27 July 2024: The untold stories of doctors in Dhaka

On 5 August, around noon, a father arrived at the National Institute of Neurosciences and Hospital in Dhaka carrying his injured son in a van. He was also carrying a piece of the boy's brain.

"His skull had been blown away. The father said, 'Sir, can you try putting this back? Maybe he'll survive.' The boy was already gone, a spot death," said Dr Md Mahfuzur Rahman, Associate Professor of Neurosurgery. He said doctors administered saline to the patient as a measure of comfort for the family.

Dr Rahman was among the doctors who treated people injured during the July Uprising. Hospitals across Dhaka received large numbers of patients during the period. According to doctors, the highest numbers arrived on 19 July and again between 3 and 5 August. They said many patients sustained gunshot wounds to the head, eyes, chest, neck and spine. Some required surgical treatment and now live with long-term physical complications and psychological trauma.

"We saw our country's youngest generation aged 18 to 25, arriving with bullet wounds. Some without skulls. Four of our patients were 'broad death' — the entire skull was gone," Dr Rahman said.

At the National Institute of Neurosciences and Hospital, 755 injured people were treated, of whom 155 were admitted. Thirty-two died, according to Dr Rahman.

Dr Rahman also worked shifts at Aurora Specialised Hospital in Dhaka. He recalled that on one night, between 15 and 20 gunshot victims arrived at the hospital in a short period.

"One had a dangling leg, another had a bullet in the spine. Blood was everywhere. Only two or three doctors were on duty. It was horrific," he said.

Dr Rahman said doctors subsequently faced pressure over the admission and documentation of patients.

"The government's pressure began. DB police came to stop us from admitting patients. Hospital management told me to refuse them. I said, 'If you're sick, should we not treat you? We are doctors.' So I started changing their records. I wrote 'Road Traffic Accident' instead of bullet injury."

According to Dr Rahman, the changes were made to patient records because of pressure not to document some injuries as gunshot wounds.

From pellets to live ammunition

Dhaka Medical College Hospital was among the largest recipients of injured people during the movement's most intense periods. Dr Shahidul Islam Akon, Professor of the Spine Surgery Department, said he observed a change in the nature of injuries over the course of the unrest. In the early days, most patients arrived with pellet or shotgun wounds. After 19 July, he said, the hospital began receiving more patients with injuries caused by live ammunition.

Routine surgeries across most of DMCH's operation theatres were suspended, with the theatres instead used to treat people injured during the protests. When the hospital canteen shut down during the curfew, Dr Akon said he arranged food for doctors and nurses so that staff could continue working in the wards.

Dr Akon said police also collected patient information and fingerprints from registration books and photocopied national ID cards. He said reports of this led some injured people to avoid hospitals, returning home after receiving only initial treatment rather than risk having their information recorded. According to him, some families of people who died also declined postmortems because of concerns about police scrutiny.

On 23 July, senior government officials instructed doctors at Dhaka Medical not to show "too much interest" in protest-related injuries, Dr Akon said. Two days later, he was transferred to a biochemistry post at Sunamganj Medical College, despite his training as a spine surgeon.

"It was punishment. Five of us were sent away," he said.

Dr Akon continued to assist injured people after the transfer. He said he and other doctors established a private fund to provide support outside the formal system. He returned to Dhaka Medical the day after the government fell.

"Following that declaration — particularly around 23 July — we came under significant pressure from the government and intelligence agencies. Private healthcare providers faced considerable pressure and harassment,"  Dr Mohammad Sayem, associate professor, Holy Family Red Crescent Medical College

Treating eye and head injuries

Professor Dr Khair Ahmed Chowdhury, Director of the National Institute of Ophthalmology and Hospital, had witnessed state violence against protesters before, having participated in the anti-Ershad movement as a student. He said the injuries treated during the 2024 protests differed significantly from those he had encountered during that period.

"In our student life, we also participated in anti-Ershad movements. Back then, we knew the police would shoot at the legs. But this time, they shot in the eyes, in the head. Never before have we seen so many young people with gunshot wounds to the eyes and head at once. The experience was horrific. Our operation theatres were active 24 hours."

"Our female doctors stayed in the hospital and continued treating patients. Surgeries were carried out in 10 theatres. We could never have imagined such a scenario. Most of the injured were between 15 and under 25 years old."

Private hospitals under pressure

Dr Mohammad Sayem, an associate professor at Holy Family Red Crescent Medical College, was stationed at AMZ Hospital in North Badda. He said he was present at the hospital for 24 hours a day for five days beginning on 18 July, and again from 3 to 5 August.

"I was present at the hospital for 24 hours for five days beginning on 18 July and then again from 3 to 5 August. We certainly endured some harrowing experiences during that period. Then, on 23 July, my consultation chamber was deliberately targeted and fired upon. I was sitting with my feet resting on the desk when a bullet grazed my leg, tearing the skin."

The hospital announced at 2pm on 18 July that it would provide treatment to all patients free of charge. Dr Sayem said the decision was followed by pressure from the government and intelligence agencies.

"Following that declaration — particularly around 23 July — we came under significant pressure from the government and intelligence agencies. Private healthcare providers faced considerable pressure and harassment."

Despite the pressure, he said the hospital continued providing free treatment.

"One of my colleagues, Dr Asad, performed around 100 surgeries entirely free of charge during that crisis. We had conducted over 1,000 free CT scans for the injured."

Dr Sayem said the lack of formal recognition for the medical response had also affected his willingness to discuss the events.

"In truth, our efforts have simply not been formally recognised. That is why I no longer wish to speak about it. Frankly, the lack of acknowledgement has left me thoroughly fed up with the entire situation."

He also recalled public support for doctors during the protests.

"On the afternoon of 5 August, right here in Middle Badda, crowds marched outside our hospital chanting, 'Long live the doctors!'"

Doctors outside the hospitals

Trainee doctors and medical researchers were also involved in treating people injured during the protests. Among them was Dr Salman Abdullah, a public health physician and researcher who was then serving as a WHO Tropical & Infectious Disease Research Fellow at the BRAC James P Grant School of Public Health.

"On 18 July, I had my MPH class this morning. It was a class on implementation research. As the university had been closed down, the classes were being held online. At that time, I saw on Facebook that the police and the Chhatra League were carrying out a joint attack on BRAC University. The police had breached the premises and were firing tear gas, whilst the League members were cracking people's heads open with sticks."

"Because my friend had given my number to their students, they contacted me, as they were in desperate need of doctors. Both Gate 1 and Gate 2 were shut. The Jubo League was standing guard at Gate 2, smashing the head of anyone who attempted to go through. The situation was exceedingly grim."

"Ultimately, after quite a daring and risky undertaking, we set off towards BRAC. Pushing past numerous obstacles, we managed to get inside through an alternative gate. Even then, the police and the League were still brutally beating anyone they could get their hands on. After that, we provided medical treatment to all the emergency patients there until 5pm."

In the following days, Dr Abdullah said he set up a small temporary pharmacy in Motijheel, where he treated protesters during the curfew when access to the area was possible.