Doctors to go to rural areas

Doctors should serve the poor and ailing humanities
Bangladesh experiences the dearth of doctors particularly in the rural areas and the specialists prove to be acutely scarce as one or two experts are available in one area of medical science in the country which seems quite abnormal comparing to the number of population. To meet a specialist doctor one is to wait months together which seriously deteriorates the patient’s condition. As a result, the affluent ones go abroad for treatment and the rest are left to the fate or just to the lap of death. Again, millions of poor throng towards government hospitals where they just meet a series of harassment --------harassment from the gate keeper, sweepers, middlemen, nurses , staff and finally the doctors. Who cares for that? Government comes and goes. But the situation of government hospitals witnesses no change allowing the private hospitals and clinics to flourish as a viable business centers from upazila to the capital city along with pathologies or diagnostic centers. With the change of the government two things change ---one is harassment in the government hospital and more private hospital grow with more facilities. Wherever you go, whatever doctor you meet you must undergo a series of tests at the cost of a huge amount of money which always go beyond your means whatever your ability is or whether you need it or not. Who bothers about it? If you have means, you just move from this private hospital to that if you cannot afford just meet the tragic death. Whose concern is it? But we have a big ministry of health and family welfare, we have ministers, we have lots of meetings, seminars, symposiums on the health situation, we have BMA, several medical colleges and we produce a lot of doctors every year. So what, qualified doctors are not for the poor.
Our prime minster on March 12, 2011 sounded a note of warning to the government doctors posted in rural areas, asking them to stay at workplaces or quit job.” If you do not feel good to do job in rural areas, please quit the job—you will do government job and take salary but would not provide service, it cannot happen.” She said this while inaugurating the 19th conference and special annual general meeting of Bangladesh Medical Association at Bangahandu International Center. She further said, “Wherever I go including parliament, I hear the same allegation that the doctors do not stay in rural areas. I do not want to hear the allegation further.” Yes, as a prime minister of this nation and representative of the fourteen crore people must warn the medical community. But this kind of warning we hear in the grave and somber meetings and seminars many a time. No change actually takes place. Only her one meeting or warning will not work at all. Many facts and figures and phenomena are related with it. Why doctors will go to villages? They were brilliant students in their student life. They left the village for a better living. They have become doctors to leave the village. They don’t have environment to live in the village. If we really want to see them in the village, we must make a well thought out plan and program. Just in the meeting uttering some chronic facts does not give the solution. We cannot give qualified doctors to the union hospitals but upazlia hospitals. If we want them to stay in the upazila hospitals, we must give them some incentives. In some newly advancing countries they send their doctors and teachers to the village by giving them double salaries. If we can send some young doctors to the upazila hospitals, we must give them the double of the usual salary. When it is done, many doctors will show interest to go there as they are unmarried and don’t have enough scope to do private practice in the town because of being new doctors; they will go to the village to earn some money. If some pragmatic steps like these are taken, they will go to rural hospitals.
This poor nation spends the highest amount of money to produce a doctor and the poor people bear this expenditure. Students’ monthly tuition fee in the medical college is Tk 12 and hostel fee is Tk 5. Moreover, each and every student receives scholarship every month from government’s fund. Gopal Sen Gupta has expressed his astonishment at this in his write up in the Financial Express (March 18). To speak the truth I am not astonished because the students who study medicine in government hospitals, most of them also hail from poor and middle class family but they are brilliant students. Many of them cannot afford to bear the huge cost of studying medical science. So, the poor nation has the duty to bear the expenses of the medical students through scholarship and subsidy. It is our pride that we produce doctors mostly on state run money. But we cannot employ those doctors for the greater welfare of the nation and particularly for the rural and poor community is our failure. We cannot teach these doctors how to work for the ailing humanity. We cannot rouse fellow feeling and brotherhood in these doctors though many of them come from poor financial background. We must teach them social science, give them moral and religious education otherwise we will just produce people having some knowledge to apply medicine and sell the medical knowledge for their personal gain . Our prime minister asked physicians to provide medical services to poor people with a sympathetic mind. She said, “Patients get half-cured due to your little affection, words and care.” Exactly. It’s a great part of giving treatment which our doctors either don’t know or they miserably fail to do it. When we meet any foreign doctor, we get astonished to see their behavirour and conduct with the patients as well as the companions of the patients. What happens to the doctors of our country, they remain grave and serious with the patients. They don’t talk to the patients let alone the visitors, give many tests and then give a big prescription. No talk, no encouragement, not background, no explanation of the disease at all. I can clearly remember many incidents regarding this issue. Once I met a doctor with my pregnant wife. Surprisingly the doctor did not talk a single word with me. He just did his work and one or two words he said only with my wife. Another example is I met a doctor at Lab aid hospital with my son. The doctor did not talk to me at all. I asked him what the problem with my son was. He just told me ‘problem in the leg’ which is known to me. This is the response of the doctors. They must have training on socialization which is a part of treatment. But I find the Indian doctors who are very friendly; they ask the history of the patient, talk elaborately to the visitors and give explanation of the disease, its future etc.
The prime minister announced that 11000 community clinics have already resumed their activities which are benefitting the people. The PM said arrangements are being made to set up coronary care unit and heart surgery at the district level, while 4331 doctors, 1747 nurses’ and 6391 health assistants were recruited. Recruitment of the doctors and even the teachers of medical colleges are said to have been done giving political consideration which must call for careful attention of the authorities. It is not unknown to us that the students of medical colleges also now are engaged in serious student politics who give more attention to political activities than study. Many student leaders who don’t have strong footing and knowledge of medical science get the appointment as medical college teachers. This thing must be taken into consideration to save the nation. Doctors need extensive research which now receives scant attention and importance.
Finally all the medical college hospitals, government hospitals whether at upazila or distict town or in cities of the country see awfully dirty atmosphere and obnoxious smell comes out of the toilets and bathrooms always? Even, a healthy man is bound to become sick if he remains in the hospital area for several minutes. The food prepared in the kitchen of the hospitals is another source of spreading disease. There is none to look after it. The peons, guards and sweepers have their own union under the banner of strong political parties. They are the actual governments of the hospitals. The higher authorities of the hospitals are also the supporters of strong political parties. Definitely the common people are not supposed to have any treatment. If they don’t give treatment to the poor, there is none to ask them. They are the government. If any patient does not receive treatment and even dies, the relatives cannot take any action against those people as they have strong party background. PM made it known that DMC has 37 gynecologist whereas many district hospitals don’t have any gynecologist. This is another picture of corruption and mismanagement. Who will take the initiative to address these unlimited problems? As there is none to look into these issues, the doctors not only rob the money like lawyers but also rob the lives of the people without any hesitation. We the general people can just write something through print media with the hope of raising a little bit awareness. I am sure both print and electronic media can play a meaningful role in this regard.
Md.Masum Billah
Email: mmbillah2000@yahoo.com