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Overseas travel spree and local healthcare system

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May 10, 2010
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Overseas travel spree and local healthcare system

Overseas travel spree and local healthcare system

Shahiduzzaman Khan

Healthcare facilities, particularly in the private sector in the capital city and a few other places, have expanded and developed well in Bangladesh. Even then the number of patients going abroad for treatment has been rising. The situation is really baffling for those who have otherwise been claiming that some of the facilities available in a number of private hospitals in the country are comparable, in quality, to their counterparts in this part of the world and even beyond.

A national daily reported this week that on an average, 0.15 million patients go abroad every year for treatment. Most patients go to India while those belonging to the affluent section prefer going to Singapore, Malaysia, Thailand and some European countries. Such patients, according to a study, go abroad to undergo by-pass and plastic surgeries, cancer treatment, organ replacement etc. With them also go a substantial amount of precious foreign currency for meeting their treatment expense.

There is no denying that there are a host of specialist physicians in the country and their diagnosis capabilities are beyond question. But their services are hardly available for the patients admitted to the public hospitals. They remain busy with their practices in private hospitals and clinics. Even at their practising places they can hardly devote sufficient time to patients. They visit at least 50-60 patients at the clinics every evening for earning as much money as possible.

A good number of private hospitals and clinics have brought modern medical machines and equipment for various check-ups and examinations, but men operating those machines are not always technically sound. There is an acute shortage of qualified and competent medical technicians and laboratory assistants in the country. Inexperienced personnel handling such equipments bring at times greater problems for treatment of patients.

Besides, the country does not have the facilities for critical analysis of blood samples for rare diseases. For that matter, either the samples need to be sent to the developed countries or the patients have to go abroad for the required treatment. Facilities for closed-end monitoring of the patients are hardly available in Bangladesh. Due to carelessness and negligence of duty on the part of doctors and nurses, many patients die in public hospitals. Lax monitoring also causes fatalities in private hospitals as well. None is found accountable for such mishaps. This is really frustrating.

However, in many cases, it has just become a fashion for the affluent people to go abroad to recover from even minor illnesses. Although the medical equipment used in the local hospitals and clinics are almost the same compared to those of the other countries, lack of quality services encourages such affluent people to go abroad. In many cases, doctors advise critical patients, who have to undergo micro-surgeries, to go abroad because hospitals in the developed countries are more experienced in dealing with sensitive cases.

In such a backdrop, why patients prefer to go abroad is self-explanatory. In the private hospitals like Square, LabAid, United or Apollo, open heart surgery costs more or less Tk 0.6 million. But in India, the cost is only Tk 0.3 million. A patient can eventually save Tk 0.1 to Tk 0.2 million even after meeting all costs that include his and his aide's travel and food charges. If one can save such an amount of money, he or she will definitely prefer going India or elsewhere for further treatment.


Why treatment cost is so exorbitant in Bangladesh was never taken up seriously by the authorities concerned for a critical review. There is no virtual control over the fixation of charges in the private hospitals. Charges are levied at the whims of the owners of such medical clinics. It varies from clinic to clinic. The government is trying to streamline the system through a 'pragmatic' health policy. But the policy is yet to get its final approval.

The most striking feature of the country's healthcare system is that the doctors here, particularly in the public hospitals, colleges and universities, are allowed to do private practice. In the neighbouring states, such practice is strictly prohibited. Doctors can do little justice to the patients if they have to visit so many patients a day. However, the draft health policy has proposed to slap restriction on their private practice while serving in public hospitals and educational institutions.

Professional attitude is most strikingly absent among most physicians and surgeons in the country. They do need to be imbued with true spirit of professionalism and patriotism. Unfortunately, most physicians, posted in rural areas, remain absent in their workplaces for months together and stay in the capital only to pursue their cases for transfer to the city or elsewhere. In the process, village people fail to get their services. The government is, however, preparing to enact legislation in order to make their stay in rural areas for at least a year mandatory.

The government is reportedly developing Medical Practice and Private Clinics and Laboratories Ordinance (Amendment) in order to tightly regulate private medical practitioners, hospitals, foreign doctors and nurses. If the ordinance gets through, private medical practitioners and hospitals may face criminal charges and can be sued under tough new laws to protect patients from maltreatment. However, it remains to be seen how such laws will be implemented in the present context of Bangladesh.

Cases of mismanagement in the public hospitals are galore as local nurses, brothers and ward boys are often found to be more powerful than doctors. In most cases, the petty employees in different government medical college hospitals show little or no respect to doctors, let alone providing good services to the patients. Proper management in the healthcare sector can improve the situation through a strategic plan and its strict implementation. If this can, indeed, be ensured, it will facilitate the country to become a hub of better healthcare.

szkhan@dhaka.net
 
The Apollo is un-believably expensive. It charges almost same as a Govt. Hospital in Singapore. One person told me for one particular procedure they estimated it will roughly cost $750 a day for treatment, just about what the hospital in Singapore was going to charge. They ended up going to Singapore as the treatment took few weeks, don't know about the other fancy ones.
 
The Apollo is un-believably expensive. It charges almost same as a Govt. Hospital in Singapore. One person told me for one particular procedure they estimated it will roughly cost $750 a day for treatment, just about what the hospital in Singapore was going to charge. They ended up going to Singapore as the treatment took few weeks, don't know about the other fancy ones.

Apollo is just for show ... last year my sister admitted in to the hospital for a cyst operation and it cost 2.65 lakh only for 4 days. Many people asked to go to India as it will be much cheaper over there. But my mom was not willing to go there. So, the operation happened in bangladesh. This is too high charge for such a operation. This can be compared to robbery. Bangladesh government should establish more hospital with reasonable cost of treatment and with all the necessary facility and should make sure doctors are getting enough pay. Otherwise they will opt for private practice. In recent time government has made some power sector, BTTB and bank privatized as government holding company and paying handsome salary to the officials and even drivers are getting around 22 thousand taka. This should also be done with the hospitals and we need to increase number of hospitals and medicals to train up more doctors as it is ridiculously expensive to study in private hospitals which majority of the middle class can not afford.

This will also reduce the tendency of people to go to India and reduce the chances of draining of national money by spending it abroad. N would also like to see investment from foreign countries in hospital sector to promote medical tourism in Bangladesh at a reasonable cost in Bangladesh.

Can any one tell me what is the status of investment of dhabi group which wanted to invest as much as 1 billion to set up a world class hospital in dhaka may be in bashundhara to promote better treatment and medical tourism in bangladesh.
 
^^ I expected Apollo to be more competitive. It seems like their pricing model is considering the population as a captive one. They are not passing the savings of the cheap labor to the patients. Additionally, people are not too thrilled about the quality of care.
 
People nowadays go to the local hospitals only if time is an issue, otherwise foreign hospitals turn out to be cheaper.
 
The Apollo is un-believably expensive. It charges almost same as a Govt. Hospital in Singapore. One person told me for one particular procedure they estimated it will roughly cost $750 a day for treatment, just about what the hospital in Singapore was going to charge. They ended up going to Singapore as the treatment took few weeks, don't know about the other fancy ones.

Same here, after the local specialists at square
scratched their head off for an auto immune disease
that triggered accidentally, I had to travel for NUH in Singapore.

For some weird reason that came
out cheaper.
 
Including the rural poor?

And thats where the question is........
There is is still a tendency for all the doctors
who comes out flapping their wings, not to settle in
rural areas, how much the GOV request them to do so.

Unfortunately they end up traveling to the city only to be
butchered up by the docs. This will take time to change.
Heard some sort of mechanism on fixation
of chargeable fees are being considered by the gov officials
right now. May be that will help to lessen the hurdles a bit.
 
Medical healthcare for the affluent is no great shakes.

They can go to the US if they have the money.

What is important, not only in BD, but everywhere in the subcontinent is the medical care for the poor.

Even against the US way of thinking, Obama has made healthcare for the poor (yes, there are poor in the US also) feasible to some extent.

These private hospitals for the affluent are but medical factories, where they make you go through unnecessary tests and procedures just to mint money.

They appear good for statistics and indicating good healthcare of a country, but they are of only use to the affluent and those from abroad who come for medical tourism.
 

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