That the doctors skip postings at government hospitals in rural areas is an old piece of news. Doctors are not solely to blame, medicines and medical equipment are also in short supply in those state-owned facilities. What the residents of an Upazila usually see is a concrete structure called Upazila Health Complex (UHC) that can hardly satisfy their medical needs.
Newly appointed Health Minister Dr. Samanta Lal Sen, who has already set his eyes on some major problems of the health sector, like some of his predecessors lamented the unavailability of doctors in rural government health facilities. Dr. Sen however sounded a bit different from others. He is, seemingly, trying to see two sides of the same coin --- problems the rural people face due to the unavailability of qualified doctors in UHCs and factors that discourage the government doctors from coming to rural hospitals and clinics.
Undeniably, remote rural areas do not have the facilities available in major urban centres. But the situation is now not as bad as it was 10 to 15 years back. In rural hats and bazaars, almost all items of modern living are available. Access to electricity and dish TV service is also there. More importantly, reaching even remote destinations by road within a short time is not very difficult these days because of a notable improvement in road network across the country.
When government doctors, usually junior and mid-level medical professionals, are found reluctant to stay in remote rural areas, officials of other public departments have been working for decades without venting much dissatisfaction. It is not that these officials do not try to stay in major urban centres, primarily in Dhaka, but that has not been a big issue for the government. Besides, many registered junior non-government doctors are doing private practice at the upazila and union levels.
Why blame the junior or middle-level doctors? They are following in the footsteps of their seniors, who use everything at their command to get transfer orders cancelled. Senior and specialist doctors are, as per government rules, transferred to district or medical college hospitals. When such transfers are made, high officials at the Health Ministry and Directorate General of Health Services (DGHS) come under tremendous pressure to cancel those. All connections, political or otherwise, are used for the purpose. Some come out successful in their bid and some others move out only to stage a comeback after a few months. These doctors are hardly found at their duty stations and stay in Dhaka most of the time. There is hardly any monitoring by the DGHS. The money the senior government doctors earn through private practice acts as a major incentive for making all-out efforts to remain in Dhaka and other major cities in particular.
The health minister told an event held in Dhaka on Tuesday that he was trying to find appropriate incentives that could motivate the government doctors to stay in rural areas.
Dr Sen would be doing a great service to the rural people and also to doctors employed at thana and union-level government health facilities by ensuring an adequate supply of medicines and diagnostic services. The unavailability of medicines, diagnostic facilities and ambulance service, on most occasions, gives rise to frustration among the rural people and on-duty doctors as well.
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