Causes of outbound medical tourism from Bangladesh
Sunday, 9 September 2012
Muhammad Mahboob Ali in the first of his two-part article on medical tourism
Health care ought to be one of the basic privileges of the citizens of any country. Population density in Bangladesh is 990 persons per/sq kilometer. Unfortunately medical treatment is not easily available in Bangladesh for which each year a considerable section of patients undertake medical tourism abroad. Medical tourism is a term involving people who travel to a different place to receive treatment, seeking reasonable costs but higher quality of care, better access to care than they could receive at home.
The marginalised people of rural as well as slum dwellers of the urban areas are treated in a highly discriminatory nature as regards access to health care services. Even the lower middle class and the middle class do not get proper treatment facilities. On the other hand, the affluent sections of the people do not rely on health care personnel including doctors and nurses. Only in case of emergency when there is no other alternative, they take treatment in the country. Otherwise the affluent people, even for minor sickness fly abroad to meet health care needs.
Medical Tourism is one of the fastest growing healthcare industries. The world is in a healthcare crisis, given the ageing population, increasing costs and long waiting patients from developed as well as developing countries. Streams of people now quite often travel abroad with the objective of obtaining immediate health care.
Outbound medical tourism to different countries from Bangladesh has been taking place due to inefficient human resources in health care management industry. Low quality or absence of health care in the country is forcing patients to travel abroad. Thus the country is losing huge amount of foreign exchange.
The reasons for outbound medical tourism are manifold. Currently there are one medical university, twenty four public medical colleges and hospitals including Unani, Ayurvedic and Homeopathic medical colleges and hospitals throughout the country. Besides, there are around fifty medical colleges and hospitals in the private sector. Recently, some private hospitals were established. But their numbers and the facilities they are able to offer are too inadequate to meet the growing demands.
Health policies and strategies are not working properly. In fact health sector of Bangladesh is characterised by lack of facilities, lack of skilled manpower and physical infrastructure. Corruption in health management, high costs of treatment, politics among the health service providers are also contributing to the already ailing sector. Measures for emergency response are almost nil, organisational behaviour and managerial capability obsolete. Community action has not properly developed while research activities in the health sector are also very poor.
The share of GOB in the Health, Nutrition and Population Sector Programme (HNPSP) is 38 per cent and that of development partners 62 per cent. In the 2011-12 budget, only 5.4 per cent has been allocated to the health sector-- the annual per capita allocation in healthcare is only Tk 590, which is not sufficient for attaining the MDG as well as Vision-2021 targets of the present government.
The Financial Express report on June 10, 2012 observes that a section of unscrupulous hospital staff realises money from helpless patients either for providing them a trolley or allotment of a hospital seat. In some hospitals, it is alleged that middlemen (dalal) allure patients to go to private clinics promising them better treatment. A section of doctors and hospital staff are also reportedly involved in such malpractices. Moreover, medicines supplied to the public hospitals find their way into the outside shops for sale. These have been continuing over the years unabated. Alleged wrong treatment and ill behaviour from the doctors, nurses and other support staff have further added to the misery of the ordinary patients.
Given the state of affairs, in particular the growing need for healthcare and the severe lack of facilities, investors in the private hospitals, nursing homes and diagnostic centers consider this sector as a source for quick money. Though there are some good hospitals in private sector, these are too expensive and beyond the reach of common people.
The situation reflects a pitiable condition of the health sector as regards doctor-patient ratio, or nurse-patient ratio, or physician per nurse ratio, or population per bed.
It is this precarious situation that has largely prompted the rise of outbound medical tourism in the country. Physicians and nurses, biotechnologists and other staff are not providing desirable services to the patients. Besides, the diagnostic centers have not been able to earn confidence of the service seekers. The fees charged at the diagnostic centers are also much higher than they should have been.
Improved technologies and expert services in target countries have played a pivotal role in the expansion of medical tourism from Bangladesh.
The target country is determined depending on income of the individual and nature of diseases. Common destinations for medical tourism from Bangladesh are India, Thailand, Singapore, USA, UK etc. However, common people find India a suitable destination. Outward remittance on account of medical ground amounted to $ 82 million in the period 2008-09 which has increased almost ten times during the preceding ten years. This is merely an official figure. The unofficial figure will surely be much higher.
In view of the dismal state of our healthcare industry and the resultant flow of considerable amount of foreign exchange, it is extremely important that the government should put in its best to take control of the situation. It is true a section of the affluent people will always prefer to travel overseas for better treatment facilities, but there is no reason why a commoner with barely any means to afford treatment abroad should be forced to spend hard earned foreign currency for not-so-critical ailments.
The writer is a Professor and Head, M H School of Business, Presidency University. pipulbd@gmail.com
Health care ought to be one of the basic privileges of the citizens of any country. Population density in Bangladesh is 990 persons per/sq kilometer. Unfortunately medical treatment is not easily available in Bangladesh for which each year a considerable section of patients undertake medical tourism abroad. Medical tourism is a term involving people who travel to a different place to receive treatment, seeking reasonable costs but higher quality of care, better access to care than they could receive at home.
The marginalised people of rural as well as slum dwellers of the urban areas are treated in a highly discriminatory nature as regards access to health care services. Even the lower middle class and the middle class do not get proper treatment facilities. On the other hand, the affluent sections of the people do not rely on health care personnel including doctors and nurses. Only in case of emergency when there is no other alternative, they take treatment in the country. Otherwise the affluent people, even for minor sickness fly abroad to meet health care needs.
Medical Tourism is one of the fastest growing healthcare industries. The world is in a healthcare crisis, given the ageing population, increasing costs and long waiting patients from developed as well as developing countries. Streams of people now quite often travel abroad with the objective of obtaining immediate health care.
Outbound medical tourism to different countries from Bangladesh has been taking place due to inefficient human resources in health care management industry. Low quality or absence of health care in the country is forcing patients to travel abroad. Thus the country is losing huge amount of foreign exchange.
The reasons for outbound medical tourism are manifold. Currently there are one medical university, twenty four public medical colleges and hospitals including Unani, Ayurvedic and Homeopathic medical colleges and hospitals throughout the country. Besides, there are around fifty medical colleges and hospitals in the private sector. Recently, some private hospitals were established. But their numbers and the facilities they are able to offer are too inadequate to meet the growing demands.
Health policies and strategies are not working properly. In fact health sector of Bangladesh is characterised by lack of facilities, lack of skilled manpower and physical infrastructure. Corruption in health management, high costs of treatment, politics among the health service providers are also contributing to the already ailing sector. Measures for emergency response are almost nil, organisational behaviour and managerial capability obsolete. Community action has not properly developed while research activities in the health sector are also very poor.
The share of GOB in the Health, Nutrition and Population Sector Programme (HNPSP) is 38 per cent and that of development partners 62 per cent. In the 2011-12 budget, only 5.4 per cent has been allocated to the health sector-- the annual per capita allocation in healthcare is only Tk 590, which is not sufficient for attaining the MDG as well as Vision-2021 targets of the present government.
The Financial Express report on June 10, 2012 observes that a section of unscrupulous hospital staff realises money from helpless patients either for providing them a trolley or allotment of a hospital seat. In some hospitals, it is alleged that middlemen (dalal) allure patients to go to private clinics promising them better treatment. A section of doctors and hospital staff are also reportedly involved in such malpractices. Moreover, medicines supplied to the public hospitals find their way into the outside shops for sale. These have been continuing over the years unabated. Alleged wrong treatment and ill behaviour from the doctors, nurses and other support staff have further added to the misery of the ordinary patients.
Given the state of affairs, in particular the growing need for healthcare and the severe lack of facilities, investors in the private hospitals, nursing homes and diagnostic centers consider this sector as a source for quick money. Though there are some good hospitals in private sector, these are too expensive and beyond the reach of common people.
The situation reflects a pitiable condition of the health sector as regards doctor-patient ratio, or nurse-patient ratio, or physician per nurse ratio, or population per bed.
It is this precarious situation that has largely prompted the rise of outbound medical tourism in the country. Physicians and nurses, biotechnologists and other staff are not providing desirable services to the patients. Besides, the diagnostic centers have not been able to earn confidence of the service seekers. The fees charged at the diagnostic centers are also much higher than they should have been.
Improved technologies and expert services in target countries have played a pivotal role in the expansion of medical tourism from Bangladesh.
The target country is determined depending on income of the individual and nature of diseases. Common destinations for medical tourism from Bangladesh are India, Thailand, Singapore, USA, UK etc. However, common people find India a suitable destination. Outward remittance on account of medical ground amounted to $ 82 million in the period 2008-09 which has increased almost ten times during the preceding ten years. This is merely an official figure. The unofficial figure will surely be much higher.
In view of the dismal state of our healthcare industry and the resultant flow of considerable amount of foreign exchange, it is extremely important that the government should put in its best to take control of the situation. It is true a section of the affluent people will always prefer to travel overseas for better treatment facilities, but there is no reason why a commoner with barely any means to afford treatment abroad should be forced to spend hard earned foreign currency for not-so-critical ailments.
The writer is a Professor and Head, M H School of Business, Presidency University. pipulbd@gmail.com