Barguna’s healthcare crisis

Barguna finds itself in a unique position regarding its healthcare services. While the technology and facilities in the local hospitals are regularly updated, the lack of awareness about available healthcare services, as well as an absence of adequate human resources, have created a vacuum.

Equipment gathering dust

The only mother and child welfare centre in Barguna was provided with the necessary equipment for caesarean deliveries four to five years back. Although there is an operation theatre with modern facilities, it is not in use due to the lack of an anaesthesiologist.

The Medical Officer in charge of the organisation, Shahnaz Begum, said, "Only general operations are done here. In the absence of an anaesthesiologist, no C-sections can take place. Mothers are forced to take the risk of having their caesarean deliveries at Barguna General Hospital, which is about four kilometres away, or in Barisal, another 80 kilometres away."

A human resource crisis

In a public meeting at the Circuit House grounds in Barguna on May 6, 2010, Prime Minister Sheikh Hasina announced that an additional 150 beds would be added to the Barguna General Hospital's existing 100 beds. On October 27, 2018 she inaugurated the building. However, the hospital is yet to get adequate human resources and fund to run its extended operation.

The current 100-bed facility is also understaffed, with only six staff members filling in for a total requirement of 43 first-class officers.

"This severe lack of human resources has resulted in the hospital's activities facing constant disruptions," said Dr Sohrab Uddin, superintendent of the hospital. "We only have 91 staff members against the requirement of 218. Often, we don't have the space for patients. About 150 to 180 patients are regularly admitted indoors, while another 400 to 500 patients have to be treated outdoors," he added.

Barguna also has four Upazila health complexes, a 20-bed, and 10-bed hospital, eight sub-health centres, 123 community clinics, and 25 union health and family welfare centres. There are 120 posts in these institutions with 54 vacancies at present. There are vacancies in 117 out of the 202 posts of nurses.

Besides, health service providers are also found absent in health facilities.

"Most commonly, this happens in the case of the Community Health Care Providers (CHCPs). The poor quality of roads in these areas prevents them from visiting their office regularly. We must first ensure that the CHCP and other healthcare workers have proper communication facilities so they can attend work regularly," shared Towfiqul Islam Khan, Senior Research Fellow at Centre for Policy Dialogue (CPD).

Lack of awareness

Some people in remote areas in Barguna still rely on spiritual remedies when they fall ill due to the lack of awareness of available formal healthcare. There is a general trend of people living in these communities being unaware of common diseases, general health practices and the locally available facilities.

Delwara Begum, 50, from Uttar Lakurtala village of Sadar Upazila, Barguna, said, "We only go to the community clinic if we need medication for fevers. I don't know what other diseases are treated there."

When made aware of available healthcare, she felt that it should be the authorities' responsibility to let them know how and when to use such medical facilities.

Even with adequate facility and human resource allocation, more steps should be taken to ensure that the locals are using the healthcare facilities. It is of utmost importance to establish community forums that enable community members to work with the government bodies on various pressing issues including health.

The health issue needs to be addressed adequately as healthy lives and well beings are closely connected with the achievement of other SDGs including SDG 1 (no poverty), SDG 2 (zero hunger) and SDG 5 (gender equality).

Oxfam, in partnership with CPD, is implementing a project titled 'Enhancing the Participation of Community-Based Organisations (CBO) and Civil Society Organisations (CSOs) in Democratic Governance in Bangladesh' in thirteen districts of the country, including Barguna, with support from the European Union. The project strengthens the knowledge and leadership capacities of grassroots CBOs and CSOs regarding social accountability tools such as citizen-led social audit. Going forward, such a social audit system, if implemented at the community level, can help alleviate the current healthcare woes that the people of Barguna are facing.