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10 Dec 2015   05:50:02 PM   Thursday BdST A- A A+ Print this E-mail this

Many public hospitals lie moribund, cry for a cure

Moslem Uddin Ahmed
 Many public hospitals lie  moribund, cry for a cure

For no successful cure for a critical patient or a surgical trailblazing work did a hospital in Kishoreganj just make headlines and hit editorial. Only building, little healthcare facilities, is the stuff that made news. This is only a cross-section of condition of healthcare across the country.

As if to give a bit larger view, soon another piece of news told a similar tale of a Patuakhali hospital: hardly any necessary medicine, few truant medicos, rare care of the sort ailing people need. 

In the Patukhali general hospital report it is alleged that the number of doctors is inadequate, and many of them are busy running their own chambers or private clinics banking on the government health facility in all respects. There are machines bought with huge public funds but no skilled manpower to operate the equipment. Patients are forced to depend on private diagnostic centres for disease investigations. In another major irregularity, there is `certificate business’. Certificates are given for Tk 500 to far higher figures in proportion to the nature of cases in which these medical documents are used.       

About the dysfunctional Itna hospital a hard fact is laid bare that only luck decides life or death of a critically injured person or a patient of heart attack as it takes over three hours to reach district headquarters from the backwater area by boat and over an hour if a bus is available. 

“It is unfortunate that pregnant mothers have to face lengthy travel to district headquarters for safe delivery. More serious patients with injuries or having cardiovascular complications may not survive that journey but have no choice...,” the newspaper editorial says. 

Yet the public pay for such healthcare colossi.

These two, however, stand out as case studies of the situation in other areas of the country. Hospitals and healthcare in most other parts of the country’s rural areas, in particular, give no better news either.   

In October, an elderly person otherwise active in his family affairs in a Rajshahi village complained of chest complications in the morning, and he was taken to the best public medical facility in the division by a microbus. Family members said he was in his senses all the way and even after admission. There were tests given and done. But he succumbed to what physicians said to cardiac arrest. During the fairly long time, he had not reportedly received the right treatment a cardiac patient needs in such emergency. 

There have been myriad other cases of patients reported dead in the way from a village to a district hospital or medical college. Why then the UZ hospitals, some of them fairly big and upgraded? Such questions are being raised by analysts in the field—definitely not out of any ill motive but good intensions meant for much-cherished improvement.                   

And pregnant women whose families can afford move to the district headquarters, too, for safe childbirth despite the fact that there are health complexes in all upazila headquarters for which huge amounts of taxpayers’ money are spent.

The countryside—for that matter, the country as a whole—is in need of two specialized healthcare facilities for the old. Geriatric and palliative medical facilities are of utmost need for the ageing and aged people, euphemistically called senior citizens.            

Poverty alleviation, education and healthcare are the three focal points in the newly adopted UN-designated Sustainable Development Goals for humanity. The government, of course, has attached due importance to this lifesaving and life-soothing sector. The prime minister has sent in strong messages for the physicians as regards their stay in rural stations and dispensing sincere services to the ailing people. The health minister, another senior political person, seems not to have any dearth of drive for bringing about desired improvements in health sector.

But what appears to be lacking is moving the entire medical administration—the ministry people, the Bangladesh Medical and Dental Council, the civil surgeon offices and the hospital supers—for effective monitoring and enforcement of the laws, directives and measures for real improvements on the ground in proportion to whatever level of health budget is being allocated.

People who have firsthand knowledge of the ground situation, however, claim that the scenario in the capital was taking a turn for the better following health minister Mohammad Nasim’s initiative engaging elite-force RAB in clampdowns on mushrooming health-diagnostic centres and rackets of churning out substandard medicines. Such drives also ought to be in place across the country.

Apart from quality of medicines and medical treatments, experts have also stressed price control on drugs and medical tests, as prices of medicines—both local and imported ones—as well as diagnosis charges are going beyond the affordability of even middle-class people, not to speak of the common multitudes. One that undergoes bypass surgery or stenting following angiogram and, fortunately, gets a new lease of life, by spending a few hundred thousand of taka has to remain on medicine lifelong. Several thousand taka, on average, is needed every month for drugs, special diets and periodical checkups. How many can survive this way when their incomes fall and medical bills rise?  

Allegations are rife that medical multinationals, drug cartels and various associations and trade unions have their hand behind making healthcare increasingly costlier along commercial lines in Bangladesh—a country whose constitution still bears ‘socialism’ or social justice as one of the four fundamental principles. Social thinkers feel that there should be a holistic approach to the problems long prevailing and newly arising in this vital sector.

Trust deficit in this field related to life and death itself is a fatal malaise that forces those who are well-off and others who can manage millions somehow to go abroad for treatment and diagnosis to their satisfaction. Con-trick is another evil which is also not foreign to this sector even.

A report based on 2011 findings says some 150,000 patients, particularly from the affluent section of society, go abroad for treatment every year for lack of sophisticated healthcare facilities in the country, causing huge financial losses.

Another report of the same year says some 500,000 people visit India alone annually, and 25 per cent of them go for medical treatments, particularly in Bangalore and Kolkata. But the latest counts of people going abroad must jump over a million and the foreign exchanges spent run into billion.

Of late, however, there have been reported a number of success stories in the country’s medical sector. Some brilliant physicians are also coming up, doing some critical surgeries and treatments. Medicos are not life-givers, but life-keepers for sure. That’s--and should be--the guiding spirit in service to humanity. A quantum leap is possible, if only conditions are made conducive.                                                                                            

This story was written by the writer on Nov 20, 2015 and originally published in the News Today.









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