There are glaring discrepancies in the establishment of health education institutions in the country, with most of these being set up in Dhaka division. For example, there is no government or private dental college in Khulna division, not even a dental unit.
These facts emerged in a report, ‘Mapping of Health Professional Educational Institutions in Bangladesh’, prepared by the World Health Organisation (WHO). Mymensingh division has no health technology education institute.
The report, published in April this year, recommended that no more new health education institutions be set up in Dhaka.
In 1971, according to the WHO report, there were only 22 educational institutions for health professionals in the country. There included 6 medical colleges, 2 medical assistance training schools (MATS), 5 nursing colleges and 8 nursing institutes. The number of such institutes expanded significantly after independence of the country, going up by 31 times over a span of 45 years till 2016.
But this expansion has been disparate. Of the existing 674 institutes, 289, that is 41 per cent, are in Dhaka division. Barishal has the lowest number of health education institutes, only 24, comprising 4 per cent of the total.
It is the same in the case of private medical colleges. There are presently 69 private medical colleges in the country, of which 30 are within Dhaka city. Though 12 medical colleges received approval after 2010, that is, after Awami League came to power, there is not a single private medical college in Barishal.
Many students do not come to Dhaka to study despite having the merit and qualifications. Some cannot afford it and others are not comfortable with staying in Dhaka. Concerned persons say that if institutions were set up outside of Dhaka, many meritorious but poor students of remote areas could avail the opportunity to study. Such institutions would also render healthcare easily accessible in those areas.
Secretary of the health minister (health services) Md Asadul Islam termed the WHO report as important. He told Prothom Alo, the establishment of health institutions has been somewhat imbalanced as these were set up in the conventional and routine manner. However, the government’s policy is for the decentralisation of healthcare and health education. The prime minister has announced that medical universities are to be set up in every division and medical colleges in every district. Implementation of these decisions taken by the government will bring about a balance.
No dental institute in Khulna
According to the WHO report, there are 35 dental colleges and dental units in the country. There is one government dental college and 8 dental units. There are 13 private dental colleges and 13 dental units in 13 private medical colleges.
Having attained a BDS (Bachelor of Dental Surgery) from the dental unit of Rajshahi Medical College, Atiqur Rahman is now assistant professor pf Sir Salimullah Medical College’s dental unit in Dhaka. Speaking to Prothom Alo, he said, MSSB and BDS students have some common courses that is why dental units are opened in medical colleges. Setting up a dental college is cost intensive.
There are 55 health education institutions in Khulna division, including 9 government and private medical colleges. But none of the medical colleges have dental units. There are no medical colleges in this division either.
Principal of Khulna Medical College, Abdul Ahad, speaking to Prothom Alo, said, “It is unfortunate that there is no dental education facilities in Khulna. We have long been demanding a dental unit on Khulna Medical College or a separate dental college. That has not materialised so far.”
Former secretary general of Bangladesh Medical Association (BMA) Rashid-e-Mahbub told Prothom Alo that though they are eager and competent, financial constraints prevent many students of Barishal and Khulna cannot come to Dhaka to study at the medical assistance training school or the institute of health technology. Yet many of the institutions in Dhaka do not have an adequate number of students.
He said that WHO has clearly indicated the disparities in the health sector. The weaknesses in the health directorate and planning division of the health ministry have been revealed. Rashid-e-Mahbub recommended that the health ministry pay attention to the WHO report and work with the planning ministry to remove the regional disparities in the system.
Economist and former advisor to the caretaker government Hossain Zillur Rahman, speaking to Prothom Alo, said that Dhaka is the political and bureaucratic centre of the country and the rest of Bangladesh was separate. This is the same in the case of health education institutes. Added to that is a lack of coordination. Had there been coordination in the development activities, he said, it would have not been possible to have regions with no dental colleges or units whatsoever. This extreme centalisation has to be addressed and coordination ensured for balanced development. This will have a positive impact on health and education.