Even though there are top-notch doctors in Bangladesh, many people fly abroad for treatment as they cannot rely on the local medical systems, according to both healthcare experts and patients.

In some cases, they said, the patients find the medical treatment relatively more cost-effective in some countries than hospitals in Bangladesh.

"The behaviour of health workers, including physicians also matters...it's very important to me as others," said Mujibur Rahman, a retired engineer.

According to healthcare observers, mismanagement, shortage of manpower and poor waste management system, widespread corruption, and irregularities, staff's insincerity and casual monitoring by the authorities concerned are the major obstacles to ensuring quality treatment and patient-friendly environment in the country's almost all public and private hospitals.

They said the country's healthcare system needs a complete overhaul to ensure quality treatment and diagnoses at local hospitals and diagnostic centres to discourage people from going abroad for treatment and check huge foreign currency from going down the drain every year.

Talking to UNB, former World Health Organisation (WHO) Regional Advisor Muzaherul Huq, former director (disease control) of DGHS Be-Nazir Ahmed, and public health expert MH Chowdhury (Lenin) made the observations.

Growing outbound-medical tourists

According to a report carried by the Times of India on Jul 24 this year, a huge majority of medical tourists - 54.3% - who visited India last year were from Bangladesh, followed by 9% from Iraq, 8% from Afghanistan, 6% from the Maldives and 4.5% from a group of African nations.

Citing the data released by the Indian Union Tourism Ministry, the report also said Bangladesh accounted for 23.6% of medical tourists in 2009, while the Maldives had the highest share at 57.5%. While Bangladesh's share increased, that of the Maldives went down in the last 10 years.

A recent survey report of the Bangladesh Bureau of Statistics (BBS) said a large portion of people travel to different countries from Bangladesh mainly for treatment.

Among the outbound tourists from Bangladesh in the 2018-19 financial year, it said, 60.41 percent went to India alone.

The BBS report said 29 percent of the total Bangladeshi tourists abroad spent money on receiving treatment in different countries.

In the 2018-19 FY, Bangladeshis spent Tk 9,933 crore on treatment abroad while the total expenditure by the outbound tourists was Tk. 33,680 crore.

According to Bangladesh Outbound Tour Operators Forum, on average eight lakh people go abroad for treatment every year from Bangladesh while India is the most favourite destination for them. The other major destinations of Bangladeshi medical tourists are Thailand, Singapore and Malaysia. Many rich people also go to the USA, The UK and Dubai for treatment.

Experts, however, said the actual figures of Bangladeshis outbound-medical tourists and their expenditure are much higher.

Possible reasons

Dr Be-Nazir Ahmed said there are many good hospitals and qualified doctors in Bangladesh, but all hospitals cannot ensure quality treatment.

"There're many skilled doctors and quality hospitals, mainly in Dhaka. But the country's many districts lack quality hospitals and doctors. More worrying is that, many doctors compromise with medicine companies and the hospitals as they prescribe unnecessary tests and medicines, causing public trust deficiency," he said.

The expert said many people have a negative impression that they may get deceived or subjected to wrong treatment and excessive medical bills for many critical diseases if they go to private hospitals in Bangladesh. "That's why many people prefer to go abroad, including India, for treatment."

Besides, he said, there is a serious problem that many doctors in Bangladesh are not ready to properly communicate with their patients as they find it unnecessary.

"Actually, many patients get the similar treatment going all the way to India. Still, they're happy as doctors there are polite and give due attention to them," Dr Be-Nazir observed.

He said the treatment cost is relatively cheaper in the neighbouroing country. "The quality of their diagnostic centres is better than ours. We've many labs where proper tests are not possible."

Besides, the expert said, some people, mainly the rich ones, consider receiving treatment overseas as a matter of prestige. "Our many politicians and government officials go abroad for the treatment of simple diseases, giving people a wrong message about the country's healthcare system."

Prof Muzaherul Huq said there is a shortage of doctors, nurses, cleaners, medical technologists and other health workers in many government and private hospitals. "So, patients are denied their rights to receive proper treatment. More importantly, they aren't happy with the services at the local hospitals."

"We've world-class doctors, but we're losing huge money as many people go abroad for treatment as they cannot rely on the country's healthcare system," he observed.

Dr Lenin, chairman of the medicine department at the Health and Hope Hospital, said many people go abroad for treatment mainly to avoid mismanagement, hassles and sufferings in both private and public hospitals in the country.

He said the medical expenses in many Indian hospitals are less than in Bangladesh. "The cost of quality treatment is much higher in private hospitals in Bangladesh. "There're irregularities and mismanagement when it comes to medical bills in private hospitals."

Overhauling health sector

Dr Be-Nazir said the government should now focus on overhauling the health sector rigorously with a master plan to improve the healthcare system and services of both private and public hospitals. "Proper training is necessary for our doctors to improve their communication skills and professional attitude."

Besides, he said, the government should prepare a policy for the private healthcare sector to keep their services affordable and force them to maintain quality.

"Our politicians, high government officials go abroad for checkups or treatment. They can avail of such services here. It'll help boost people's confidence in local hospitals," the expert said.

He said most private hospitals in Bangladesh lack professionalism as they give focus only on making money instead of improving services. "The manpower at the DGHS must be increased to enhance their capacity to monitor both the private and public hospitals properly."

Dr Lenin said a full-fledged authority is now imperative to monitor and help flourish the private health sector and ensure people-friendly, quality and cost-effective services.

He said the government should bring the private health sector under a legal framework to enhance its quality, professionalism and restore people's confidence in it.

A senior journalist who was hospitalized twice in one year said ensuring hospital hygiene is also very important to attract patients by local medical facilities as hospitals in India are doing. "Whatever we do we need to do with sincerity. No one can deny the fact that patients always look for more compassion than commodified services."