Dr. Zafrullah Chowdhury :
I sent Dr Yunus to Oxford University and advised him to make his own vaccine with the benefit of a compulsory license under the Trip Agreement. The production cost, including royalties, was only 50 cents to two dollars. The government did not take this advice. Corona vaccination for 15 crore people will cost 15 crores X 10 dollars = 15 crore dollars X 80 taka = 120,000 (one hundred and twenty thousand taka) million. The 20 million Soviet Sputnik-V vaccines are available for 8 dollars. The money that will be saved by cancelling the quick rental in the power and energy sector will ensure the vaccination of all citizens. The vaccine reduces both death and infection and helps to achieve efficiency. In addition, the World Bank and the Asian Development Bank have agreed to lend 500 million and 940 million, respectively, to provide affordable vaccinations for all. Assistance for the purchase of vaccines will also be available from the European Investment Bank.
XI. Poverty and Health
In 1994, Dr. Hossain Zillur Rahman, a researcher at BIDS, showed that one of the main reasons for not eradicating poverty in Bangladesh is the high cost of medical treatment, misdiagnosis and over-treatment. The first reason is natural disaster and the third reason is misuse. Later, Dr. Binayak Sen, Director General of BIDS and Dr. Jim Young Kim, former President of the World Bank, presented the underlying relationship of health with poverty in his book. If the quality of health management could be determined by the building, then the Prime Minister of Bangladesh would get the Nobel Prize. There are about 5,000 unprotected union health and family welfare centres, about 450 upazila health complexes and 14364 community clinics and several hundred districts, divisional and medical college hospitals in the country. Only a few doctors are seen in the Upazila Health Complexes, not even one at the union level. About 60-65% of the people living at the union and upazila levels do not have the privilege of seeing an MBBS doctor before their death.
It is good to hear that the Finance Minister has exempt 10 years tax to build 100-bed cancer hospitals in all government medical colleges, nephrology units and kidney canters in all medical colleges and all district hospitals, 33 autism and neuro development canters, 100 beds at the union level as well as maternity and child care services. The sector is building a 250-bed general hospital for child and maternal health, oncology (cancer) preventive medicine and a specialized hospital with at least 200 beds on the basis of 10 years’ tax exemption in all districts except Dhaka, Narayanganj, Gazipur and Chittagong. But who will run these? Like bureaucrats, by sending their cars to Uber, more than one government doctor is absent from the government hospital and travels to the private hospital for health care at a reduced rate?
In order to ensure full-time attendance of all doctors in government hospitals, it is necessary not only to increase the allocation, but also to make some fundamental changes. The rule is that no government doctor can work in a private hospital or clinic. All infrastructure needs to be developed, hospital safety wall, deep tube well, electric substation, accommodation of 5 doctors in all union health and family welfare canters, accommodation of 10 nurses, accommodation of technicians and physiotherapists, dormitory for students, accommodation of 2 intern doctors. The stage needs to be made safe and attractive. Acceptance will be attractive if 500 to 650 square feet of accommodation is provided and a monthly union allowance of Tk. 10,000 (ten thousand) is given to the doctors at the union level. 5 doctors will be trained in multiple subjects for 6 months in a row, will have to be promoted to certified specialists with examinations. Non-practicing specialist allowance of Tk. 50,000. It is to be noted that the government pays a monthly car maintenance allowance of Tk. 50,000 (fifty thousand) to the bureaucrats.
Over the next ten years the population of the Union will increase from 50,000 to 60,000 (fifty thousand to seventy thousand). Repair of security wall of Union Health and Family Welfare Centre, 650 square ft accommodation for 5 doctors and 750 square ft accommodation for 10 others, 30 bed hospital and extended outpatient department, operation theatre, 5 bed CCU, delivery room, laboratory, dormitory for students.
The construction of the library and dining room will cost about Tk 5 crore at a cost of about 16,000 square feet.
Every Union Health and Family Welfare Centre should have an ambulance system. The referred patient will be taken to the upazila and hospital at the rate of 500 taka. Union
The chief doctor of Union Health and Family Welfare Center will hold the equivalent administrative status/designation of a Deputy Civil Surgeon. Junior doctors will get interest free loan for purchasing motor cycles. In order to take the health care service more close to the people Union Health and Family Welfare Center must have a pathological diagnostic center with X-ray, ECG, echogram, microbiology, hematology analyzer, cardiac monitor and other modern diagnostic facilities. The expected expenditure will not be more than Tk. 4 crore for this project. There will be an 800 hundred square feet maternity ward, pathology, dialyses center and waiting room for patients which will cost no more than Tk. 2 millions.
(Dr. Zafrullah Chowdhury is Trustee, Gonoshasthaya Kendra)
To Be Continued
