How the country’s biggest hospital feeds its patients free of cost
With 30 chefs, two stewards, and a dietitian, Dhaka Medical College and Hospital (DMCH) cooks for 5,000 patients on an average day
On a cloudy June morning, I was at the forefront of the DMCH kitchen's ancient circular corridor. It was empty and with an olive-uniformed guard sitting on a chair at the front. Suddenly a gigantic iron trolley - full of hundreds of pumpkins - was approaching behind me. I hurriedly moved to the corner and the guard gave me a wicked smile as if he was saying - "welcome to the hell".
As you enter the 1,200 square feet-ish kitchen, you would admit that this is nothing less than hell. Even on a cold rainy day, the inside was boiling hot. Md Bilal, one of the stewards said, "Madam, 22 stoves are burning. Today, we are cooking for 2,000 patients. Do you know how hot it is when 300KG cooked rice is separated from its 'mar' (rice starch)?" - I did not know.
Bilal said that it was comparatively an average day as this kitchen had the experience to cook for 5,000 patients.
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Looking all around the kitchen - the pale yellow patches on the mosaic floor, thick layers of carbon-black smoke on the chimneys and windows, sticky countertops and cranky vintage doors - I wondered how it used to look 70 years back when this hospital was built in 1947 and when it had only 800 beds altogether.
And just like that, I was ready to know how DMCH, the country's biggest hospital feeds its patients - with 30 chefs, two stewards, and a dietitian who plan and cook for patients every day.
From Dinajpur to Barishal - the food comes from around the country
It starts with a diet chart. DMCH Nutritionist and Dietitian, Nazneen Ahmed deciphered, "Different patients need different diets. So the meals are prepared depending on the number of patients and their physical condition."
Generally, the DMCH kitchen follows four menus - for the general patients, ICU patients, diabetic patients, and newcomers who are still not included in the diet list. During the pandemic, as the hospital has a corona unit, they have a diet plan for the Covid-patients as well.
The food components here are distributed in eight groups - grains (rice and pulse), confectionery (milk, biscuits, and sweets), fish, meat, bread, eggs, vegetables, and banana.
The supply chain is based on contracts. Contractors and suppliers from around the country can participate in tenders and if accepted, they supply that particular group of food components for the next one year.
For the last four years, Tota Mia has been supplying rice and pulse to DMCH and this year, he got the contract for milk, biscuits, and fish as well. He said, "Before the pandemic, I supplied more than 1,600KG of rice per day. But now it has decreased to half."
The rice comes from Dinajpur, Rangpur, Barishal, among other places. Generally, the grains are collected in bulk from rice mills, kept in storage, and supplied to the kitchen according to their need.
Now dry grains can be stocked but what about perishable components like fish, meat, milk, bread, banana, and eggs?
"These items are supplied on a daily basis," informed Md Mohsin, the supplier for chicken and eggs. Mohsin collects the chicken and eggs from farms every day. According to the number of patients, the chickens are then cut, processed, and sent to the hospital.
Mohsin also sighed at the fact that the business is standing on a downslope. "Prior to the pandemic, I supplied 7,000 eggs per day. But now although the Covid patients are given three eggs per day, last week I supplied 2,000 eggs per day," he said.
How is it all done?
"It has been 17 years since I entered this kitchen and till now, I have not celebrated Eid with my family. From 2004 till today, I worked every day, cooking for the patients coming from all around the country," said Mohammad Deen Islam, one of the chefs of DMCH Hospital, who was sharing his experience with us.
Like Deen Islam, Mia Humayun, and Md Rafiqul Islam, there are 30 chefs working here in this kitchen. And like Deen Islam said, without any weekly leaves, they get 20 days annual holiday, most of which are unused.
All 30 chefs are divided into two equal batches per shift. The morning shift works on breakfast and lunch and the evening shift prepares afternoon snacks and dinner.
So the epic meal preparation begins at 5 am. With prayer caps on, the chefs and helpers enter the kitchen and start the day by putting on red and green cotton fotua (traditional uniform for DMC chefs).
Before the first batch of bread for breakfast arrives, the chefs and helpers start preparing for lunch - cutting 350kg to 500kg of vegetables and up to 500kg of fish.
From 7 am within half an hour, the breakfast is organised on trolley and taken to the general wards, cabins, and ICU sections. Just after that, they all giddy-up for lunch preparation. The morning shift ends around 3 pm, with cleaning up the kitchen right after lunch is served.
And after that, all 22 stoves are fired again where a new batch of chefs will start preparing dinner. Around 9 pm the kitchen and pantry are finally closed until the next day.
"The food is for the patients, not for the relatives"
Salma Nasreen (pseudonym) has been living in the general ward for the last one month with her 9 years old daughter Lamia. Lamia has a large tumour on her right leg and doctors are saying that she probably needs surgery. Salma and Lamia came all the way from Madaripur as Lamia did not get good treatment there.
It was around 1 pm when I met Salma as the lunch was being served by the ward boys. Lamia said that she likes breakfast with milk, bread, egg, and banana. But she doesn't feel like eating rice and all other things.
Slama said, "But I still try to feed her. I personally like fish and meat. But the dal and vegetables are bland."
For a free seat and free food for one month, this is more than a fortune for her family.
When I approached Brig. Gen. Md. Nazmul Haque, the director of the medical college hospital, he said, "This food is for the patients, who are sick and are not supposed to digest all the spices and oil that make foods 'tasty'. If you take reviews from healthy relatives, that would be wrong."
Nazneen Ahmed, the dietitian also said, "Here we have patients who have had throat operations, who have serious gastritis and other grave illnesses. They are not supposed to have spicy food. And it's not possible for us to prepare different meals for every patient."
Later, as I was speaking to Md Nazmul Haque about the quality of food he went into a sarcastic mood for a second. He said, "Have you seen our toilet lanes? People would even lie down there. Madam, we have 2,600 seats in this hospital but except for the pandemic situation, we have had 5,000 patients and we fed all of them. For a daily budget of Tk125 per general patient and Tk300 for the Covid patients, how do you ensure taste on top of all that?"
This year, the hospital got a budget of Tk20 crore and according to Md Nazmul Haque, it is not enough.
He said, "Every year, audit officers complain that we feed more people than we are supposed to. But this is the last hope for the underprivileged people. Not everyone can afford a bed in CMH or even in BSMMU hospital."
For Aslam Mia (pseudonym), a thoracic ward patient, DMCH was the place where he got a free bed to stay with free food, and doctors and interns visit him twice a day. To him, sometimes, the ward boys and cleaning 'khalas' (female cleaners) are a bit rude, but "if they did not take me, where would I have gone?"
