|A Challenge for Bangladeshi Medical Expatriates|
|By Mahfuz R. Chowdhury|
|Thursday, 01 May 2008|
Although healthcare in Bangladesh has improved significantly over the years, it remains critically ill. The government is the biggest healthcare provider, to which all citizens supposedly have equal access. But most government-run hospitals, especially in rural areas, lack adequate resources, such as doctors, medicine, equipment, and skilled technicians—and the service is terrible. In big cities, doctors usually prioritize their private practices, sometimes to the patients’ detriment. Wrong diagnosis followed by incorrect treatment resulting from unreliable lab tests or misinterpretations have become daily occurrences. It is not uncommon in Bangladesh for a person with heart disease to be treated for asthma or a patient with appendicitis to be prescribed for stomach virus.
While the general public remains trapped in this system, the very rich travel to other countries for their medical needs. India, Singapore and Thailand have become popular healthcare destinations for the country’s rich, which drains millions of dollars of precious foreign exchange. In this lopsided healthcare market, imaginative ventures can make a big difference.
Bangladesh is well known for producing many medical doctors through its state-funded medical schools. Some of them have gone on to become top-notch specialists in various advanced medical fields. But a good number of them have left the country and are now settled permanently outside the country. The idea is to involve Bangladeshi expatriate medical professionals—doctors, dentists and pharmacists—toward playing an important role in initiating or bringing about a change.
The international NGO “Doctors Without Borders” provides a potential model to follow, especially to offer medical services to critically vulnerable groups. Professionals would manage the organization while Bangladeshi expatriates would provide the services. The gain from this arrangement could be threefold: benefit to specific groups, foreign exchange savings, and a pressure on existing medical facilities to improve. Moreover, the expatriate doctors could help spread medical knowledge through workshops, seminars, and short courses in Bangladesh’s medical colleges.
To be more effective, this arrangement would need an institutional setup with at least one permanent and well-equipped hospital unit in Bangladesh. Expatriate medical professionals would sign up on a database to donate at least two weeks of their services in a given year. Those who might not give their time in a particular year can donate a comparable amount of money. An interactive web site could serve as a clearinghouse, by allowing the doctors to post their expertise and availability, and permitting the local institutions to communicate with them.
Next, a fleet of buses furnished with proper medical equipment and supplies, including power generators and sleeping arrangements, would be obtained. These mobile hospitals, similar to the floating hospital presently set up in Bangladesh, would be served by expatriate and local doctors. They would travel to different parts of the country, and augment services provided by local doctors, helping diagnoses, treatment, and further referrals to the permanent hospital unit. The area in which this system can make a quick impact is in diagnosis, since misdiagnosis is common in rural Bangladesh.
These mobile hospitals can also provide important outreach and education services, especially in infectious diseases among the local populace. Arsenic-contaminated water and birth control are also topics that could benefit from further education. Expatriate doctors could organizing small discussion groups and show videos and slides in areas where they would camp their mobile hospital every month. Exchanges of information with local doctors who often have special knowledge of local conditions would benefit the expatriate doctors as well, and possibly serve as inputs for their research, if needed.
How to get started?
Bangladeshi expertise is now available in almost every medical field, and the expatriates have the resources to implement a plan to deliver their services to the country. Outside medical care, other Bangladeshi professionals, such as engineers and scientists, who too had availed the country’s state-funded education facilities, then succeeded abroad, have later undertaken projects to give something back to their native land, out of a sense of moral obligation and personal satisfaction. But instead of small individual projects, a lot more could be achieved if the expatriates were to combine their resources to generate momentum a large scale.
So the main innovation needed for this venture to succeed is an effective mechanism to pool the available resources. Bangladeshi medical associations abroad could take the lead, and with the help of the information technology professionals, could put together a workable plan, inviting others to join as the organization expands. International organizations can be asked to lend monetary and logistic support. The dispensing of quality healthcare service in the country would surely be a worthwhile cause to consider for such a collective international effort.