A protest that highlights a deeper malaise

The students' protest now being waged in Barishal Metropolitan city against the poor state of Sher-e-Bangla Medical College Hospital (SBMCH), one of the oldest public health facilities of the country, points to a serious health sector malaise. A section of the media, rightly or wrongly, has paid increased attention to the blockade put up by students on the Barishal-Kuakata highway and consequent disruption caused to vehicular movement. There is no denying that the protesters should have avoided an important transportation hub since the blockade programme has been causing sufferings to long-distance travellers. The protesting students, however, have raised a point in support of their ongoing agitation. They argued that their disruptive programme has paid off, as the health authorities in Dhaka are trying to reach them with assurances that they would try to improve the situation at the SBMCH. 

One has reasons to be scepitcal about the assurances given by the health authorities. For, coming under pressure, many state agencies at times make promises, but only to forget the same as soon as agitations or protests subside. Truth is, the Barishal episode of protests speaks for the state of the public health service delivery in most part of Bangladesh. The public medical college hospitals and general hospitals, mostly located in district headquarters and upazila health complexes, are not able to cope with rush of patients. They have myriad problems that include shortage of beds, medicines, diagnostic equipment, ambulances and, above all, the lack of specialist doctors, which is a perennial issue. Inadequate budgetary allocation coupled with the lack of proper attention from the health sector honchos is primarily responsible for the crisis. Patients are forced to occupy corridors after not finding beds in hospitals. Worse yet, they have to buy almost everything, including medicines. They are required to do most diagnostic tests outside. Specialist doctors remain absent from the workplaces, as they consider posting outside Dhaka as punishment.  

Obviously, being the capital city, Dhaka offers better and improved healthcare facilities. Of course, those are expensive and beyond the reach of the poor patients. The state health facilities in Dhaka, though finding it hard to cope with the onrush of patients, are still better equipped and somewhat more efficient than their counterparts in districts. This is primarily due to the fact that these are nearer to the centres of control, including the health services directorate and exposed to media scrutiny. Still, the state of affairs in government hospitals remains far from satisfactory. They too have management problems and shortage of necessary medical equipment. Patients very often make complaints about service delivery. 

That the quality of health and education facilities available in districts is far from satisfactory is hardly disputed. The number of health and educational facilities in both private and public sectors has gone up in mufassil areas in recent years. But people are not happy with their service delivery. A section of dissatisfied people, who can afford, choose to come to Dhaka either to seek medical help primarily from modern private hospitals or get their children admitted to highly reputed schools and colleges. One of the reasons for Dhaka being increasingly crowded is the unending influx of this type of people. What pains most is the relevant authorities prefer to be oblivious of what is happening around them. They have never felt the need for putting in place better and improved health and educational facilities in the districts. Even the incumbent interim government headed by Dr. Muhammad Yunus formed nearly a dozen reform commissions for different sectors but not for health and education. Still this void can be addressed by the government to some extent, by ensuring quality service delivery and encouraging the private sector to set up modern hospitals and educational institutions in districts.