‘Please save my son’: Forced to beg to bear medical expenses among others

Standing beside one of the entrances to the Karwan Bazar metro station, Maryam Begum (pseudonym) was holding out her hands for help. Her voice trembled as she pleaded, “Please save my son, help me. I am helpless and have come out onto the streets. If I lose my son, I will have no one left.”

This scene was observed on 27 September. Maryam continued asking for assistance, but very few responded. Approaching her for a conversation, she said she had one son and one daughter. Her son is an undergraduate student at a public university; her daughter studies at a government college. Eight months ago, her son was diagnosed with cancer, and she is now appealing to the public to cover his treatment costs.

Maryam has received some financial help from various sources, including her son’s classmates. But it has not been enough. She told Prothom Alo that more than Tk 1 million has already been spent on his treatment. This included Tk 300,000 left by her late husband. They are now virtually destitute.

Over the past three months, Prothom Alo has spoken with 50 individuals across different parts of the capital who were seeking help or begging. The selection focused on people whose clothing, behaviour and manner of asking for assistance did not resemble those engaged in regular, long-term begging.

Of the 50 interviewed, 38 said they had taken to the streets because of illness or the medical expenses of a family member. Six said they were begging because they had lost their jobs and had no alternative. Another four said they were asking for help because their income from other work was insufficient to sustain their families. Two had lost their homes due to natural disasters.

On 1 October, a man who claimed to be a schoolteacher (identity withheld) was found begging in front of Mohammadpur Krishi Market. He said he was suffering from kidney disease and had accumulated several lakhs taka in debt due to medical treatment. He now begs to cover the Tk 6,000 per week needed for dialysis.

The teacher is from Gaibandha. To avoid social stigma, he does not beg in his own locality. From time to time, he travels to Dhaka to ask for help on the streets. “The debt, household expenses and my own treatment — I can no longer manage it all,” he said.

A 2024 study by the Bangladesh Institute of Development Studies (BIDS) found that 61 per cent of households struggle to meet healthcare expenses. According to 2022 figures, 3.7 per cent of the population fell below the poverty line due to out-of-pocket medical costs.

In a welfare-oriented state, the government should bear a substantial share of citizens’ healthcare expenditure. But in Bangladesh, personal spending continues to rise.

According to the Health Economics Unit’s report, Bangladesh National Health Accounts 1997–2020, individuals bore 64 per cent of total healthcare costs in 2018. The 2023 report, based on 2020 data, indicates that this has risen to 68.5 per cent.

Many of the 38 people approached by Prothom Alo initially sought treatment in private hospitals. But due to soaring costs, some later turned to government hospitals, where they complained of poor cooperation and favouritism. Describing their experiences in private hospitals, they said the expenses were overwhelming.

A man from Chuadanga, aged around 50, was seeking help at Shahbagh. He said he had run his household through agriculture but had recently been diagnosed with kidney disease. Physicians had advised tests, but he could not afford them.

He said he had withdrawn his two daughters from school and put them to work in agriculture so the family could survive. He was begging to finance his treatment.

During the Awami League government, overthrown in the July mass uprising, major infrastructure development was prioritised while the health sector remained neglected.

According to 2022 data on the World Bank’s website, Bangladesh lags behind India, Sri Lanka, Nepal and Bhutan in terms of health spending as a share of GDP.

After assuming office, the interim government formed a commission to review health reforms alongside 11 other sectors. The commission recommended allocating at least 15 per cent of the national budget to health, equivalent to 5 per cent of GDP. However, the interim government allocated only 5.3 per cent of the national budget to health for the 2025-26 fiscal year—barely one-third of the recommended amount.

The commission’s recommendations have not been discussed in the National Consensus Commission, nor have they been implemented meaningfully. In this context, national professor AK Azad Khan, head of the health reform commission, wrote to the chief adviser on 3 August urging swift action.

He told Prothom Alo that implementing the recommendations would significantly ease the public’s suffering. The reforms propose recognising primary healthcare as a right and an obligation for the government, and bringing treatment for critical illnesses under insurance coverage.

Asked whether he was satisfied with the progress, he said, “No one is satisfied.”

Even at night, people can be seen begging in the capital. On 1 October in Mohakhali, a 53-year-old woman said her husband had died and that she had no son. She has one daughter, but they have not been in contact for seven years. However, the daughter left her own son in the woman’s care; he is now 15.

She said she had previously sold clothes to run her household, but illness forced her to stop. Now she begs.

“I feel ashamed to come out during the day,” she said. “So I come out at night. It is very hard to manage. I beg so I can buy medicine and food.”

The government provides an allowance of Tk 650 per month for widowed and abandoned women via the Department of Social Services. Some 2.9 million women receive this benefit. But many others do not. Moreover, Tk 650 is roughly equivalent to the price of only 13 kg of rice.

Families with low or modest incomes fall into crisis when a breadwinner becomes ill. Siddiq Ullah (pseudonym), formerly a driver, lost his job in January 2024. He then suffered a stroke, leaving one arm and one leg paralysed, and affecting his speech.

On 5 October, Siddiq’s wife was seeking help in Moghbazar. She said they had three daughters: two married, one living with them despite being married. Her husband’s treatment, her own medication and household expenses require more money than she can earn. She has no option but to beg.

Many observers believe that rising living costs, stagnant incomes and insufficient job creation have driven the increase in begging. Although no national survey has been conducted, beggars are now visible in streets, shops and marketplaces everywhere.

Shahabuddin Khan, a resident of Shewrapara in Dhaka, told Prothom Alo, “If you stand on the street for half an hour, at least five people will ask you for money. I do not recall seeing so many beggars before.”

The Department of Social Services says it has no data on the number of people engaged in begging nationwide. Nor does it know whether the number has increased. Its deputy director Md Shah Jahan said they were considering a survey.

Given the rising poverty rate, some presume that begging has indeed increased. According to research by the Power and Participation Research Centre (PPRC), the poverty rate rose from 18.7 per cent in 2022 (official data) to 27.93 per cent in 2025.

Communication specialist and academic Khan Mohammad Robiul Alam, who regularly speaks with low-income individuals, told Prothom Alo that one does not need extensive research to understand that begging has increased; it is visible everywhere. The underlying cause, he said, is a deteriorating economic situation.

He added that the economic crisis has affected every social class, but the low-income population has suffered the most. Many of them have adopted begging as a last resort.

Prothom Alo’s investigation found that most of those who died during the July mass uprising were workers and low-income individuals. But there are allegations that the interim government has done little for them. While the annual increment for government employees has been raised, the government has also formed a new pay commission.

Speaking about this, economist and member of the Citizens’ Rights Committee, Anu Muhammad, told Prothom Alo, “The chief adviser dreams of zero unemployment and zero poverty. But both have increased under his tenure. What we see on the streets proves that conditions have worsened, not improved.”