

In addition, one of the two catheterisation laboratories, or cath labs, at CMCH's cardiology department has been shut for two years, depriving patients of services like pacemaker insertion and angiogram.    

Outside Dhaka, CMCH is the only government hospital with a brachytherapy machine, which is used for treating uterine cancer in women. The machine has been dysfunctional since June last year.  

The mammography machine, used for diagnosing breast tumor-cancer in women, has also not been functioning for a year, forcing insolvent patients to bear the cost of around Tk2,000-3,000 to undergo the diagnosis at private hospitals, much higher than Tk800 at government hospitals. 

Sources said the authorities of Chattogram Medical College Hospital (CMCH) wrote to the Directorate General of Health Services (DGHS), Health and Family Welfare Ministry, Central Medical Store Depot (CMSD) and equipment suppliers many times asking that the machines to be repaired. But the applications have yielded no results so far. 

Moreover, medical equipment suppliers of the hospital are not acting as per contract compliance, and there are outstanding bills, hindering repairs of the equipment.

CMCH Director Brig Gen Md Shamim Ahsan told The Business Standard, "We are repeatedly writing to the concerned to repair MRI, cath lab, brachytherapy and the mammography machine. We have to rely on suppliers for repairs".

According to CMCH sources, the brachytherapy machine imported from Germany was installed at the hospital at a cost of around Tk6 crore in 2019. Later, engineers from the supplier recommended replacement of some spare parts of the machine after it went out of order on 6 June last year. The machine is not being repaired due to an unpaid bill for a package of the CMSD. 

A majority of the 5,000-7,000 new patients at the CMCH outdoor each year have to undergo brachytherapy. Currently, a session of radiation therapy costs Tk5,000 in private hospitals in the capital, up from Tk1,500 at government hospitals.

The mammography machine broke down four times since its installation at CMCH in August 2018 to 2022. New Tech GT Ltd, supplier of the machine, did not take any initiative to repair it, despite repeated appeals from the hospital.

Kamal Hossain, manager of the supplier company, told TBS that the warranty period of the machine had expired. "However, at the request of the hospital authorities, it will be repaired by the end of this month".

CMCH installed an MRI machine at a cost of Tk9.84 crore in August 2017, which broke down in late 2020 following the expiry of a three-year warranty period. The machine was then repaired by the supplier company, Meditel Private Ltd, at a cost of Tk9 lakh. In May last year, the imaging machine became completely ineffective following dysfunctions several times.

As per CMC guidelines of the Ministry of Health, the maintenance cost is charged at the rate of 6.5% of the cost of the machine in the first year after delivery. Accordingly, the maintenance cost of the MRI machine is estimated at Tk63.96 lakh, but the supplier has demanded Tk93 lakh to fix it, said sources from the hospital.

An MRI scan costs Tk5,000-20,000 at private hospitals, up from Tk4,000 at government hospitals.

An official of CMCH said the durability of an MRI machine in government hospitals should be higher than in private hospitals, considering its use. The device lasts at least 10 years in private hospitals.

Besides, one of the two cath labs in CMCH's cardiology department has been shut for two years since December 2021, increasing the pressure of patients on the existing lab. According to the hospital authorities, repair of the lab will cost Tk1.83 crore. 

An average of 300 people take medical care every day at the 60-bed cardiology department of CMCH. Half of the patients have to undergo ring (stenting) and pacemaker implantation, and angiogram and angioplasty.

Currently, the existing lab provides block detection angiograms and pacemaker placement to around 15-20 patients, and ring insertion to 3-5 patients every day.

Given the situation, some patients have to wait two to three weeks for the cardiac services at CMCH, while many others rush to private hospitals for quick service.

Mahfuzur Rahman, convener of the Public Health Rights Protection Committee, told TBS, "Due to the failure of these hospital equipment, poor patients are being deprived of medical services. They cannot afford to go to private hospitals."

Necessary steps are being taken to quickly solve these problems, said CMCH Director Brig Gen Md Shamim Ahsan.