Taking advantage of the deliberate oversight by the monitoring authorities, unscrupulous medicine dealers are active within hospitals and clinics and selling date-expired life-saving drugs, according officials sources.

The drug administration officials said they are too poorly manned and equipped to take action against these "criminal acts." Most private hospitals and clinics run in-house pharmacies without any permission whatsoever, they said.

People seeking treatment at the private hospitals said the findings of date-expired drugs and blood bags by the mobile courts have created alarm in the public minds.

"Nurses and doctors administer all required drugs to the patients admitted to hospitals where there is hardly any scope for the relatives to check whether the drugs are valid or date-expired," said Shamsul Bari, a businessman who was visiting his sister admitted to Bangladesh Medical College Hospital in Dhanmondi on Friday.

"We are really helpless, and personally my faith in the country's healthcare system that runs without any monitoring, is waning fast," Bari said.

The Director General (DG) of the Directorate of Health Services (DG Health) Professor Mohammad Shahadat Hossain termed the situation alarming and said the anomalies are occurring in the absence of effective supervision for a long time.

"There is no denying that date-expired drugs are sold at hospital drug stores and sometimes they tamper with the dates and inscribe a valid date on the expired medicines to cheat the public," the DG admitted.

The director of Drug Administration, another body to monitor drug trade, Professor Mohammad Habibur Rahman said that all drug stores within hospital premises or elsewhere must obtain licence before selling drugs. "Selling date-expired drugs is a punishable offence but the Drug Administration cannot mete out punishment on the culprits. All we can do is to file a case with the drug court and wait for years to know the results," Dr Rahman said.

A drug store must separate the date-expired drugs in a clearly marked pack. Pharmacists must not put expired drugs on display for sale, Rahman said.

A drug store must have a qualified pharmacist and be well-equipped with storage facilities particularly for vaccines and hormones that need proper chilling storage.

In absence of any acceptable supervision mechanism of the Directorate of Health Services, private hospitals, diagnostic centres, pathological laboratories, blood transfusion centres and radiological centres have mushroomed around the city.

"I agree that many of these medical establishments have been set up without obtaining licence and registration from the government, and many who have obtained registration, do not bother to renew their licences as per requirement," said the DG Health.

As per existing health service rules, hospitals and clinics must be service-oriented, he said. "But we all know what the reality is."

Recently, mobile courts have found a good number of city's self-proclaimed outstanding private hospitals running unlicensed drug stores, selling date-expired drugs, operating unlicensed blood banks and dealing with contaminated blood and using date-expired reagents for pathological tests.

"No doubt, the situation is alarming," said the magistrate of a mobile court Narayan Chandra Debnath, who has recently conducted a number of random drives and fined some well-known private hospitals and diagnostic centres in the city on various charges.

The mobile court of Debnath fined three well-known private hospitals Tk 50,000 in the city on July 31 for using date-expired medicines and reagents and for not maintaining hygiene in pathological laboratories.

The court raided Bangladesh Medical College Hospital, Central Hospital and LabAid Cardiac Hospital on Green Road.

The court comprising DCC representatives and a 12-member BDR and a 20-member police force, found all three hospitals using date-expired drugs and pathological testing reagents. Conditions inside the labs were unhygienic.

The court realised Tk 20,000 each from Bangladesh Medical College Hospital and Central Hospital and Tk 10,000 from LabAid on the spot.

The court fined Gastroliver Hospital and Research Institute on Green Road Tk 60,000 on August 28 for keeping date-expired drugs and failing to show trade licence.

Debnath's court fined Ekram Hossain Biplob, owner of Mahanagar Diagnostic Centre on Mirpur road, Tk 30,000 as he failed to show a licence. The manager of the same diagnostic centre had been fined Tk 50,000 just five days ago on similar charges.

The court of magistrate M Abdul Jalil on August 29 fined Samorita Hospital at Panthapath Tk 30,000 for using a chemical bearing no expiry date for medical tests.

The mobile court of magistrate AKM Tariqul Alam on April 6 seized expired drugs and faulty medical equipment from Millennium Heart and General Hospital in Lalmatia and arrested five employees including a doctor.

Magistrate Saiful Islam on the same day fined Joya Maternity and Pathology Laboratory Ltd at Mirpur Section-1 Tk 40,000 for not having full time doctors and nurses with proper qualification.

The court of magistrate Tapan Kumar Biswas fined Life Line Urology Centre and Millennium Diagnostic Centre in Green Road Tk 55,000 for failing to ensure hygiene and employing unskilled laboratory workers.

Director of the Drug Administration said with only 29 drug superintendents to monitor around 100,000 drug stores across the country he feels helpless. "Drug Administration has no transportation facility other than a vehicle for the director alone," Rahman said.

"I will be removed or face political pressure in case I go for drastic action against unauthorised drug stores," said Prof Rahman. "Now, how can you expect us to streamline the huge irregularities in the sector."

Director of Central Hospital Dr MA Kashem admitted lapses in his hospital in maintaining the drug store. "Usually we throw away date-expired drugs on the 25th day of every month but on the day the mobile court arrived we forgot to do it," Kashem said.

According to rules, pharmaceutical companies have to withdraw and destroy the date-expired drugs on request by the pharmacy operators. But according to Dr Kashem the pharmaceutical companies never come to collect these date-expired medicines despite their requests.

Adviser (Administration) of LabAid Hospital Brigadier General Monjur A Mollah said, "Actually the court found a date-expired disposable medical equipment for which it fined the hospital." Asked how the same incident could occur, as previously another mobile court slapped a token fine of Tk 1 on the hospital for using a date-expired chemical within its operation theatre (OT), Mollah replied, "This may happen mistakenly."

Managing Director of Samorita Hospital Dr ABM Harun said, "The date-expired chemicals that the court took to be reagent for medical test was actually a slide cleaner."