Rogi Nibas: Where hotel guests are patients from outside the city
Patients and their caregivers from outside the capital take refuge in guest houses near government hospitals in Dhaka. Though not well-maintained, these guest houses are an affordable solution for them
Rumpa was scrubbing her face with a wedge of lemon while her mother lay on the bed with bandages on both legs. The dirty green wall was peeling off onto the pink bed, the only furniture in the room. The black cement floor under the bed was covered with potatoes, garlic and onion.
"We have been living in this 'hotel' for the last 10 days. And the doctor said we will have to be here for 10 more days, until the infection in my legs goes away. We cook for ourselves in the kitchen," said Rumpa's mother.
By 'kitchen' she means a small room with damp green walls at the end of a spiral lane of similar small rooms at the Shahbagh Guest House and Rogi Nibas. There is also an attached toilet in every room. Situated in the capital's Shahbagh area, the guest house consists of 30 rooms on the third and fourth floors of the building on the west side of the BSMMU hospital.
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"You can use the fridge and cook your food here, we don't charge for that. Otherwise, you can order food from a nearby bhaater hotel," said Saifur Islam, Shahbagh Guest House and Rogi Nibas' manager.
Rumpa and her mother are from Feni, a southern district of Bangladesh. The mother is currently under the care of a doctor at BIRDEM Hospital in Shahbagh. The treatment first began two months ago when both her feet were covered in warts.
"The local hospitals couldn't do anything and suggested we visit the capital. At the time, we got a seat at the hospital [BIRDEM]. The doctor said it was an infection and needs to be dressed every day," Rumpa recounted.
With prescription in hand, the duo went back to their hometown and started visiting the local government hospital for dressing. But in just a week, the situation deteriorated and the infection spread further. They immediately returned to BIRDEM to see the doctor.
"The doctor said the local doctors couldn't do the dressing properly, and so the infection got worse. Now we have to stay here and the doctor himself will do the dressing. The doctor visits Amma every morning. We have to pay him Tk1,000 daily [for the visit]," added Rumpa.
Like Rumpa and her mother, patients and their caregivers from outside the capital take refuge in such guest houses near government hospitals in Dhaka. Though not well-maintained, these guest houses are an affordable solution for them.
The rooms are priced from Tk500 to Tk2,200
A double bedroom – one similar to where Rumpa and her mother are staying – costs Tk1,200, while a room with two single beds costs Tk 1,400 in Shahbagh Guest House and Rogi Nibas.
"But if you request and pay in advance they will give you a discount. We got the double bedroom for Tk500 a day," Rumpa added.
Rupali, a 30-year-old woman, stays in a room at Star Guest House and Rogi Nibas, which is just a few metres away from the Shahbagh Guest House.
Rupali is from Jessore and has bone and muscle complications. She is currently under the care of a doctor at BSMMU. "The doctor said I do not need to get admitted to the hospital, but I will have to visit them regularly for two weeks. [But] I do not have any relatives in the city. This seemed the best option for me," said Rupali. She stays in one of the non-AC single bedrooms, which costs her Tk1,500 a day.
"Although it is a bit pricier than the other one, this one is cleaner. Also, I cook my food here, for which I do not pay anything extra. I can also use the fridge," she explained.
The guest house has 29 rooms under four categories: AC, non-AC, single bed and double bed, covering the building's first to third floor.
The price of the rooms range from Tk1,500 to Tk2,200, Mijanur Rahman, one of the staff members informed. He also said, "generally the patients prefer rooms on the first floor because they cannot climb stairs."
Md Jamal and his father were looking for such a room on the first floor at a lesser price. "My mother has a brain injury; she cannot climb stairs. We came from Chuadanga and no one [we know] is here [with whom] we can stay. Now the room price [at Star Guest House and Rogi Nibas] is also more than Tk1,500. We cannot afford that," Jamal said.
Beyond the confines of Rogi Nibas
Jamal and his parents are going to stay in a hostel room and get food from the nearby small restaurants, until his mother gets admitted and they find a bed at the neurology ward.
It is noteworthy that there aren't many Rogi Nibas available in the capital. Many families who travel to the capital from across the country are bound to stay at cheap residential hotels — which are not necessarily close to hospitals.
Tanvir, a 19-year-old boy from Rajbari, has kidney disease and both of his kidneys need to be replaced. He is currently admitted to the BSMMU hospital and is accompanied by his parents, who have two other kids who are staying back in Rajbari with their maternal aunts.
Like many other patients coming from outside the city, this family also has no relatives staying in the capital city.
Tanvir secured a patient's bed in the men's ward at the nephrology department of the hospital. But where are his parents staying at night?
"Between the two patient beds in the ward. We have a rug that we place on the floor and use our clothes as makeshift pillows. Tanvir's father sometimes sleeps on the balcony or the benches," Fatema, Tanvir's mother, said.
"We need Tk7 lakh for Tanvir's surgery. There is no way we can spend Tk1,000 per day on accommodation. We are fine here," Rafiq, Tanvir's father, said.
Family members as caregivers
To help patients follow the prescriptions that doctors give, we need caregivers at the hospitals. There are two options in that situation – either institutional caregivers or family members acting as caregivers.
"In our healthcare system, especially in government hospitals, we have fewer nurses – which means fewer institutionalised caregivers – there are a lot of people staying at the hospitals with the patients," said Professor Dr Be-Nazir Ahmed, public health expert.
The country's health sector is running with 76% fewer nurses than what is needed. As per World Health Organisation guidelines, three nurses have to be recruited against one doctor.
The 2021 health bulletin of the Directorate General of Health Services (DGHS) notes that the number of BMDC (Bangladesh Medical and Dental Council) registered doctors in Bangladesh is 1,35,195 and there are 1,389 patients per doctor. This means the country needs more than four lakh nurses.
However, the number of registered nurses in the country is 94,918 as of October 2023, according to the Bangladesh Nursing and Midwifery Council (BNMC).
It is understood that nurses at the government hospitals (which are also known to be understaffed), do mostly administrative duties and provide medicines to patients. Beyond this, nurses cannot do much else, mainly due to an overload of patients and responsibilities — such as bathing or feeding patients, changing clothes, taking them to the bathrooms etc. or assisting in these activities.
However, this does not change the necessity of caregivers for patients. In most cases – similar to Rumpa or Tanvir's case – the family steps in as caregivers. These caregivers also need accommodation.
Many of these caregivers are forced to stay at the hospital – be it on the floor or balcony. And often there is little to no room for hygiene and cleanliness in crowded hospital floors and spaces. Caregivers may spit on floors or not follow bathroom etiquette – this, in effect, increases the chance of the spread of germs.
"We need to include this in the planning of our health system and management. We need to train these caregivers on hygiene, otherwise the entire situation gets unmanageable. Sometimes you have to bribe to even get a trolley for the patient," Professor Be-Nazir concluded.
