Healthcare for profit

On Sep 9, 2015, several Dhaka news outlets carried a short piece about Apollo Hospital, which was fined Tk 16 lakh after a RAB mobile court found contraband drugs in the hospital's pharmacy. None of the news reporters bothered to go into detail about where the drugs came from and how they ended up in this particular hospital-run pharmacy.

One report quoted Executive Magistrate Firoz Ahmed, who led the raid, as saying: "Illegal drugs worth about Tk 1 million were seized from the pharmacy." According to Mr. Ahmed, the hospital authorities kept these medicines without any regulatory approval.

A RAB Officer, Muhit Kabir Serniabat, gave a few details: "Illegal drugs of 51 categories were seized from the pharmacy as they were not authorized by the government or quality was not properly maintained."

The RAB official quoted the hospital authorities as saying that they had bought the medicine without approval "as many of the patients who were treated abroad asked for those when they visited the hospital".

So, now, it is established that Apollo Hospital in Dhaka provides special services if you have money.

What does one think is wrong with this? It is obvious that perhaps the hospital has been doing this kind of illicit business for quite some time.
Apollo Hospitals Dhaka is a joint project of India's Apollo Hospitals Enterprise Limited and Dhaka-based STS Holdings Limited. This hospital is actually owned by Bangladeshis – they are owners of International School of Dhaka, Shanta Properties, Shanta Garments and part owners of Dhaka Bank. It is managed by Indian-owned Apollo Hospitals possibly under a franchise agreement.

In the last few years private hospitals have sprung up in Dhaka like wild mushrooms – primarily with wealthy patients in mind. Sometimes a patient from the middle income group ends up there as a last resort, hoping for better care. We all have vivid memories of how in the summer of 2014, another private healthcare provider in Dhaka – United Hospital – refused to release the body of a 54-year old patient to his family for five days because of non-payment.

I have not been to Apollo Hospital, and had I been living in Dhaka, that would be the last hospital where I would want to be in the case that I needed emergency medical attention. Last October, one morning, my own brother was taken there because of respiratory complications.

According to family members in Dhaka, a lot of the doctors that morning were on leave because of Eid ul-Adha and Puja. The hospital emergency room was in the hands of young interns. As a result, the medical supports were not able to assess the seriousness of his condition. He went into a coma.

As it turned out, he needed to be hooked up to a life-support system immediately. I was told that the oxygen tank in his Intensive Care Unit was empty. The list goes on and on about the negligence in taking care of the patients. In a few days' time, my brother was taken to Singapore by air ambulance. The doctors there confirmed that Apollo Hospital had installed the life-support equipment very late. My brother never gained consciousness. We lost him on Oct 10, 2014.

Since his passing, I have written to the Apollo CEO, and to some of the Apollo investors demanding an explanation. The CEO had one of the Indian doctors write back to me with charts and figures, and of course, they denied any wrongdoing. So did the two investors. They all have tried to convince me that they run the hospital by the book, and that no misconduct or negligence took place.

Did I believe their claim? Absolutely not.

Now, is it any surprise that Apollo got caught with its hand in the cookie jar? Not at all. Hospitals like Apollo have been set up with the sole purpose of doing business and earning profit. From my brother's case, I came to the conclusion that at Apollo, patient care is minimal. It doesn't seem to be a priority for them.

If the hospital authorities were really sincere about running a clean operation – would they be importing drugs illegally into Bangladesh?

After getting busted for malpractice, a fine of Tk 16 lakh is a mere slap on the wrist. Apollo owners and investors are sitting on millions of dollars. Their bottom line is money-making in an extremely poor regulatory environment.

The lack of regulatory oversight has encouraged a private hospital such as Apollo to disregard laws so blatantly. It was astounding to read that these drugs were not even properly stored.

The hospital authorities, including the doctors, are an essential group of professionals who should abide by an ethical code of conduct. Their goal shouldn't be to serve the needs of rich patients alone.

Slapping a meager fine is not the best way to handle a situation as serious as this one. The authorities must do much more and take the issue to the fullest extent permitted by law.

A hospital is not just a business organization. In Greek mythology, Apollo was the son of God, whose attributes were 'prophecy, medicine, law and wisdom'. How ironic is it, then, that a hospital named after him doesn't represent a single one of these virtues?

Zeenat Khan writes from Maryland, USA