The Upazila Health Complex in Birganj, Dinajpur, was established to provide medical services to a population of 356,152—comprising 87,824 households—across 11 unions and one municipality. The 50-bed health complex is currently in a dire state due to a severe shortage of personnel. The hospital authorities are struggling to provide adequate medical care. Established in 1978, the health complex is located in Chakai village of Sujalpur Union, along the Dhaka-Panchagarh regional highway. In 2013, the facility was upgraded from a 31-bed to a 50-bed hospital. However, the staffing level remains that of a 31-bed facility.

Due to its location along a major highway and its proximity to several neighboring upazilas, the hospital experiences a high patient volume. Although it now has a 50-bed capacity, it operates with the staff allocated for a 31-bed facility. There are no MLSS (Class IV/support) staff members at the hospital. While a 31-bed facility should have six MLSS positions, this 50-bed hospital has none at all. Although the hospital has received a national award for its performance in conducting normal deliveries, the lack of a gynecologist, an anesthesiologist, and a surgeon has severely hindered its ability to perform Cesarean sections.

Even though the operation theater (OT) is functional, C-sections cannot be performed due to the absence of the necessary medical specialists. This has tarnished the reputation of the otherwise well-known hospital. When pregnant patients are referred to Dinajpur Medical College Hospital, the resulting delays and the desire to avoid further hardship often lead them to seek care at local private clinics instead. Local private clinics are taking advantage of this situation. They are charging patients exorbitant fees. Furthermore, there are no *ayas* (female ward attendants) at the hospital.

The entire 50-bed facility is being managed with only four sweepers—the same number allocated for the original 31-bed setup. Given its location along a highway, the hospital also faces a heavy influx of patients involved in road accidents. There is no orthopedics specialist.

The ultrasonography machine is broken, and there is no doctor available to operate it. Although the facility—comprising a 50-bed hospital and 10 union sub-centers—is sanctioned for 43 staff positions (including 10 for the sub-centers and 12 for consultants), only 13 doctors are currently present. Of these, three are on deputation elsewhere. There is a requirement for 35 Class III employees, but only 22 are employed, leaving 13 positions vacant. No positions for Class IV employees have ever been created for this 50-bed hospital.

The facility currently operates under the framework of a 31-bed hospital; out of 21 sanctioned positions, only 13 are filled, leaving 8 vacant. In 2016, the current government appointed several doctors, including an orthopedics specialist. However, the appointee—Dr. Md. Monirul Islam (from the 30th BCS batch)—has been working at Dinajpur General Hospital on “deputation” ever since he joined, reportedly to access better facilities.

Similarly, Dr. Md. Mamunur Rashid (a cardiologist from the 32nd BCS batch), who was appointed in January 2024, has been performing his duties at Dinajpur Medical College Hospital via “attachment” ever since he joined the Upazila hospital. They continue to draw their salaries solely from the Birganj Health Complex. Regarding this situation, Abdur Rashid, from Jhaljhali village in Palashbari Union, stated, “I admitted my father early this morning due to respiratory distress, but because there is no doctor available, he is being denied proper medical care. Now, I have to take him to Dinajpur Medical College Hospital.” Shahinur Rahman, from Bholanathpur village in Bhognagar Union, shared, “My wife was admitted for a normal delivery.”

“The baby has not been born yet, and my wife is in great distress. We may soon have to take her to a private clinic in Birganj town for a Caesarean section.” Resident Medical Officer Dr. Harun-or-Rashid noted, “Previously, we used to see 200 to 250 patients in the outpatient department.” “Because the hospital is located along a highway, we now see 400 to 500 patients daily. While the inpatient department used to accommodate 40 to 50 patients, there are now consistently 70 to 80 patients admitted to this 50-bed hospital.” This has led to a shortage of hospital beds for patients.

Most of the patients are suffering from diarrhea, pneumonia, or respiratory issues such as asthma. Additionally, there are patients admitted due to various other causes, including road accidents. Dr. Afroz Sultana Luna, the Upazila Health and Family Planning Officer, stated that the operation theater (OT) is in good working condition. However, the ultrasonography machine is currently out of order.