Download Recently on Asia Calling we heard how a group of Bangladesh nurses threaten to burn themselves alive if their demands for employment weren’t met.
At the last minute, the Minister of Health promised to address their grievances and they went home...still without jobs.
But while the striking unemployed nurses have gone home, they haven’t given up the cause.
Bangladesh Ric Wasserman investigates the causes of the nurses’ strike and began by taking a look inside one of the country’s hospitals.
Today they’re repainting the white colonial style Dhaka Medical Hospital, one of the oldest, and largest in Bangladesh.
The long, poorly lit corridors are filled with people. Whole families have taken up positions in the dark corners, the sick member lying amid them.
While the atmosphere is friendly and the wards are clean, there are only 550 beds here...but more than 4000 patients.
Brigadier Gen Dr. Mohammed Mallik is the hospital director. He’s in military dress, and carries a meter long bamboo stick.
“In this hospital, the largest public hospital, all the complicated cases are rushed to here from every part of the country. We can restrict the admissions, but practically that is not feasible considering the socioeconomic conditions, and economic background of the patients. It is not possible, because this is the place where they can get access to treatment. I cannot give them the beds, but I can give them the treatment, the medicine, the diet.”
But it’s not only the problem of adequate beds that worries the General. It’s the serious lack of lack of staff, mainly nurses.
According to the Bangladesh Health Directorate, there are over 33,000 vacant posts waiting to be filled, one fifth of the workforce.
The last hiring for government health posts was in 2003.
The positions haven’t been filled due to both serious funding shortages, and slowness in the recruiting process, and corruption, while as many as 3000 trained nurses are unemployed and available for work.
Meanwhile, caseloads increase as thousands have come to Dhaka the capital, in search of treatment.
Monirul Shadar has been on dialysis for kidney failure for six months and comes twice a week. But sometimes the machines are shut down when he gets here.
“We’re getting the facilities but not always the machines. Sometimes we have to purchase them from outside.”
For the nurses he has only praise.
”The nurses, they’re excellent, the service they are giving is excellent.”
Nurse Tahera Khatum twists a dial and checks Monirul’s health chart: She sighs deeply when I ask her about her frustrations.
“There are at least twice as many patients as machines. But we also need more technicians. We’ve been asking the director for more staff and technicians but we’re still waiting. It’s sad to see the people suffer.”
In the children’s ward sick children are packed three to a bed. Their families are on the floor in clusters around the rooms.
Here there is a ratio of one nurse for every 20 children…four times the minimum staff per patient recommendation from the World Health Organisation.
Iftekar Zaman is the executive director of Transparency International the organisation working hard to flush out corruption here.
”Corruption is quite deep and widespread in the context of Bangladesh and is ranked at the top of the list of Transparency International corruption perception index 2001-5. So it's a huge challenge and there is hardly any sector in this country which is not affected by corruption.”
The Ministry of Health is no exception, especially when it comes to who gets jobs.
The unemployed hunger striking nurses want a change in the quota recruitment system.
In essence, the system, which applies to all government jobs in Bangladesh, was created to guarantee the sons and daughters of the 1971 freedom fighters 30 percent of state jobs.
Women are guaranteed at least 15 percent, and recruitment is done on a national, district-wise basis.
The striking nurse’s claim that those with years of experience are not considered and they want recruitment to be based on merit.
Transparency International has been investigating the heath ministry’s recruitment practices for corruption.
”Most often this quota is abused by the people who are in the positions of power. We have to remember that people in positions of power can be within the government or outside the government. It can be political power. It can be economic power.”
But Abdulla Al-Baki, the Deputy Secretary of the Ministry of Health Nursing department refutes accusations of corruption.
“I can tell you that this nursing branch is more or less free from corruption. Monetary corruption. I have recorded nothing like that is happening here.”
The 150 striking nurses are demanding not only employment, but a more just system of hiring. They also want their status upgraded.
Abdulla Al -Baki is not happy. They’re not playing by the rules, he says.
”They don’t like to follow recruitment rules; they simply want to have jobs after getting their diploma. They agitated against this quota system, and now the government is under process to recruit about 2,600 nurses by mid-April.”
While it’s not enough, the promised employment of nurses will make a big difference for patients.
And it must be said that in spite of the enormous pressure on health services Bangladesh has made progress. Both maternal and child mortality has gone down significantly in the last 10 years, in spite of population growth.
For now, say the unemployed nurses, they’ll wait and see if the government will implement the recruitment plan, and get them back in the health system. They will wait instead of taking to the streets.
“We are thousands of nurses who want jobs. We shouldn’t be here, we should be working.”