Seven-year-old Sifad Zaman Ayan had two eye conditions that required treatment: a squint in his left eye and a drooping right eyelid.
His father, Kamruzzaman Bachchu, looked into treatment options in Bangladesh before deciding to take him to Chennai.
The family spent around Tk2 lakh on the entire 12-day trip to Sankara Nethralaya, including surgery, airfare, accommodation and meals.
Bachchu said the treatment would have cost more than Tk3 lakh in Bangladesh, but money was not his main concern.
He had been told that the chances of success were uncertain, and he was unwilling to take that risk with his son’s eyesight.
“We simply did not want to take any risks,” he told Dhaka Tribune. For Bachchu, the decision was about confidence in the treatment.
For thousands of other Bangladeshis seeking medical care overseas, the reasons are often similar: doubts about diagnoses, repeated tests, expensive procedures and dissatisfaction with the attention they receive from doctors.
The consequences extend beyond individual families.
Bangladesh is losing an estimated $5 billion annually as patients seek treatment abroad, according to a figure cited by Prime Minister Tarique Rahman in July.
Bangladesh Bank data also shows a sharp increase in money transferred overseas for medical treatment through formal banking channels, from $3.4 million in FY2021–22 to $32.7 million in FY2025–26.
The nearly tenfold increase comes after the authorities relaxed restrictions on medical remittances.
The banking figures, however, capture only formal transfers and do not establish the country’s total overseas medical expenditure.
Much of that expenditure is believed to take place through cash payments and informal channels.
Why patients are leaving
Nayan Das turned to India after his wife underwent prolonged infertility treatment under several doctors in Bangladesh without success.
He said doctors in India performed diagnostic tests and laparoscopic surgery to address blockages affecting her reproductive system. His wife subsequently conceived.
According to Nayan, the treatment available in India was less expensive and involved fewer risks than the options the couple had explored in Bangladesh.
Another parent, identified by the pseudonym Sukanta, travelled to Chennai after consulting two paediatricians at a hospital on Green Road in Dhaka about his child’s suspected epilepsy.
He said the difference was not simply the medical equipment or medicines available.
In Dhaka, he felt doctors were prescribing medicines without listening carefully to the child’s history.
In Chennai, he said, several physicians spent 30 to 40 minutes examining the child, asking about symptoms and family medical history.
His son, Sourajoy, is now healthy, he said.
These are individual accounts rather than independent assessments of the treatment provided in either country.
But they illustrate why some families are willing to spend substantial sums overseas even when treatment may be available at home.
Patients interviewed for this report described repeated diagnostic tests, conflicting results and uncertainty over treatment costs as major sources of frustration.
For those with complicated conditions, the fear of receiving an inaccurate diagnosis can be enough to prompt a journey abroad.
Doctors acknowledge problems, question the exodus
Medical professionals acknowledge weaknesses in the healthcare system but argue that the growing preference for foreign hospitals cannot be explained by poor treatment alone.
Dr Md Zohirul Islam Shakil, secretary general of the Doctors Association of Bangladesh, said unreliable reports from diagnostic centres were a major reason patients lose confidence.
He blamed the proliferation of unauthorised facilities, inadequate equipment and untrained personnel, calling for tighter regulation.
Shakil also acknowledged complaints that doctors spend too little time with patients.
He attributed much of the problem to the absence of an effective referral system, which allows patients with relatively minor illnesses to seek appointments directly with senior specialists.
As a result, popular physicians often have to see large numbers of patients in limited consultation hours.
He proposed a system in which patients first visit primary healthcare providers and are referred to specialists when necessary.
But Shakil also alleged that consultancy agencies promoting foreign hospitals were exploiting dissatisfaction with domestic healthcare and persuading patients to travel abroad unnecessarily.
Dr Habibur Rahman Sohag, associated with the Doctors’ Movement for Justice, raised similar concerns.
He said foreign hospitals and their local representatives have developed organised systems to attract Bangladeshi patients, helping arrange appointments, medical visa documents and accommodation.
Such services may make overseas treatment easier to access, but Sohag argued that commercial promotion can also create the impression that quality treatment is unavailable in Bangladesh.
The system with achievements, shortcomings
Sohag said Bangladesh’s medical achievements were often overlooked in discussions about treatment abroad.
He pointed to improvements in maternal and child health and the availability of complex procedures, including open-heart surgery, kidney transplantation and bone marrow transplantation.
Bangladesh also became the first country recognised by the World Health Organization for eliminating visceral leishmaniasis, or kala-azar, as a public health problem in 2023.
Prof Dr Md Zahid Raihan, additional director general (administration) of the Directorate General of Health Services, said the country was increasingly capable of providing advanced medical care.
He acknowledged shortcomings but said some patients travelled abroad because of personal preferences, while others were influenced by intermediaries working with foreign hospitals.
Raihan alleged that brokers were active even around major public hospitals, referring patients to overseas facilities.
He said health authorities lacked the enforcement powers needed to act directly against such operations and called for stronger intervention by law enforcement agencies.
The allegations against intermediaries have not been independently established in this report.
The cost of lost confidence
Speaking at Dhaka Medical College on July 11, Prime Minister Tarique Rahman questioned why Bangladesh was unable to retain more patients within its healthcare system.
He urged doctors to rebuild public confidence through professional competence, compassionate treatment and greater attention to patients’ needs.
The financial implications are considerable. India has traditionally been a major destination for Bangladeshi patients, but visa difficulties since 2024 have pushed some towards Thailand, Singapore and other countries where treatment and travel can be substantially more expensive.
The higher costs have placed additional pressure on families already paying for medical care from savings or borrowed money.
Doctors argue that Bangladesh has the expertise to treat many conditions for which patients travel abroad.
Patients, meanwhile, describe experiences that have left them reluctant to depend on that expertise.
The gap between the two is not one that can be closed simply by building more hospitals.
For families such as Ayan’s, the decision comes down to a question they consider more important than the cost: where do they feel confident placing a loved one’s life in a doctor’s hands?
