Hospitals Lack Emergency Plans for Mass Casualties, Experts Say

Hospitals in Bangladesh lack comprehensive plans to manage mass casualty events, such as earthquakes or major accidents, according to experts. The absence of such protocols hinders the ability to save lives when numerous individuals require immediate medical attention. Strengthening emergency services necessitates coordinated efforts and genuine commitment from the government, hospital authorities, politicians, and the media, as emergency departments are considered the face of any healthcare institution.

Discussions around a draft emergency medical plan took place at Dhaka Medical College Hospital on a Saturday, organized by its casualty department with support from Doctors Without Borders (MSF). This initiative is part of an effort to develop and implement an emergency treatment plan for the hospital. Dhaka Medical College Hospital's emergency department consistently faces a surge of patients from large-scale accidents, violence, and daily road incidents.

Brigadier General Md. Asaduzzaman, the hospital's director, stated that if other hospitals could absorb some of the patient load, Dhaka Medical College would see an improvement in the quality of care for its injured patients. He also noted a significant difference in patient intake compared to typical hospitals: while most hospitals admit 80% of patients from outpatient departments and 20% from emergency, Dhaka Medical College sees the reverse, with 80% of admissions originating from its emergency department.

During the event, Associate Professor Mostak Hossain of the casualty department presented a draft plan, emphasizing that a structured approach improves patient management, treatment, and can prevent some deaths. His proposal detailed coordination among various departments, increasing personnel, managing medical supplies, and patient handling. He outlined that in major accidents, patients are typically categorized as 50-70% minor (green), 20-30% moderate, and 10-20% critical. Effective triage, the process of sorting these patients, is crucial for optimal emergency care.

Several senior physicians and attendees highlighted challenges in managing the crowds of relatives accompanying patients during emergencies, with some noting interference from political figures and their supporters. Complaints were also raised about journalists, with suggestions for establishing formal channels for information dissemination to reduce overcrowding. Some proposed establishing entirely separate emergency departments. A representative from MSF, Md. Jamil, who has worked in Bangladesh since 1972, stressed that a plan alone is insufficient; it requires regular drills and practice to identify and rectify its flaws.