Emotion has strange ways of expressing itself; we cry when we are sad or hurt, laugh when happy, and so on. But, often, we express our emotions with contrasting outbursts: In fear, we act strong, we cry in victory, we laugh hysterically when all hopes crumble …
The death of 32 patients on February 10 at the Sylhet MAG Osmani Medical College and Hospital left us numb with shock. It’s understandable that in any hospital, the life-death balance is 50-50. But the nation was left dumbstruck at the response of the hospital management and physicians during the crisis. The deliberate ignorance of the hospital authority which resulted in the deaths is actually a syndrome, affecting the whole healthcare system.
This is neither the first nor the last incident of such monumental callousness. The problem is, we experience the trauma and then we forget about it. So, nothing changes.
While Bangladesh has made phenomenal progress in health and development over most of our neighbouring countries in last 25 to 30 years, we are still plagued by glaring failures. Lack of adequately skilled medical attendants is one of the prime reasons for inconsistencies in our healthcare system. Still today, in a country of 160 million people, only four hospital beds are available for every 10,000 with one doctor for every 2,800 persons.
There are around 39,000 doctors, 15,500 nurses, and 1,700 hospitals including 678 government facilities in the country. Not surprisingly, 85% of births in Bangladesh still continue to take place at home, 80% of childbirths are managed by unskilled attendants who can neither recognise related complications nor provide effective interventions.
An absence of a revamped policy and failure to ensure quality medication are the main challenges. Food adulteration, indiscriminate usage of chemical fertilisers and hormones in crops, fruits, and vegetables place us in a vulnerable position. As the state of healthcare in the entire country suffers, commercial Dhaka-centric healthcare facilities without consistent service quality have started mushrooming.
Let me share one of my recent experiences: A person close to me had to take dental treatment in one of the city hospitals, widely extolled for top-class service. After a few days of treatment, he started to feel weak. Local doctors, following a protracted check, identified infections in his liver and asked him to be hospitalised immediately. Luckily, he was supposed to go to a mission in another country at that time, so he decided to get a second opinion in a foreign hospital. It was Hepatitis C and further examinations discovered that he got the infection when he was being treated in the local hospital.
Every day, such in-hospital infections get to patients. This is just the tip of the iceberg!
One of the key pillars for any healthcare system is flawless diagnostics and there is no shame in accepting the fact that lack of proper diagnostic services is one of our major challenges, making effective treatment difficult.
There is a common joke regarding our diagnostic services. A man got a urine test done as part of his regular health check-up; and his report confirmed his “positive” pregnancy. The problem with Bangladesh is that we are inured to the loss of human lives, be it from some accident, natural disaster, or medical condition.
On an average, 20 people die and many more become victims of fatal road accidents every day. For the road accident victims outside the capital, most divisional hospitals don’t have the basic facilities. When injuries are serious, they need to be transferred to Dhaka.
Bangladesh has been growing at 6% GDP per year for the last 25 years, harbouring an ambition of joining the developed economy club soon. But higher economic development requires reliability of medical services. The blunt fact is we don’t have that yet.
But it’s never too late. Like any other system, we need a management team as administrators and appropriate tools/instruments including, hospital facilities, modern diagnostic technologies, trained nurses and physicians, plus appropriate motivation for the entire system to work well. To make this system work, we need an up-to-date policy.
It’s also difficult to ignore that all eminent politicians, bureaucrats, academics, celebrities, businessmen -- whoever has the money that is -- are going to foreign hospitals for their child birth, immunisation, even regular health check-ups, relying only on foreign medicines. They know what is needed, but promises have not translated into action. As long as they are in good shape, the worry is for the common people. But this apathy can hardly take us on a road to economic ascendancy.
A comprehensive plan for this struggling health care system should be considered as one of the top priorities for the country. Beyond any politics and business, a reliable healthcare system and private medical institutions that put service before profit are a must.