Tawhid Hasan DuhaThe current system of healthcare in Bangladesh poses numerous challenges to people ignorant of medical conundrums and their consequences. These are shown by my own experiences seeking healthcare solutions for my father, who has been diagnosed with Bell’s palsy since 2021. We have been to many doctors both in and out of the country to ascertain the most excellent type of care for him. Throughout the process, I have discovered several other patients with the identical problem, with many of them being from rural places. They are equally ignorant of the position they are in and have difficulties explaining their issues to medical practitioners.
As mentioned above, my father was unable to clearly communicate the symptoms of his illness to the doctors. In this complex situation, I had to intervene for him, realizing an important detail about the work of the healthcare system: all the calculations about the success of the treatment process are based on the actions of the patients and their family. Unfortunately, as a rule, the latter are unable to provide the necessary information due to their discomfort, incapacity, or the lack of a qualified way to express their problems to the doctor.
Recent research published in the Journal of Primary Care & Community Health reveals that communication gaps significantly impact patient outcomes in Bangladesh. The study identifies key factors contributing to these gaps, including insufficient health literacy among patients, limited training for healthcare providers in effective communication strategies, and systemic issues within the healthcare framework that prevent clear information exchange . Addressing these communication deficiencies is crucial for improving health outcomes and patient satisfaction.
In September, as we celebrated International Heart Day, the importance of advanced healthcare facilities, such as catheterization laboratories (cath labs), came to light. Cath labs are essential for heart disease treatments, including procedures like angiograms and angioplasty. However, according to a report from the Daily Samakal, there are only 87 cath labs nationwide, with 58 of them located in Dhaka, and eight remain non-functional due to staffing shortages. This reflects a broader issue in the healthcare system—resources exist, but their utility is compromised by a lack of skilled personnel.
Heart disease is one of the main reasons of deaths in Bangladesh. Though worldwide statistics show higher mortality rates in people older than 70, in Bangladesh deaths from cardiac conditions have been happening at early age. It is evident that people in the rural areas of Bangladesh have limited information about diseases such as heart failure. The question remains, are we doing enough to educate the people in the rural areas about their conditions in order to prevent further occurrences of these diseases? Are we following up to check if they are complying with their medications?
Beyond the evident communication and awareness failures, our national health budget remains insufficient. Government hospitals do not receive the level of funds necessary to provide cheaper services, and with no structured health insurance system, the country’s citizens are left at risk. Our continent and country’s health sector problems are not only attributable to bureaucratic complications. In part, the issues are due to a lack of timely, valid initiatives as well as poor efforts to raise awareness. Just like we did with the COVID-19 outbreak, we should invest the same resources to raise awareness of diseases where verifiable prevention measures will reduce the incidence rate.
Corruption and irregularities connected with the healthcare sector might be one of the other issues. Most often in the news, there are reports about corruption in government hospitals, but little to no accountability follows. It is necessary to ensure that patients receive a service for which they will not be overcharged by intermediaries. Also, in the hospitals, nurses should play a greater role in guiding patients, for whom they, together with their families, should ensure that they understand the process of treatment, they should be treated and cared for exactly as the doctor prescribes.
The issue of the difficulty in obtaining a doctor’s appointment in this overpopulated country may not be easily resolved due to the shortage of physicians. However, an online ticket booking system of being able to see the desired doctor can be implemented in public and private hospitals. This initiative can be first trailed for less critical medical cases. We have an ICT division, and cooperation with the health sector can improve communication and introduce an effective online system. Patients will have electronic information and use the system to access available information and services. This will help bridge the communication gap. The right to information must be ensured – no patient can be left uninformed on what to do next, what tests to do, or what preventive measures to take. It is unacceptable for a patient to die because he did not know what to do.
If we want to effectively solve the problem of communication in the health sector, it is essential to attract non-governmental organizations that are dealing with this sphere. I think that the role of these organizations will be in the facilitation of training for medical workers in this field. Increase in health literacy levels will let patients and population in general feel free to recognize their problems and better acknowledge possible ways to solve them.
In addition, as seen with the youth-led movement for quota reform in the job sector, the youth in the country have shown that they can advocate for change. This energy can be channelled towards creating space for health communication interventions that cater specifically to the needs of the elderly and vulnerable populations. Moreover, many young creatives are looking for experience in the health communication field, and they can come up with innovative campaigns. These campaigns can help to reduce the gaps in health communication that can be observed in the country.
To sum up, the healthcare system in Bangladesh is in profound need of reform, and addressing the existing communication gaps is the first move to make. The concerted efforts of NGOs, young creatives, and healthcare specialists will help to eliminate those gaps and make sure that the patients get the information they need on time and accurately. At the same time, the sustainable health insurance system will ensure that all citizens have financial protection and thus access to necessary care. Through the efforts of the government, civil society, and the younger population, the healthcare system can be efficiently reformed to become fair, transparent, and genuinely patient-oriented.
