Why not a rural medical service cadre?

The Financial Express on August 10 quoted the health minister as advising newly-recruited 6,221 doctors to serve rural people at least for the first two years of their service life with full dedication. Unauthorised absence of on-duty physicians from the government-run rural hospitals is a major challenge to the objective of ensuring the basic health care services to the common people living in remote areas. When doctors are reluctant to stay in villages to render services to the poor and helpless people, health centres like community clinics and union health and family welfare centres are of no use. The MBBS and the specialist doctors are reluctant to serve in the rural areas mostly owing to less opportunity to earn money from private practice.
It is also a matter of concern that students are losing interest in studying science subjects at secondary and higher-secondary levels. After studying in the science group, students at present get very limited opportunities to study further in science-based professional subjects in the country. Setting up of more medical colleges can encourage students to study science subjects at secondary and higher-secondary levels.
To address this practical problem, it is necessary to set up medical colleges in all the new district towns and to create a Rural Medical Service Cadre for the under-graduate qualified doctors like LMF in per-liberation period.
Under-graduate doctors from these institutions should be required to serve in government-run health centres and hospitals in the rural areas. The government should create an adequate number of posts for under-graduate doctors at union and upazila-level public healthcare centres and hospitals. Thus, from the very beginning of their studies, they will be mentally prepared to serve in the rural areas.
After serving in rural areas for certain years, interested under-graduate doctors may be allowed to go abroad with employment. This will open new vistas for jobs and help reduce the existing acute unemployment problem in the country. It will also contribute to foreign exchange earnings of the country and reduce unemployment problem.
In addition to that, medical colleges may be set up at the seven divisional cities for providing graduate-level courses in medical science. This will provide the rural doctors an opportunity to pursue higher studies after completion of a few years of service in the rural areas. These institutions should also impart special courses and training to help doctors upgrade their skills and knowledge.
Bangladesh has enough teachers to impart medical courses at the under-graduate level. It is a great advantage. The government needs to utilise this opportunity.
The government may take up a five-year action plan to establish such medical colleges in new districts in phases to create a rural medical service cadre to serve the rural people. Later the government can set up graduate-level medical colleges in each divisional headquarters to impart higher medical education so that under-graduate doctors can get experience.
Health Minister Mohammad Nasim, who is a veteran politician, should take an initiative to introduce Rural Medical Service Cadre in Bangladesh with better pay and facilities.
mah120cb@yahoo.com