In the early 80s, I had a posting as a medical officer in rural Sylhet. It was very difficult to leave the comfort of Internee Hostel and the familiarity of friendships that I was blessed with over a span of six long years. Yet, when the time came, I parted.
I joined there, at a remote Thana Health Complex. No, none was waiting there to greet a new doctor just out of school. The senior medical officer (administrator of the complex) was nowhere to be found. There was no place to sleep and no desk to sit and work.
It was made abundantly clear that the senior doctor would not mind at all at if I was to be AWOL (absent without leave). I collected a few personal letters from the non-existent office and the left the post of my first employment without even seeing my immediate superior. I was young. My heart was yearning to go back to the city. I did not feel bad for my dereliction. In fact, I was happy.
Now, one-and-a-half score years later as I remember those days, my heart wells up with shame and sadness. Sometimes, I try to understand and explain it. However, I just cannot do so without being shamelessly defensive. And for that, I seek pardon in advance.
Except for a few bright lamps, honest outliers, most of the garden-variety types are nothing but the by-products of their own milieu. Absenteeism in rural medical centres is rampant in South Asia and third world countries. Chaudhury and Hammer, in their 2004 report (World Bank Economic Review, Vol 18, No 3), revealed a 40% absenteeism of physicians at larger clinics and a surprising 74% absenteeism of physicians at smaller sub-centres with a single physician.
Even at centres of learning (I mean, the medical colleges), absenteeism on the part of the professors is rampant. During my third year in medical school, I had a three-month clinical (clerkship) rotation under a famous professor. He never relocated from Dhaka to Sylhet. Once in a blue moon, he used to fly to Sylhet to show up. In a period of three months, we did not get more than five or six hours of clinical teaching from him.
True, that was an extreme case. But I never saw a professor give us clinical teaching for more than 2-3 times a week. They were all in town tending to their own “mint-chambers” or some other obscure non-teaching profundity. That’s how it was in the late 70s and early 80s. And I was a product of a culture where the concept of AWOL was not unholy.
Well, does this exonerate me of my failure? I was a thoughtful college graduate at that time. I knew the difference between right and wrong. No, these justifications definitely do not absolve me of my guilt.
