A Daily Star investigation reveals that doctors at the biggest public hospital in the country are reluctant to perform less expensive normal delivery, and instead go for caesarean section that multiplies the cost. In addition, a section of the hospital staff and employees are engaged in pilfering drugs and medical accessories and the patients are forced to buy these. This adds substantial amounts of 'hidden cost' to the expenses for childbirth.

A normal delivery at the hospital now costs roughly Tk 2,500 on average, including payments for drugs. Delivery through caesarean section costs between Tk 5,000 and Tk 10,000.

Eighty percent of the patients, spoken to by The Daily Star, who had come to the DMCH Gynaecology and Obstetrics department for delivery, complained they are compelled to spend much beyond their expectation. Most of the patients are poor, and they come to the public hospital since it is supposed to provide treatment free of cost.

According to sources, a section of ward boys, nurses and doctors at the department are involved in pilfering drugs and other related items of patients, which are sold back to the same pharmacies that had earlier sold them. A number of brokers are allegedly engaged in the process.

Plainclothesmen recently arrested one of the brokers, Mobarak Hossain, from his house close to the hospital. He had allegedly stockpiled 29 categories of medicines worth about Tk 50,000. Detective Branch (DB) police quizzed him to learn that for the last 25 years he was buying at very low prices medicines mostly required for surgical interventions from various departments at the hospital.

He admitted that more than 10 brokers are engaged in such illegal purchase of medicines.

Roni Begum, 25, from Mahakhali Sattala slum was admitted to maternity ward -2 at the hospital recently. Half an hour into her admission, the attending doctors asked her husband Arif, a rickshawpuller, to bring a number of drugs and medical accessories for caesarean section.

Doctors who had examined her prior to her admission to the DMCH had said she would have a normal delivery.

Arif failed to pay for the cost of the drugs and accessories and took his wife back home about two hours later. She gave birth to a baby within half an hour of returning home.

"We are very poor and we come to the hospital (DMCH) for less expensive delivery. But I have seen many other attendants of patients being asked to buy costly drugs," Arif said.

Rahela Akter, 22, had come to the hospital from Singair, Manikganj. The attending doctors gave her husband a list of drugs and medical accessories worth about Tk 9,000. But earlier she was told that she would have a normal delivery.

Rahel's attendants expressed their inability to pay for a cesarean section and doctors later asked them to buy drugs worth about Tk 1,900.

A broker at the hospital offered loan to Rahela's husband Fazal Huq, a rickshawpuller. "I was asked to give a guarantee to pay him back to get the loan at a very high interest. Initially, I borrowed Tk 4,000 and then more," Fazlul said.

Kalpana Begum, 20, from Shanirakha also narrated similar experience. "We had no idea delivery at the public hospital will cost us so much. We also borrowed money at a very high rate of interest," said Md Monir, Kalpana's husband.

A common sight at the maternity section is worried attendants of patients rushing to the nearest pharmacies to buy medicines and other things the doctors say are urgently needed.

"The attendants hardly know that about half of the items are later pilfered," one source said.

A number of pharmacies located at nearby Chankhar Pool area offer drugs and medical accessories even on credit to poor patients at much higher rates.

On caesarean section, doctors said however they opt for such costly surgeries only when normal delivery involves risks.

They also denied allegations of pilferage of drugs and other things. "It is not true that a section of doctors and nurses here are linked to pilfering drugs from patients," said a senior doctor.

"We have a poor fund to help extremely poor patients in cases of surgery," she said.