Unutilised Cancer machine at DMCH

By Ziauddin Ahmed Khan, A retired government servant, Dhaka
13 May 2004, 18:00 PM
The news items on the above subject in your daily (May 10) has drawn my attention. It is a pity to see such irresponsible behaviour of the DMC management. The statement of the doctors cannot be an excuse. These specialists are commercial people (with a very few exception) who always prefer to see patients in their private chambers, tell not only lies but also shift responsibility to others. I have experienced their inhuman attitude and irresponsibility when my young daughter ( only 27), a student of Masters in Health Economics Unit of DU, died of ovarian cancer on 25 April, 2004. About 40 thousands women die in Bangladesh every year due to ovarian cancer. The lady professional rightly says that more than 75% cancer patients can be fully cured, if diagnosis and treatment are done properly. I had been working on monitoring and coordinating the whole gamut of procurement of Health Logistics for about three years from the planning perspective. In fact, procurement of health logistics ( particularly the foreign procurement) is the responsibility of the Director of Central Medical Stores (CMSD) under the Directorate of Health Services. It is observed during HPSP planning period that after a long persuasion, CMSD could collect the requirements of a big wish list of items and instruments without proper specification and even knowledge of operating such machines and equipment.

Since most of those highly sophisticated and costly instrument are procured with the IDA/ donors' funds, it has to go for open bidding and with a neutral specification and there is no scope for mentioning any particular brand or preferring a particular company's item. It is not only barred by IDA procurement rules but also by the country's financial and procurement rules and procedures. Procuring such goods takes a long time, not less than 12-15 month. Getting the requirement list, CMSD tries to get a neutral specification. But the request provided by the specialists cannot provide specification in most cases. The specialist doctors always prefer the branded machine which they handled during training abroad. This creates a lot of problems for making specifications of machines/instruments for the health care system. In certain cases, CMSD even had to hire expatriate consultants for preparation of specifications. As such, a lot of time had to be lost. After completion of formalities the CMSD goes for bidding, and bids are evaluated technically by those specialised doctors/professors. When they approve the matter , financial evaluation is made at the appropriate level of authority according to financial involvement of the procurement. Sometimes it goes to the ministerial purchase committee and even to the prime minister. There is little scope for the ministry's officials to choose any particular company at their will. So blaming the ministry for importing obsolete machinery is not right.