‘Free’ treatment is turning out not so free for uprising victims

Anyone familiar with Bangladesh's healthcare system is painfully aware of the fact that syndicates are all too common in public hospitals. Even after the July uprising, they are as active as ever and trying to swindle the victims of the movement.

For instance, on 27 October, a National Institute of Neuro Sciences and Hospital emergency wing doctor told an attendant, "You are supposed to pay only Tk2,000 for the CT scan, nothing more — even if you are asked." He would go on to repeat it at least twice more.  

Worse still, the interim government's "free treatment" for injured victims of the July uprising is not holistic against the backdrop of a chaotic process to enlist the number of martyrs and injured victims. 

TBS spoke to injured victims at the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR) and the National Institute of Ophthalmology and Hospital (NIOH), hospital authorities, the interim government's July Shaheed Smrity Foundation (more commonly known as the July Foundation) and others to gauge the brunt of public health care cost in the aftermath of the unprecedented massacre. 

No one left behind    

On 12 September, the interim government announced a Tk100 crore fund for injured victims. The July Foundation was to disburse this fund. 

On 29 October, Sarjis Alam, a coordinator and general secretary of the foundation, posted on Facebook that 245 victims of the July-August mass upsurge had received over Tk2.41 crore in financial assistance until then. 

"We have reached over 300 families of the injured [by now]," he said on 31 October at the foundation's Shahbagh office. 

The verification process, according to Sarjis, is a tall order. This is causing the delays in the fund disbursements. "Once we have a confirmed list, we will disburse all the funds…hopefully by the end of November. Also, this is a life-long verification; we are working to ensure life-long benefits," he added. The foundation is working with hospitals and the health ministry. 

"In these two months, we have made a verified list of 30,000+ injured and 1,600+ martyrs," said Sarjis, adding, "The published martyrs' list by the interim government [which hovers around 700] will be updated accordingly upon further verification."  

Currently, the 20-member foundation includes a dedicated six-member verification team. 

"We had five members earlier and added one more. If needed, we will make it 10," Sarjis said. 

The beneficiaries

In mid-October, the foundation visited Nitor and collected information on the injured patients admitted to Ward A. In a day or so, nearly everyone at the ward received Tk1 lakh each. 

Munir was among the few left empty-handed. "They asked for verification papers. My brother had visited the Shahbagh office twice in October and then on 4 November," he told TBS over the phone. "We were told that maybe we will receive the fund in one week." 

With a family of three, Md Munir Hossain (32-year-old garment worker and a Gazipur resident) is currently on his second admission at Nitor. He was discharged in early September, only to return later in the month with worse, infected legs. He has been through six surgeries.  

Their healthcare costs, including ambulance fare and food for attendants, amounted to over Tk1.5 lakh. Donations from private citizens had also been a saving grace for these families. "We have received over Tk1 lakh," said Munir, the sole breadwinner of the family.  

In the corner bed at Nitor's Ward B lay Khorshed Alam.

Once approached, two things became clear at first glance. He speaks at a low volume and his injury — the bandaged right thigh. 

Upon closer look, the severity is clear. The bullet exit wound left a deep gash. The pink flesh peeking through the bandage gap looked as though someone had filleted Khorshed's thigh. 

A Manikganj resident, Khorshed, was discharged from Nitor in mid-August. But his condition deteriorated. He first sought help at local hospitals and ultimately had to make his way back to Nitor by early September in a worse condition than when he was released. 

"I did not want to leave when I was first discharged," Khorshed said. 

"Readmission happens. Many have smaller complications… However, we are giving them special care. But readmission is not happening due to any major complications though [some are being] referred," said Dr Kazi Shamim Uzzaman, director of NITOR.

"There is no case of life-threatening critical conditions. But we do have patients with chronic disability. We are thinking about them, that we need expert opinion, and are in talks with Thailand and other countries about them for better care," he added.

Dr Kazi Shamim further said, "Sometimes patients come from far away. They are fine but need physiotherapy. When they request not to be discharged, we keep them because we don't want them to go through the hassle, since they are honoured people."  

On 22 October, Prof Dr Khair Ahmed Choudhury, director of NIOH, said, "We have 45 patients admitted here now. They don't need any treatment, maybe their vision is impaired or completely gone — we cannot give vision to everyone… but why are they staying here?" 

He continued, "Because they believe they can raise their demand to the government. Because if they return home, they become an individual. But if they stay here, they can have a collective voice. Some patients get donations and stay here. They think 'Maybe I will get something tomorrow if I stay here.'" 

From 15 July to 22 October, a total of 468 patients took treatment from Nitor. Some 61 patients are still admitted, according to the hospital director. 

Mehedi Alam (26), a day labourer, was shot on 18 July near the Brac University campus. One of his legs was decimated from the knee down by a bullet. His sister Dalia had been sleeping on the hospital floor for months. 

At our fourth meeting on 1 October, she was hesitant for the first time. 

The reconstruction of Mehedi's left leg was coming to fruition. You could see the replenished flesh in the left calf. His right leg, cut for skin graft and later infected, was also on the mend. 

"But you see," Dalia said, pointing to his left knee, on 30 September, "this part is stiff like a rod, doctors said we have to go to CRP [Centre for the Rehabilitation of the Paralysed]." 

Why do patients need to be sent to CRP? Does Nitor not have rehabilitation facilities? 

"We have rehabilitation. But if you talk of top-level rehabilitation, it is at CRP. We referred a few who needed advanced physiotherapy. But we are regularly providing them with physiotherapy from the physiotherapy department," Nitor's director replied.  

On 4 November, Mehedi and Dalia were at Uttara, one of their sister's houses. "Every ambulance trip costs us a minimum of Tk6,000. And we have follow-ups at Nitor bi-weekly for now. Mehedi's medication cost amounts to Tk10,000 a month," said Dalia. 

Mehedi has completed nine surgeries thus far.  

At Nitor, amputee 16-year-old Md Morsalin Miah stayed for weeks before getting discharged on 9 October. Then they got referred to Brac's Limb and Brace Centre at the capital's Babar Road. Morsalin had been admitted there in late October and was receiving treatment. 

His mother received Tk1 lakh from the July Foundation. "I won't lie; in donations, we have received around Tk3.5 lakh so far in total. I have about Tk50,00 or so in hand," she said. Morsalin used to work at a hotel in Gazipur before 5 August, when he was shot.   

On discharge, they were handed Tk5,000 for ambulance bills and Tk7,000 for medication bills from Nitor's Somaj Seba Fund. 

Nitor also has a Patient Welfare Association, which functions through various public donations and funding of the Social Services Department. 

Since the massacre, "We have received a massive response. We received around Tk69 lakh in August-September. People and groups donated money, crutches etc. People are still donating to our fund [in October]. The total number of patients served from this project is more than 200," said Roushanara Khatun, SSO, NITOR.