Common people bear brunt of poor healthcare in Bangladesh
Saturday, 20 October 2007
Ayesha-E-Fahmida Khatun
Sumona Islam, 30, started seeing doctors after she failed to conceive for six years after her marriage. Her husband, a banker based in her hometown Barisal, took frequent leave to take her to Dhaka for medical checkup. Despite seeing many doctors, Sumona is still childless.
``I've been a regular visitor here for quite some time. I've a feeling that the doctors here are not sincere. They don't always listen to my problem," says Sumona, a schoolteacher. ``I come here from Barisal. But I can't always see a doctor."
Such complaints against doctors in Bangladesh are no exception. Many patients like Sumona grumble that even though the doctors are professionally efficient they don't take enough care of them. The alleged lack of care is seen not only in state-run hospitals, private hospitals or clinics are also not what they promise with regard to services.
Private clinics are expected to offer better services since treatment is expensive there. So, it hurts the patients more when they do not get good services at private clinics.
Local media often publish reports detailing how corruption and negligence have plagued many hospitals in the country. In 2003 a leading Bengali daily in Dhaka carried reports on alleged corruption and wastage of public money in two hospitals run by Dhaka City Corporation.
An emergency section at one of the hospitals was being used to cook food for a wedding party, the report said. Doctors were found performing stomach washing of patients with dirty water. Patients have suffered extra blows, as surgeries on them were not successful because doctors left medical equipment inside the patients' bodies. Reports of wrong treatment have been in plenty. A doctor in Khulna has recently been arrested for attempting to rape a female patient.
The health ministry has launched a programme to help doctors improve their behaviour towards patients. Known as Behavioural Change Communication or BCC, the programme focuses on how doctors should behave with patients. It recognises that doctors' attitude plays a vital role in mitigating sufferings of patients. Good behaviour can work as medicine for patients. The BCC programme covers civil surgeons, registrars, indoor and outdoor doctors. It is still not clear how this programme has improved doctors' overall attitude to patients.
Consider Yasmin Sultana who went to a private clinic in Dhaka's Eskaton for her first delivery. Nurses were about to slap her as she screamed in pain. Sulatana's mother Zohra Begum wonders, "How could nurses behave like this unless they get indulgence from the authorities."
National leaders often urge doctors to behave well with their patients. Even doctors admit that they are not always perfect. At a conference organised by Bangladesh Society of Medicine, some specialist doctors resorted to self-criticism. The conference was told that lack of proper behaviour by doctors in Bangladesh is driving many patients abroad, especially neighbouring India. A media report recently mentioned that thousands of Bangladeshis travel to India for medical treatment every year and spent up to 1,200 crore takas.
A World Bank report in 2004 found that 74 per cent of doctors remain absent in primary health complexes, their work place. The rate of absence is 40 per cent in urban areas. On the other hand 40 percent posts for doctors are lying vacant.
Bangladesh Medical and Dental Council is the body responsible to deal with professional allegations against doctors and take punitive actions. The council has taken punitive actions against only two doctors in the past three decades.
Says J.H. Basunia, Registrar at BMDC: "There are complications. Many complaints can't be heard properly for lack of proper address, names of patients. In many cases the victims don't press the allegations and so we can't do anything."
According to BMDC, there are 38,674 registered doctors in the country. BMDC has a five-member discipline committee, which hears the allegations. A doctor can lose his registration if found guilty.
Says Basunia, "There are certain requirements before we can start proceedings against a doctor. The complaint must be written with duly signed by the plaintiff with his/her full address. The plaintiff must mention whether he/she personally knows about the allegations, the sources of the allegations and whether he/she thought the allegations are credible. Or else we don't accept any complaint."
A survey has revealed that only 22 per cent of the country's population get the health services provided by the government. This figure should increase to 60 per cent with proper utilisation of the available resources. Bangladesh has at least 86,000 people working in health administration and services sector; thirty-one per cent of the health manpower are at field-level. There are more than 26,000 health inspectors, including their deputies.
The government has allocated Tk. 3,732 crores in the health sector for fiscal year 2004-5. Yet, Bangladeshis do not get proper healthcare. Those who can afford travel to Thailand, Singapore or India, they go there for better treatment and the poor suffer here.
— NewsNetwork
Sumona Islam, 30, started seeing doctors after she failed to conceive for six years after her marriage. Her husband, a banker based in her hometown Barisal, took frequent leave to take her to Dhaka for medical checkup. Despite seeing many doctors, Sumona is still childless.
``I've been a regular visitor here for quite some time. I've a feeling that the doctors here are not sincere. They don't always listen to my problem," says Sumona, a schoolteacher. ``I come here from Barisal. But I can't always see a doctor."
Such complaints against doctors in Bangladesh are no exception. Many patients like Sumona grumble that even though the doctors are professionally efficient they don't take enough care of them. The alleged lack of care is seen not only in state-run hospitals, private hospitals or clinics are also not what they promise with regard to services.
Private clinics are expected to offer better services since treatment is expensive there. So, it hurts the patients more when they do not get good services at private clinics.
Local media often publish reports detailing how corruption and negligence have plagued many hospitals in the country. In 2003 a leading Bengali daily in Dhaka carried reports on alleged corruption and wastage of public money in two hospitals run by Dhaka City Corporation.
An emergency section at one of the hospitals was being used to cook food for a wedding party, the report said. Doctors were found performing stomach washing of patients with dirty water. Patients have suffered extra blows, as surgeries on them were not successful because doctors left medical equipment inside the patients' bodies. Reports of wrong treatment have been in plenty. A doctor in Khulna has recently been arrested for attempting to rape a female patient.
The health ministry has launched a programme to help doctors improve their behaviour towards patients. Known as Behavioural Change Communication or BCC, the programme focuses on how doctors should behave with patients. It recognises that doctors' attitude plays a vital role in mitigating sufferings of patients. Good behaviour can work as medicine for patients. The BCC programme covers civil surgeons, registrars, indoor and outdoor doctors. It is still not clear how this programme has improved doctors' overall attitude to patients.
Consider Yasmin Sultana who went to a private clinic in Dhaka's Eskaton for her first delivery. Nurses were about to slap her as she screamed in pain. Sulatana's mother Zohra Begum wonders, "How could nurses behave like this unless they get indulgence from the authorities."
National leaders often urge doctors to behave well with their patients. Even doctors admit that they are not always perfect. At a conference organised by Bangladesh Society of Medicine, some specialist doctors resorted to self-criticism. The conference was told that lack of proper behaviour by doctors in Bangladesh is driving many patients abroad, especially neighbouring India. A media report recently mentioned that thousands of Bangladeshis travel to India for medical treatment every year and spent up to 1,200 crore takas.
A World Bank report in 2004 found that 74 per cent of doctors remain absent in primary health complexes, their work place. The rate of absence is 40 per cent in urban areas. On the other hand 40 percent posts for doctors are lying vacant.
Bangladesh Medical and Dental Council is the body responsible to deal with professional allegations against doctors and take punitive actions. The council has taken punitive actions against only two doctors in the past three decades.
Says J.H. Basunia, Registrar at BMDC: "There are complications. Many complaints can't be heard properly for lack of proper address, names of patients. In many cases the victims don't press the allegations and so we can't do anything."
According to BMDC, there are 38,674 registered doctors in the country. BMDC has a five-member discipline committee, which hears the allegations. A doctor can lose his registration if found guilty.
Says Basunia, "There are certain requirements before we can start proceedings against a doctor. The complaint must be written with duly signed by the plaintiff with his/her full address. The plaintiff must mention whether he/she personally knows about the allegations, the sources of the allegations and whether he/she thought the allegations are credible. Or else we don't accept any complaint."
A survey has revealed that only 22 per cent of the country's population get the health services provided by the government. This figure should increase to 60 per cent with proper utilisation of the available resources. Bangladesh has at least 86,000 people working in health administration and services sector; thirty-one per cent of the health manpower are at field-level. There are more than 26,000 health inspectors, including their deputies.
The government has allocated Tk. 3,732 crores in the health sector for fiscal year 2004-5. Yet, Bangladeshis do not get proper healthcare. Those who can afford travel to Thailand, Singapore or India, they go there for better treatment and the poor suffer here.
— NewsNetwork