Medical infrastructure has significantly improved across the country. The healthcare sector has also expanded. However, there remains a persistent shortage of personnel in rural health centers. Across four districts in the Sylhet division, there are 767 sanctioned posts for medical officers and junior consultants at upazila (sub-district) and union levels. Of these, 442 posts remain vacant, accounting for over 42 percent of the total. Due to this long-standing doctor shortage, marginalized communities are being deprived of adequate healthcare services.
Experts state that the quality of healthcare for marginalized populations in the Sylhet region is declining day by day. They attribute this primarily to the shortage of doctors at government health complexes in the upazilas.
Data from the Office of the Director of Health, Sylhet, reveals acute doctor shortages at upazila health complexes. These facilities also face shortages of nurses and technicians. Consequently, patients unable to get adequate care are turning to private hospitals, clinics, and diagnostic centers.
Discussions with concerned parties confirm that the staffing shortage in upazila health complexes is a long-standing issue. Many of these lack specialist doctors. Junior doctors often refer patients to district headquarters or medical college hospitals, even for primary treatment. Consequently, district and medical college hospitals are constantly operating beyond their capacity. Occasionally, patients requiring immediate medical attention at the upazila health complex emergency departments die due to the absence of a doctor. Due to these, the marginalized population has always been deprived of medical services.
Advocate Irfanuzzaman Chowdhury, former president of the Sylhet committee of Shushashoner Jonno Nagorik (SHUJAN), believes the doctor shortage has heightened public anxiety, especially amid ongoing COVID-19 and dengue outbreaks in Sylhet. He told Bonik Barta, “Strengthening monitoring is crucial to ensure health service delivery by upazila-level officials and staff.”
Health Services Division sources indicate the Sylhet division has 35 upazila health complexes, three 20-bed hospitals, and 85 sub-health centers. Healthcare services are disrupted due to doctor shortages. Inadequate numbers of doctors, nurses, and technicians are a daily challenge. Notably, most health department staff, including doctors, reportedly show reluctance to serve at the upazila level. This means that even when vacancies are filled, shortages reappear within a short period.
According to data from the Office of the Director of Health, Sylhet, there are 526 sanctioned medical officer posts at the upazila and union levels across the division’s four districts. However, only 225 are currently employed, leaving 301 posts vacant. In the Sylhet district, 102 doctors are employed against 171 posts. In Sunamganj, only 57 medical officers are working against 133 sanctioned posts in various hospitals. Furthermore, in Habiganj, 44 doctors are employed against 119 posts, and in Moulvibazar, 22 doctors are working against 103 posts.
An analysis of Health Services Division data reveals that only one doctor is serving the 300,000 people of Kanaighat, Sylhet. Out of 16 doctor posts in the upazila, two residential medical officers are officially listed. However, while one works in the upazila, the other is employed at Sylhet Osmani Medical College Hospital while drawing salary and allowances from Kanaighat Hospital.
Shamsul Islam, a resident of Kanaighat’s Durgapur, told Bonik Barta: “I suddenly felt chest pain and went to the upazila health complex. The doctor barely examined me and sent me to Osmani Medical College Hospital.”
Shafiq Mia, a resident of Taral village in Derai upazila, Sunamganj, had his daughter undergo an operation at Osmani Medical College Hospital. Complications arose after bringing her home. He then rushed to the upazila health complex, but the doctor merely prescribed medicine and again sent them to the medical college hospital. “Even though there’s a district hospital, in most cases we have to go to Osmani Medical,” he added.
Regarding the crisis, Divisional Director (Health) of Sylhet, Dr. Anisur Rahman, told Bonik Barta, “Though doctors are fewer than needed, those serving are dedicated. The issue of doctor shortage has been communicated to the higher authorities. Efforts are underway to resolve the crisis. The BCS examination is currently ongoing. The crisis will be alleviated once those who pass the BCS (Health) examination are recommended and assigned to their posts.”