2 technicians can 'triple' efficiency

The cardiac surgery ward of Chittagong Medical College Hospital (CMCH) conducts over a hundred open heart surgeries annually, but the number could be tripled if two perfusionists, who assist the operation, are appointed, said head of the ward.

The posts of two perfusionists have remained vacant since 2013 when the ward started its journey, offering the expensive operation at a fairly low cost.

A perfusionist is a technician who operates the heart-lung machine during the surgery.

Dr Nazmul Hasan, associate professor and head of the cardiac surgery ward of CMCH, said currently eight to 10 heart surgeries were performed a month.

“…we hire perfusionists from Dhaka on contract and patients have to pay them,” he said. “The hired perfusionists come to Chittagong once or twice a month.

“If two perfusionists are appointed in the ward, 30 operations can be performed every month.”

Dr Nazmul also said that of all government medical college hospitals in the country, only CMCH had a cardiac surgery ward. After its founding, the ward conducted 235 surgeries at lower costs, while patients had to travel to Dhaka or abroad and pay many times higher earlier, he added.

Still CMCH cannot treat all cardiac patients requiring the surgery. Around 8,000 to 10,000 patients undergo open heart surgeries every year in Bangladesh, of them 2,000 to 2,500 coming from the Chittagong region, according to Dr Nazmul.

“A patient has to spend around Tk 50,000 for an open heart surgery in CMCH, whereas the cost is Tk 1.2 lakh at the National Institute of Cardiovascular Diseases and Tk 2.2 lakh at National Heart Foundation in Dhaka,” he said. “The cost of an open heart surgery goes to as far as Tk 10 lakh to Tk 25 lakh abroad.”

The ward has a 97 percent success rate in operations as well, said Dr Nazmul. "[the rate] is an international standard." Only eight out of the 235 patients died so far, he said.

SHORTAGE OF NURSES, DOCTORS

There is also a crisis of nurses. While there are 30 posts for nurses at the ward, only nine nurses are appointed till date, said Nazmul.

Two posts of professors also remain vacant, and there is a shortage of anesthetics and junior surgeons, he added.

The 60-bed cardiac surgery ward, including 12 beds at its Intensive Care Unit, cannot be made fully operational because it has only five beds at the ICU, said Dr Nazmul.

“No ward boy and cleaner have been appointed in this ward till date,” he said.“I have been an associate professor for 14 years and have not been promoted although two posts of professors remain vacant.”

CMCH Director Brig Gen Md Jalal Uddin said the health ministry recently assured that an anesthetic would be appointed in the ward.

Regarding perfusionists, he said there was a crisis of this technician all over the country. “We sent a proposal to the ministry to initiate a training course to produce perfusionists at CMCH in 2013 but the proposal is still under consideration,” he said. “If the course is launched, we can produce perfusionists here.”