When Medicines Rot and Patients Suffer
H. M. Nazmul Alam :
The recent findings of the Anti-Corruption Commission (ACC) expose a disturbing reality of Bangladesh’s public healthcare sector.
In a span of nine months, separate raids and secret investigations across 64 government hospitals and health complexes in 37 districts revealed a systematic pattern of corruption, negligence, and malpractice. The very institutions entrusted with healing the nation are instead failing its most vulnerable citizens, eroding both trust and accountability.
The list of irregularities is long and alarming. Medicines meant for patients are left unused in warehouses until they expire, while patients are told there is no supply and are forced to purchase the same drugs from outside. Allocated food rations are reduced, with many patients receiving half-portions of poor quality meals. Diagnostic equipment often remains idle, depriving patients of essential tests. Procurement and recruitment processes are manipulated, fake bills are generated, and low bidders are excluded to favor higher-priced contracts. Patients are also denied basic amenities such as clean sheets and proper beds, while negligence by doctors and staff compounds the crisis.
These are not isolated incidents but part of a consistent pattern of malpractice across the country. The ACC has identified seven broad categories of irregularities: reduction in food quantity and quality, denial of free medicines, excessive fees, non-use of medical equipment, lacks of basic facilities, corruption in procurement and recruitment, and negligence of duty. Together, these represent a structural failure of governance in the healthcare system.
The case of Kapasia Upazila Health Complex in Gazipur illustrates the depth of the problem. Patients seeking treatment are often denied government medicines and forced to buy drugs from outside pharmacies. When the ACC raided the facility in April, they discovered large quantities of expired medicines and abandoned equipment in storage. The Upazila Health and Family Welfare Officer has subsequently been removed, but the damage to public trust had already been done.
In Jessore’s 250-bed hospital, patients suffering from diarrhea were forced to purchase saline from outside shops despite sufficient stock being available within the hospital. Food rations were found to be reduced, with breakfast of especially poor quality. When questioned, the hospital superintendent admitted that “every allegation is true” but expressed helplessness in addressing them. He pointed to a system where short-term postings of doctors contrast with entrenched employees who have worked in the same institutions for decades, making entrenched corruption extremely difficult to challenge.
The ACC also found expired reagents in the Katiadi Upazila Health Complex in Kishoreganj. Patients there were given inadequate and substandard food: for instance, 70 grams of fish were provided at lunch instead of the prescribed 105 grams. At Madaripur’s Kalkini Upazila Health Complex, doctors were found to be prescribing unlisted medicines rather than distributing the allocated government drugs. In Rajshahi’s Paba Upazila Health Complex, test fees were collected using unofficial receipts and tokens, with funds not properly deposited into the government treasury. Brokers within the hospital were also discovered diverting patients to private clinics.
These cases highlight a larger systemic crisis. The dismissal of 50 officials and employees in nine months shows that accountability measures have begun, but the persistence of such widespread irregularities suggests the presence of entrenched syndicates that outlive individual dismissals. Corruption in hospitals is not an individual act but an institutional practice—sustained by networks of officials, contractors, brokers, and suppliers who profit from the system’s dysfunction.
The consequences are severe. For patients—most of whom turn to government hospitals because they cannot afford private care—this malpractice often means life or death. Being denied medicines, food, or diagnostic services pushes families into financial hardship and erodes trust in public institutions. For healthcare workers who are honest and committed, this environment makes it almost impossible to deliver quality service. And for the state, the result is both financial loss and a weakened social contract with its citizens.
The ACC’s findings also extend beyond hospitals. Investigations are ongoing into irregularities in a Tk 334 crore project of the Public Health Engineering Department, 15 medical colleges, and the establishment of dialysis units in 44 districts. Raids in Rangamati, Jhenaidah, and Jessore revealed further irregularities. What emerges is a picture not of isolated corruption, but of systemic mismanagement across the entire health sector.
Transparency International Bangladesh’s Executive Director, Dr. Iftekharuzzaman, has called for exemplary punishment of all those directly and indirectly involved. He emphasized the need to dismantle the syndicates that control hospital operations. This is a crucial point: without structural reforms that address networks of corruption, dismissals of individual officials will remain superficial remedies.
Yet, government responses to these revelations have been muted. The Health Secretary and the Director General of the Directorate General of Health Services both claimed they had no knowledge of the ACC’s raids or findings. This bureaucratic indifference illustrates the lack of coordination between oversight agencies and the health administration. If the highest authorities remain uninformed—or choose to remain uninformed—about such widespread malpractice, accountability will be difficult to achieve.
The challenges ahead are formidable. First, healthcare budgets must be protected from leakage. Already, the daily food allocation for patients is limited; when theft occurs even within this small budget, patients are left with inadequate nourishment. Second, stock management of medicines and medical supplies must be digitized, transparent, and closely monitored to prevent hoarding, expiration, and diversion.
Third, citizen monitoring committees, civil society organizations, and local communities should be involved in overseeing hospital operations to create accountability from outside the entrenched bureaucratic networks. Fourth, whistleblowers within the health system must be protected and encouraged to come forward. Finally, punishment for corruption in healthcare should be swift, visible, and exemplary to deter future malpractice.
The ACC’s report should be a wake-up call. Corruption in hospitals is not simply a financial crime—it is a direct attack on the health and dignity of citizens. Medicines left to rot in warehouses while patients are denied treatment symbolize a wider moral crisis. At its core, healthcare is about trust: the trust that when one falls ill, the system will respond with care, not exploitation. That trust is now dangerously eroded.
Restoring it will require more than raids, dismissals, or public statements. It will demand a comprehensive reform of how hospitals are managed, how resources are distributed, and how accountability is enforced. Without such reform, the warehouses will continue to fill with expired medicines, while patients outside continue to hear the same devastating response: “There is nothing available.”
(The writer is an Academic, Journalist, and Political Analyst based in Dhaka, Bangladesh. Currently he is teaching at IUBAT. He can be reached at [email protected])