Around 58 per cent of the patients in Bangladesh consult pharmacists, homeopaths, hakims, pirs and other unqualified persons for their medical ailments rather than going to qualified physicians, reveals a report of Bangladesh Bureau of Statistics. And so over half of the patients do not receive proper treatment.
The Report of Household Income and Expenditure Survey (HIES) - 2016 was published in June this year.
According to the report, 16 per cent of the patients visit government community clinics and other hospitals in districts and upazilas for medical treatment. Around 26 per cent of the patients go to private hospitals, clinics and private chambers of physicians. Many also go abroad for medical treatment.
Despite big hospitals, specialised medical institutions, cutting edge technologies in detection of diseases and a rise in the number of physicians and nurses trained at home and abroad, most of the people are not happy with the overall medical scenario. There are some, however, who appear content about the health care system in the country.
Speaking to Prothom Alo professor Asit Baran Adhikari of Bangabandhu Sheikh Mujib Medical University (BSMMU) said cardiac surgery facilities have significantly improved in the country. There are physicians and hospitals in the country that can treat complex heart diseases like congenital heart defects. Around 1000 surgeries are being done successfully in the country every month. This cannot be demeaned.
- Number of patients and physicians -
According to the BBS Health and Morbidity Status Survey-2014, around 170 persons out of 1000 people suffer from some health ailment, mostly fever. The prevalence of various non-infectious diseases like arthritis, diabetes, heart disease and cancer has increased.
However, not all people go to physicians when they fall ill. Around 58 per cent of the people consider their ailments not important enough to seek help. Around 17 per cent do not take treatment because of the high costs involved. Many people do not seek treatment as there are no hospitals or physicians near their home. Again, some avoid visiting the physician in fear of being diagnosed with a serious disease. Sometimes, they do not go to hospitals or physicians for lack of people to accompany them. This tendency is present among both men and women in cities and villages.
According to the BBS’ latest Household Income and Expenditure Survey, 42 per cent of the patients visit government and private hospitals for treatment as well as government and private medical college hospitals, specialised hospitals, NGOs and at private chambers of specialists. This suggests the remaining 58 per cent take treatment from people who are not registered with the Bangladesh Medical and Dental Council.
BBS said around 23 per cent of the patients receive treatment at the private chambers of incompetent physicians. Around 33 per cent people take treatment from pharmacy attendants and compounders while 2.23 per cent take treatment from homeopaths. Another 0.76 per cent go to hakims and 'kabirajs'.
People do not go to hospitals or physicians immediately when they fall ill. On an average, they only go to the doctors four days after falling ill. On the other hand, 93 per cent of the people buy medicine from pharmacies while only three per cent get those from government hospitals.
Directorate General of Health Services (DGHS) director general Abul Kalam Azad told Prothom Alo that people’s tendency to go to quacks for treatment has reduced notably. All the patients will get quality treatment if they are conscious and if countrywide programmes for healthcare are implemented.
- Medical treatment, where and how -
Distance, money and time also play an important in availing medical treatment. According to the BBS study, people choose facilities within walking distance as around 44 per cent of them go to the health centres on foot. Auto-rickshaws are the most commonly used vehicle to go to the medical centres as around 27 per cent of the people use these while 17 per cent use rickshaw vans.
However, people do not get treatment immediately after reaching the institution. They wait for around 19 minutes on average for physicians or health workers. The wait longest, 53 minutes, in government medical college hospitals and specialised hospitals.
The wait is 40 minutes in mother and child care centres while those who take treatment at pharmacies wait for nine minutes on average.
Speaking to Prothom Alo professor of Institute of Health Economics at Dhaka University Syed Abdul Hamid said it is hard to say that significant advancement has been made in medical treatment. Advancement has been achieved in treating some diseases but statistics show most of the people do not take proper treatment. They still go to unqualified persons for treatment.
Statics suggest most people do not get quality treatment in the country, he added.
*The report, originally published in Prothom Alo print edition, has been rewritten in English by Shameem Reza