Why our health sector is not doing what it should
Covid-19 has stunned the whole world like nothing else in recent memory. From the most developed to the least developed countries, every single country is going through this hardship.
Bangladesh’s health sector has been under criticism for long. But now, the coronavirus has exposed its actual status.
The challenges to the health sector are multi-faceted and intractable. Though the authorities concerned are trying to hush some things up, they have not been able to cover up their Achilles heel.
According to DGHS, currently there are 15,728 hospitals and diagnostic centres in Bangladesh. This means, only five institutes are available for every 10,000 people.
The World Health Organization says that at least one doctor is needed for every 1,000 people. There are only 78,300 government-appointed doctors, nurses, and medical practitioners, which is frightfully inadequate for our population.
The budget allocation is too low for our health sector. According to a report conducted by the World Bank, the average expenditure towards the Bangladesh health sector during 2000-17 was only 2.33% of total GDP, with a minimum of 1.99% in 2001 and a maximum of 2.57% in 2017. The government must spend 5% or more on its rapidly increasing population.
If we evaluate the example of another developing country in Asia -- China’s health care spending is expected to account for 6.5-7% of its total GDP in 2020.
Public health experts are saying Bangladesh has emphasized more on developing infrastructure than creating manpower and ensuring quality medical education in the last decade or so.
Even now, we observe the gradual improvement in setting high-flow nasal cannulas, HDU, ICU, etc.
But the number of public health professionals is low. Furthermore, there is still no comprehensive health policy.
The most crucial and alarming challenge is the lack of dynamic and pro-active stewardship. Furthermore, deep levels of corruption are worsening the problem, as laid bare by the recent scandal involving fake Covid reports.
A lack of authority
We have seen the sudden retirement of Director General Dr Abul Kalam Azad on July 21. The Anti-Corruption Commission has already disclosed that his assets are under investigation.
Shahed, Sabrina, and Arif were involved in corruption involving a huge amount of money. But more importantly, they were playing with people’s lives. Where did they get that authority?
DGHS has stopped telecasting the daily health bulletin.
Many have taken this message positively, thinking that the coronavirus threat is gone for good.
Some 60,000 tests daily are necessary to calculate representative data in proportion to the massive number of people. But DGHS has failed to collect that representative data due to a shortage of coronavirus testing.
So, the question is, why has DGHS stopped telecasting the health bulletin? By stopping the health bulletin, facts and figures, and suggestions, isn’t DGHS stopping awareness?
Because of all these things, people are losing faith in the health system.
Anita Medhakor and Md Mahbub Ali had investigated and researched on a field level why Bangladeshi people visited India in large numbers. They witnessed that the treatment policy of Bangladesh was regressing. People were more willing to take treatment from abroad.
According to a report by Bangladesh Investment Development Authority, the treatment cost in India is twice of Bangladesh. India’s Business Standard says India earned Tk3,000 crore from Bangladeshi patients in 2015-16.
In Bangladesh, we have noticed a lack of harmony and coordination from both the Ministry of Health and the DGHS. One is incriminating the other. The failure in providing a curative public health policy combined with mismanagement has proved how fragile and wonky the Bangladeshi health sector is. Coronavirus has proved everything more clearly.
“Cessante causa, cessant effectus” is a medical Latin phrase which means “to cease the cause, the effect must cease.”
To get a fit and competent health sector, no matter what, the rotten apples should be kicked out, even if they are in the upper echelon of power.
A revolutionary change must be brought about today or tomorrow.
Nadim Zawad Akil is a law student, North South University. He can be reached at [email protected]