"Corruption In Health Sector Won't Stop Unless It Stopped At Highest Level"

Fragile condition of health sector in Bangladesh. One hand is one of the corrupted sector , on the other is the distrust of people. Despite having so many specialized hospitals in the country, people have to go abroad. Famous public health expert of the country and chairman of Health and Hope Hospital Dr. HM Lelin Chowdhury. Interviewed by Salim Ahmed.

We see many people start providing services without fully hearing the disease history. As a result, people cannot trust them. It is partly true that people distrust doctors in Bangladesh. The overall truth is that people distrust every profession in this country. Be it politician, judiciary, police, engineer or any other profession. When most of the people in the country suffer from lack of trust in each other, it means that people lack trust in themselves.

Even though there are so many specialized hospitals in Bangladesh, why do people go abroad for treatment?

There is no effective reference system in the country. That is, a patient will first see a doctor. The doctor examined the initial history of the disease and determined that it should be seen by a surgeon. He referred to a surgery doctor. Later the surgery doctor will see the patient on priority basis. After that, if he thinks that a chest problem needs a doctor's consultation, then he will send to that doctor. This effective reference system is missing from lower to higher levels of our treatment.

Again, in this country, those who have money pay money to see important doctors for even a small problem. And the one who needs to show can't show that he doesn't have money. The number of specialist doctors and hospital beds are both low in the country. In other words, there is no state support needed to get special treatment for the poor. In this situation, those who have economic capacity are going out of the country. Besides, there are several marketing people working from our neighboring countries whose main job is to take people with the temptation that the treatment in those countries is good, everything will be solved if they go there.

Most of the doctors in government hospitals ask to see patients in his private chambers without seeing them properly. What is the way to stop this practice?

How the people of a country will get health care should be regulated by the government of that country. Since the Bangladesh government is not able to provide medical services to every person in the country; That is why more than 55 percent of the existing health care system receives private health care. In that case, my proposal is that those working in government hospitals cannot practice outside. If necessary, they should be appointed for government hospitals with more money. When a government hospital doctor is unable to see outpatients, he is forced to see inpatients.

Many doctors in our country are more busy with politics than research. Why is this?

When politics becomes a means of sharing power, people from all sections of the society become interested in politics. We see when leaders of doctors' organizations of the party in power get better postings and promotions. If the posting-promotion of doctors was based on merit alone, this crisis would not have existed. That is why a statutory legal framework is needed. It is not in our country.

Private medical colleges and hospitals do not have good teachers and research facilities, the quality of education is not good. As a result they are not able to contribute much to the society.

There is a law on how to study in medical colleges of this country. This legal framework has how many teachers there will be as opposed to how many students. Illegal routes are created because the officials of the health ministry of the government are not monitoring whether this law is being implemented. How many medical colleges are needed in the country, how many doctors will be released every year, the health care system will be complete, no such complete health plan has been done after independence. As a result the government when it came to power allowed some of its own people to set up medical colleges as a means of earning money. Proper supervision in accordance with the law will close this opportunity.

Every year, dengue takes a terrible form in the country. What is the permanent solution?

Aedes mosquito control is the main way to control dengue. For this, it is necessary to formulate and implement some action plans simultaneously across the country. So far there is no national plan for Aedes mosquito eradication. So the disease will continue to spread. Mosquitoes cannot be controlled by mere speech and stern reprimands.

Medicines are not properly stored in most pharmacies in our country. As a result, the quality of the medicine is lost. What needs to be done for this?

A drug store is not like eight or ten grocery stores. The person in charge of the medication should be a passed pharmacist. Most of the pharmacies in Bangladesh do not have trained pharmacists. Secondly, there are rules for keeping medicines. It is determined which should be kept in the refrigerator, which should be kept at 16 degrees Celsius temperature. But the Drug Administration—who are supposed to be taking care of it—doesn't do it right. As a result, the quality of the medicine is lost. For this reason, this issue will be solved if a legal, scientific system is created and its proper monitoring is done at every post of the health care system.

The horrors of monkeypox are appearing in different countries of the world. What kind of precautionary measures should be taken in this regard in Bangladesh?

Monkeypox has not yet arrived in Bangladesh, but it is likely to come. If you want to come, it will be by water or land. So if the kind of oversight required by public health science rules is in place, we'll have a lot of protection.

The health sector is said to be one of the sectors of irregularities and corruption. What is the way to stop corruption in this sector?

Effective steps must be taken from the highest level of the government to curb corruption. His main move will be I will not do corruption. When the President-Prime Minister, Cabinet, MPs indulge in corruption, how will the corruption of others be stopped? If they do not commit corruption it is easy to stop it.

Recently, in protest against the attack, doctors have observed a 'complete shutdown' program across the country. How logical is this movement?

Doctors have closed everything and said they will not see the patient, so we will allow some people to die? The word is of two kinds-one. I shot one dead, the second one was drowning in the water in front of me and I did not pick him up. If doctors stop everything, some people will die in front of their eyes - it can't happen.

Will the student uprising have any impact on the health sector? What are the expectations of the interim government?

Incidentally, most of the people-friendly steps taken in the health sector in Bangladesh have been taken by unelected rulers. For example, during the regime of former President HM Ershad, a people-friendly medicine policy was introduced in this country. This popular interim government can at least enact a health policy if it wants to - through which we get the Health Protection Act. There the rights of those who take service and the responsibility of those who give will be clarified. If determined by legal means, whoever breaks the law will be held accountable. Then health protection will be ensured.