They even take leave or are absent for other reasons. As a result, patients are seeking care at various private clinics and diagnostic centers outside. This situation is common in almost all upazila health complexes.

According to the Directorate General of Health Services, about 59 percent of doctor positions in upazila health complexes nationwide are vacant. The highest vacancy rates are in the Barisal and Rangpur divisions. Even when doctors are appointed, they don’t stay long at these health centers. In Barisal, 73.6 percent of doctor positions are vacant, and in Rangpur, 70 percent of positions are empty.

In the Khulna division, 67.5 percent of positions are vacant, and in Rajshahi, 63.7 percent. In the Sylhet division, 61.6 percent of doctor positions are empty. However, the situation is somewhat better in the Mymensingh and Chattogram divisions. In these two regions, the vacancy rates are 58.3 percent and 51.6 percent, respectively.

A major issue with government employees, including doctors, is that many prefer to work in Dhaka. As a result, many health complexes in Dhaka and nearby districts have more doctors than needed. Despite this, 42.8 percent of Dhaka division health complexes’ positions remain vacant. 58.5 percent of doctor positions in upazila health complexes nationwide are unfilled. This means that most upazila health centers operate with less than half the required number of doctors.

Experts say the manpower crisis in Upazila health complexes is an old issue. As a result, people in rural areas are deprived of proper healthcare. In many places, there are no specialists. Junior doctors often refer patients to district hospitals or medical colleges for even basic treatment, leading to overcrowding in district hospitals.

In some cases, patients need immediate treatment. However, since the emergency departments in upazila health complexes often lack doctors, many patients die.

Dinajpur is a relatively developed district in the Rangpur division. It has 11 health complexes, 102 union health centers, and 30 community clinics across 13 upazilas. However, all these centers face a severe shortage of specialists, consultants, senior doctors, and experienced medical staff.

In the Fulbari Upazila Health Complex, which has 50 beds, there are 182 government-approved positions for doctors, nurses, and other staff. Yet, nearly half of these positions have been vacant for years.

When asked about this, Dr. Md Moshiur Rahman, the Upazila health and family planning officer, told Bonik Barta, “We are running the hospital with just three doctors. The emergency department is almost entirely understaffed—no doctors, ward boys, or sweepers. We have to rely on inpatient staff to provide emergency services.”

Dr. Moshiur Rahman also mentioned that multiple requests have been sent to the ministry for more doctors and mid-level officers. With a hint of frustration, he said, “How many more times should I write? They don’t appoint doctors. The number of staff, nurses, and employees is decreasing every day. All hospitals in the district, like the Fulbari Upazila Health Complex, face the same manpower shortage. It is impossible to ensure proper healthcare for the public this way.”

According to the Directorate General of Health Services, there are 1,161 doctor positions in upazila health complexes in the Rangpur division. However, only 348 doctors are currently available, and the remaining 813 positions are vacant.

The healthcare crisis in the Rangpur division is evident from the experience of Runa Akter, a resident of Khalpara village in the Panchagarh district. She says, “My 10-month-old son, Wasim, has been suffering from diarrhea for a long time. He was admitted to a local health complex at first. However, due to inadequate treatment, his condition worsened. Eventually, I brought him to Dhaka. He has been admitted to Lalkuthi Maternal and Child Hospital in Mirpur for 11 days.”

In Kaunia Upazila, Rangpur, the main healthcare facility is the 31-bed Haragach Hospital. However, due to a shortage of doctors, patients are facing daily struggles. Since 1999, there has been no gynecologist at the hospital, and there has been no surgery specialist for the past three years. Two medical officers have been absent for six months, and even the position of the chief health officer has been vacant for the past month. Out of 48 staff positions, more than half are vacant.

Shafiqul Islam, a resident of Char Nojirdah village in Haragach Union, recently went to the hospital with hernia pain. However, due to the lack of a surgery specialist, he had to borrow money to seek treatment in Rangpur.

Bandarban is another district facing a severe shortage of medical staff. The district’s six upazila health complexes, including the district hospital, are struggling with a shortage of over 300 staff, including doctors. At the Rowangchhari Upazila Health Complex, 7 out of 13 positions are vacant. In Thanchi Upazila, 8 out of 12 important positions are empty. At Lama Upazila Health Complex, 14 out of 23 positions are vacant. In Naikhongchhari Upazila, 7 out of 12 positions are empty.

Despite the manpower crisis, efforts are being made to continue providing services. Bandarban’s civil surgeon, Dr. Md. Shaheen Hossain, confirmed this situation to Bonik Barta.

In the Khulna division, 896 of the 1,327 doctor positions in upazila health complexes are vacant. In the district of Bagerhat, the Kachua Upazila Health Complex has only four doctors.

Obaidul Haque, a patient’s relative at the Kachua Health Complex, shared his experience. “My wife became ill due to childbirth complications last Tuesday night. I rushed her to the emergency department of the Upazila Health Complex. A nurse sent us to the gynecology ward, but no doctors were there. My wife screamed in pain all night. The next morning, at 8 AM, we were told she couldn’t have a cesarean here and needed to be taken elsewhere.”

Dr. Moni Shankar Paik, the residential medical officer at Kachua Upazila Health Complex, admitted the doctor shortage. He said, “There are 29 positions in the hospital, but only two medical officers, one anesthetist, and one dental doctor. It’s very difficult to provide proper healthcare with such a shortage.” The situation is similar in other upazila health complexes in Bagerhat.

After taking office, the interim government decided to recruit 5,000 doctors in February. 2,000 will be hired through the BCS exam, and the Public Service Commission has already been contacted. Plans are also underway to recruit 3,500 doctors from other BCS exams. Additionally, the health ministry is creating supernumerary posts for academic appointments. However, no one was available to comment on the latest status of this initiative.

Public health expert Dr. Lelin Choudhury believes the government needs a proper plan to increase the healthcare workforce. He told Bonik Barta, “Upazila health complexes provide healthcare at the grassroots level. Rural people rely on these centers for treatment. These centers also handle many family-planning tasks. If there is a shortage of staff, it disrupts these services. Yet, many doctors who graduate with an MBBS degree remain unemployed. This is why the tendency to go abroad for work is rising. Also, more doctors are leaving the medical profession through BCS exams. The government must have a proper plan to increase the healthcare workforce. First, there needs to be a clear plan about how many doctors are needed based on the country’s population.”