Chaos in the health sector

A recent news item caught everyone’s eye about the national Vitamin A campaign being postponed due to low quality capsules. In other words, the capsules were spoilt. They had yeast on them and stuck to each other, according to a Prothom Alo report published on 18 January.

It is a matter of grave concern that a vaccination programme scheduled for children had to be cancelled due to such mismanagement. The health ministry postponed the programme on request of health field workers who first noticed the yeast on the capsules and informed their seniors.

The question is, what if they did not notice it?

A man who works for a private bank, wrote on Facebook, “Vitamin A is given to children to prevent blindness,” adding sarcastically, “May we ask the authorities, who needs this Vitamin A more? The children or the persons involved with this programme?”

This unfortunate incident raises several questions. Who was responsible for this unpardonable lapse? And what about the public money that was spent in the procurement of these capsules? Will the taxpayers have to pay all over again for the fresh batch simply because of the irresponsibility of certain quarters?

Quoting health department officials, the report also mentioned this was the first time that such an incident of ‘bad quality’ capsules happened. There were earlier incidents of other irregularities though.

A healthy country is a happy country. A country’s public health services indicate its overall health development.

A number of media reports and other surveys indicate a chaotic health sector mired with mismanagement, irregularity and corruptions.

Prothom Alo revealed that according to the Anti-Corruption Commission (ACC), an accounts officer of the Directorate General of Health Services owns at least 24 residential plots and flats in the country. The market value of these assets is over Tk 10 billion.

The newly formed government and its respected ministry has no option but to take the incident seriously and revisit their health policies.
A 25 December 2018 Prothom Alo report read, “Three important survey reports on the chaotic state of the health sector are being kept under covers by the government. A week and a half after the results of a survey on maternal mortality and healthcare were published on NIPORT official website, they were removed on 3 December.”

The National Institute of Population Research and Training (NIPORT) conducted those three surveys.

The 106-page report showed the country’s maternal mortality went up to 196 in each 100,000 mothers while the mortality rate was 194 in 2010’s survey.

The report also reveals another finding by the Bangladesh Demographic and Health Survey (BDHS) of 2017-18 which indicates an increase in neo-natal mortality.

The report indicated that of every 1000 infants, 30 died before reaching 28 days of age. In 2014 this rate was 28.

There are tons of reports of other irregularities and corruption in the sector such as shortage of physicians, unnecessary procurement of expensive medical equipments, health department officials’ unethical practices and so on.

Another 18 January report in Prothom Alo revealed that that Brahmanbaria Sadar Hospital had no ophthalmologist although there are two posts for ophthalmologists in the hospital.

A 19 January report shows, the only government angiogram equipment in Khulna division has been out of order since 2018 August, leaving the patients of the area, especially low income people, at a loss.

A number of other reports shows, expensive medical equipments have been installed in several government hospitals, although there were no trained technicians to operate them. So the heavy gadgets, bought with taxpayers’ money, remain unused.

The permanent representative of Bangladesh to the UN, Masud Bin Momen, quoting renowned British medical journal, The Lancet, said at the 73rd UN general assembly in New York last year that Bangladesh had surpassed its many South Asian neighbours in health related achievements.

However, the per capita health expenditure in Bangladesh according to the World Bank 2015 report, is $32 which is lower than other South Asian countries.

Another open secret of this sector is the involvement of the government physicians in private clinics and pharmaceuticals companies. The unholy nexus between the physicians and the pharmaceutical companies also leads to many low quality drugs being prescribed, at the cost of the patients' welfare.

The government simply cannot leave the country's health sector to profit-mongers, compromising the people's health.