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Bangladesh: 377,000 patients treated in 3 years at ICRC-supported emergency department of Sadar Hospital

Mohammad Ali Asgar was recently rushed to the emergency department of Cox's Bazar District Sadar Hospital after complaining of breathing difficulty. The experience left the 52-year-old shaken but also impressed at the quality of care he received. "It is wonderful that our country has an emergency department that meets international standards and is as well equipped. The medical care provided to me, and the professionalism of the physicians and nurses was very impressive," says Asgar.

Supported by the International Committee of the Red Cross (ICRC), Cox's Bazar District Sadar Hospital provides quality medical care for both host and displaced communities from Myanmar.

Over 377,000 patients, including displaced people from Rakhine, received free medical consultations at the hospital's emergency department as part of a joint project with the ICRC between 2019 and 2022.

The facility serves as a referral hospital for eight Upazila complexes (sub-districts), covering 142 public health-care centres and the displaced people from Rakhine living in camps.

Talking about the ICRC's support to the hospital and the transformation in the delivery of health care, hospital superintendent Dr Md. Mominul Rahman says, "We did not have modern medical equipment or resources in the past. With the ICRC's support, the emergency department is better equipped now and provides emergency care to 350 to 450 patients a day. It has also become a national model for providing comprehensive medical care under one roof to both Bangladeshis and displaced people."

As a part of the Basic Emergency Care course, an ICRC staff provides hands-on training to help develop emergency health-care services. M. KARIM/ICRC

Training for emergency department staff

The ICRC helped staff in the emergency department to widen their skill set through several training initiatives. "Earlier, the emergency department was underutilized and lacking in resources. But we have now expanded our emergency services to include patients suffering from heart conditions, breathing difficulties, children and pregnant women among others," says Dr Md. Ashikur Rahman, a resident doctor at Sadar Hospital.

Addressing violence against health workers

Results of a study initiated by the ICRC and Sadar Hospital show that over 40 incidents of violence against health-care workers have been reported at the emergency department of the hospital between July 2019 and November 2022. The ICRC worked extensively with the hospital management on several initiatives to address violent incidents against health workers.

A round-table discussion was held at Cox's Bazar District Sadar Hospital in November 2021 with the hospital management, emergency physicians, nurses and support staff to discuss violence against health professionals. M. KARIM/ICRC

One such initiative – one attendant per patient policy – was found to be remarkably effective in reducing tensions inside the emergency department. Other initiatives such as engaging with health-care workers and support staff, conducting stress management training sessions for them, and carrying out public awareness campaigns have also helped to improve the working conditions of health workers and resulted in a better environment for patients as well.

Our expert health trainers worked with the physicians and nurses of the emergency department and trained them to efficiently assess and stabilize patients, provide rapid response to trauma cases, treat acute illnesses, refer and coordinate as well as promote community outreach and preventive measures. These initiatives have significantly improved the quality of emergency medical care available for the people in need and the hospital has witnessed a reduction in the overall admission rate after receiving emergency care.

Agnès Dhur
Head of the ICRC delegation in Dhaka

The Ministry of Health and Family Welfare also appreciated the emergency department of Sadar Hospital in Cox's Bazar as a model department to be replicated across the country and awarded the hospital with the title of the second-best district hospital in Bangladesh in 2021.