Health policy...
Health policy, drug policy, aurvadi, herbal remedies, homeopathy, kavi razi, Fatowa & so on
Looking at health system from my point of view-
Medicine is a science which deals with facts obtained from years of experiments; it's not magic which will cure illness & when the spell is gone the person will die; someone may be suffering from sick people's symptoms for years but was completely well inside. Lifetime experience has it's own value & it should be appreciated. We want healthy citizens so they can work, healthy kids so they can study, healthy moms to raise children better & a peaceful home for the elderly so they can enjoy retired life.
It's a knowledge based humanitarian work, but patient must be insured to see a doctor. Government (which is centrally-controlled-health system) can fix a pay scale for the doctors based on their merits & experiences. Also, they should be sorted out by their higher qualifications after submitting their resume' to the government. Their personal life should not interfere in their profession; let the government know, if the doc needed their assistance - it could his illness or personal debt or any family crisis. Those who have nothing to hide, let them have the privilege to be known by the country. Acquiring MBBS degree in BD, whether it is from government or private medical college or from foreign country will tell the level confidence in field of medicine for practicing it. It has to be registered by BD medical association. Unemployed female doctors /confirmed bachelor doctors/ doctors with rich background with inherited property- all are equal when at work. Doctors who are engaged in government job or chose private practice should be full time engaged to their respective profession. Neglected but talented doctors should be recognized & rewarded. The bulk of money they are pouring in each month to the bank from the patient unfortunately they can't enjoy, their living status remain the same. Their hunger for more money make them a money-making-machine & unsociable day by day. By changing their views toward life, they could gain a lot; country will honor them all the time by giving them a better quality of life, inviting them to the national occasions, invitations to international seminars held in the country. Religion has a very important role in medical practice but saving life is more important. When dealing with life & death situation, doctors should be honest to the pt from beginning to the end. A criminal who may be sentenced to death should get equal opportunity treatment for curing his illness. Fake doctors growing like a mushrooms all over the country, should be identified & punished. Don't see patients as equal counterpart & adopt a negative attitude towards them as they may have better living, coming to you better dressed. Don't forget that they are sick when they come to you. Professional jealousy among doctors are so badly present that they can't recognize each other; people who look up to them for better care get confused. A junior doctor may be talented - let him have the credit. Divorced lady Doctors when married again or remained single or jointly practicing medicine with a male doctor should be known by their own name. Kolkata is a state in India even though kalkatians speaks the same language like us, it's hard to distinguish which country they belong, but they should be treated as a foreigner when they are seen by BDi doctors, unless they take the BDi citizenship. It makes lot of difference. If some one decides to practice medicine even in his late age are always welcome but they must complete 5 years course MBBS.
Doctors should have wide access to the national TV & radio, in the army & running the country from the background in emergency situations. Instead of making poor people pay large sum of money on frequent visits or spending money on lab tests, having unnecessary operations, they should see how less a patient can spend & get a best treatment. Pathology is a integral part of medical science which many of us do not know; doctors should send pt for lab tests for quicker way to diagnose a disease & also cut down unnecessary visits to doctor as well. At school level government should sort out each & every child; find out, if they are getting treatment & regularly check up. Dentist should show a child to brush his teeth regularly; not to discourage him by pulling a healthy tooth for making money. Taking permission before doing even any minor thing is a important curtsy a doctor should adopt. Young doctors should be encouraged to participate in any national emergencies. Male doctor should respect a fellow lady doctor & help her out. Don’t produce a muted lady doctor but let her have the right to speak out. Invent to cure people but not to find ways to make them more sick. Finding a resourceful patient & drag every penny out from him, even when his sickness is not serious is a crime. That patient will later become overpowering & will be ruling the doctor later. Don’t force a patient for gifts or invitation to their places. Jealousy with one doctor to another is a common issue in medical field which I saw I while was a medical trainee in BD, rather then encouraging the juniors for carrying out their duty, they let them down scrutinizing their every steps; breaking affairs with two people even though they are genuinely fallen in love, by non cooperation and also habit of taking patient's personal belongings as a gift, which may be a gift given by their loved one. In this case managing the dignity of doctors is very crucial when people from other professions like dentist Lawyer ,Engineer, Architect... who are equally qualified can outsmart them. Doctors & Lawyers should work side by side, as legal issues will be brought up in each & every step a doctor makes . Doctors will get all kind of patients during their visits like an acid attack victim , child abuser, rape victim , domestic fight victim ,child molester, attempt to suicide victim, prostitutes, transsexuals, criminals coming & revealing their secrets to them .Once conducted in BD by some senior doctors which also created lot of chaos in the country. There should be a complete list of government, semi gov & private pharmaceutical companies & the lists of drugs which are manufactured within the country . The drugs which are imported from abroad should maintain the international standard & legalized making sure band drugs are completely out of market. The local pharma where desi drugs are manufactured in a cheap unhygienic & faulty way, must be stopped immediately. Drugs which are made for geriatric, pediatric, men & women pts - doses should be given according to that category. Once a boy child died of overdose of Napa (paracetamol) given by unregistered doctor in rural area went unchecked.
BD was once part of Indian subcontinent that we can’t deny. It was once famous for black magic practice which still exists in rural areas & it has no boundary can reach you in USA. Doctors might be getting patients based on that. I don't know how much a poor country like BD can afford spending on researches but some percentage could be saved for that. I believe docs at work are not so religious sometimes they don’t even believe God but sociably they keep their religion for their marriage & children. On religious holidays doctors from other religion can run the hospital & emergency should be open -24 hours & on call doctors should be available. Pt's secrecy should be maintained all the time, they are not posing for public nudity when they come to see a doctor or go for an operation. Under no circumstances professional secrecy of a pt (like theft, child abuse, prostitution, illicit sex, transsexuals, gay & lesbian relationship, masturbation) should be disclosed. Even for the dying pt, doctors should always adopt positive attitude; assurance should be first thing pt should get from the doctor . Proficiency in English language in medical practice is not mandatory & it can be expressed in any language but the prescribing drug & it's doses must be accurate. Criticism of each other is allowed in professional line, only to improve the quality of treatment. Freedom press, if not possible but freedom of speech should always be there to better evaluate the situation we are in.
Also the government should verify all the doctor’s citizenship; if they maintain dual citizenship, the country where they are working, should get first priority. He should not be biased by the 2nd country he represents. He should not forget the oath he took when he became a doctor (his pt should be his first consideration...). We want politics free health system where they don't have to pay money to chada baz for their establishment.
Drug policy-
First Bangladesh's Drug Policy was adopted in 1982. ... Also, all essential drugs (initially 170 of them) were made available at or below the affordable price that the government has set. There were two other drug policies adopted in 2005 and 2016. The impact of these policies is visible and looks good overall
On April 27, 1982 the Ministry of Health of the government of Bangladesh, set up an 8-man expert committee to evaluate all the registered pharmaceutical products presently available, and to formulate a draft National Drug Policy. Objectives are: 1) to provide support for ensuring quality and availability of drugs; 2) to reduce drug prices; 3) to eliminate useless, nonessential, and harmful drugs from the market; 4) to promote local production of finished drugs; 5) to ensure coordination among government branches; 6) to develop a drug monitoring and information system; 7) to promote the scientific development and application of unani, ayurvedic, and homeopathic medicines; 8) to improve the standard of hospital and retail pharmacies; and 9) to insure good manufacturing practices. 16 criteria were agreed on as guidelines for evaluating the drugs on the country's market. Drugs in Bangladesh have been classified into 3 categories. The 1st is drugs that are positively harmful. They should be banned immediately and withdrawn from the market. There are 265 locally manufactured drugs and 40 imported drugs in this category. The 2nd, drugs to be slightly reformulated by eliminating some of their requirements. There are 134 drugs in this category. The 3rd is drugs that do not conform to 1 or more of the 16 criteria/guidelines. There are over 500 drugs in this category. The new drug policy will produce a saving of 800 million taka (US $32.4 million). Drug supply in Bangladesh is a problem. The public sector distributes 20% of the total. In the private sector, drugs are supplied through import and local production. Investment for research by the pharmaceutical companies is essential. The principles laid down by the International Federation of Pharmaceutical Manufacturers Associations for the supply of good medicine needs to be put into practice.
Drug development, manufacturing and marketing have become one of the most important sectors throughout the world for various reasons. Realizing its importance, the World Health Organization (WHO) has stressed the need of a formulated drug policy in every country of the world. Bangladesh responded very early to this. Experiences over the decades have shown that the said policy could not fulfill in toto the declared objectives. Our aim is to describe some of the lacunae for which total implementation of drug policy is still struggling. For this purpose, we meticulously analyzed our Drugs Control Ordinance 1982 (with an amendment brought in 1994) and upcoming National Drug Policy. We mainly focused on three factors pointed out by WHO, which are crucial of a drug policy, which include price limitation, quality and rational use. We found great variations in price which need to be controlled. Regarding quality, safety and efficacy, we have to be more cautious. Rational use of drugs is also an area to be focused on. Every physician should prescribe proper drug with due indication and in rational way. This pitfall of implementation might happen in many countries of the world and it needs a global discussion so that the future policy makers can mitigate the demand of the nation.
Homeopathy is a pseudoscientific system of alternative medicine. It was conceived in 1796 by the German physician Samuel Hahnemann. Its practitioners, called homeopaths, believe that a substance that causes symptoms of a disease in healthy people can cure similar symptoms in sick people; this doctrine is called similia similibus curentur, or "like cures like". Homeopathic preparations are termed remedies and are made using homeopathic dilution.
For the 38 million people in France who depend on homeopathic remedies to cure insomnia, backaches and other medical conditions, getting a good night’s sleep just became a little more difficult .Homeopathic remedies can range from chamomile tea for insomnia to arnica for arthritis. Highly toxic chemical elements like arsenic and plutonium are used frequently. Chemical compounds like potassium cyanide and mercury cyanide are on the homeopathic ingredients list as well. So pollen or grass could be used to create a homeopathic hay-fever remedy. Common homeopathic treatments are for asthma, ear infections, hay-fever, depression, stress, anxiety, allergy and arthritis Homeopathic remedies can be used to treat a variety of illnesses, including travel sickness, diarrhea, influenza and insomnia.
info collected from internet
In modern world homeopathy is equally popular as allopathy in curing the disease; it's only the person's personal choice which method to pick for curing his illness. It's nothing but a big headache if you are knocked down by your doctor & lost a tooth or your wrong leg amputated or you have a skewered nerve in your bladder after a major surgery which is making your life a hell.
Defining the odds-1. Is it religiously approved, producing babies without a wedlock in the infertility centers? 2. Can black magic kill a person? 3. Transsexuals -when their secret is revealed, which religion do they belong or they don't have any religion! 4. When a baby is about to be born, trying to come out to the world from the mom's womb. Twisting & turning through the birth canal , does it rape the mommy or mom rapes the baby! 5. Licensed prostitutes when they don’t break the social norm, no harm done if they seek help for basic human right like food , shelter, health & protection for their life. 6. I saw a documentary film on TV showing an Egyptian lady couldn’t gave birth in her prime age & was childless throughout her life but when she was more than 70, her tummy was big with a solid mass ,which she felt for many years but was untreated. Finally when she got the chance to see a doctor, they diagnosed it as a benign tumor & she was sent for operation to remove it. But after the operation the doctors found : it was her long lost child who died in her womb & never came out .The Egyptian heath system was so crippled that they let this woman suffer all her life & finally before her death, they made her burden free.7.Talking about medical threat, a son of a surgeon when just passed out, holding the MBBS degree was overwhelmed when he was asked to perform a minor surgery but didn’t know if he was competent enough to complete surgery to the end. A fellow female classmate agreed to have an appendectomy -a small operation in the tummy. When the anesthesia was given, she never recovered & died of overdose of anesthesia after the operation. The news was never reported & every body kept their silence. Surgery is a team work, it’s surgeon's responsibility to see everything goes right, even when anesthesiologist made the mistake. When a surgeon loses his identity in the OT table, he becomes an ordinary street mugger –ready to stab you. 8. After acquiring MBBS degree, a lady doctor was diagnosed by the competent physicians from UK that she has been suffering from intense psychological trauma & harmful enough to kill a person if she practices medicine. So, she chose a life of an ordinary illiterate citizen & found peace in her life. 9.I noticed many of our country women are embarrassed & refuses to see a doctor even when they face post delivery complications after their babies were born normally .10.Beware, sexual predators are notorious liar & shameless . He may be your child's natural father but never knew that he harbors the same sickness in him for many years. 11. Child marriage - a girl who had a sexual experience in her teens does not make her status legal; instead it means she was raped by her partner but her mental capability is still what her age states. Forced marriage , girl in captive status for many years, rape , acid thrower to disfigure a girl’s face , eve teasing still prevails in our subcontinent . 12. Identity fraud is a major problem that I saw when I first came to USA. For that Identical twins after birth or when enrolled in the voters list, must submit their birth record to the local police station. 13. Is it illegal to perform female circumcision in BD or making babies from surrogate mother by artificial insemination.14. Best advice for a couple who are facing poverty is to stop having sex.
Medical center outside city location 200-400 bed a small scale budget hospital which I presume is a place for getting treatment & getting well but not a place for amusement. We don't want a 5- star- hotel but what we need is a disease free, clean place where the pt will come to get rid of their illness but not to acquire them. A medial team includes( for surgery ): doctors, nurses includes Ayas, sweepers & brothers, lab techs. Provision for medical students from medical colleges to enroll for voluntary work during study break ; that includes a check & coupon for food. Dpt 1.Medicine: cardiopulmonary diseases/gastroenterology / pediatric /skin & venereal /endocrinology includes diabetics ,thyroid, /neurology/ infectious diseases- TB, diarrhea & mental health ; 2.Surgery : Eye, ENT/orthopedic, neuro / pediatric surgery. 3. Gyne/obs 4. dentistry . 5. Pathology dpt, X-Ray, radiotherapy, ultrasound, out pt dpt & emergency. An auditorium for case study, pt's progress & case evaluation, some studies for drugs efficacy & potency & a small research team for extended study may be encouraged , people who wants to volunteer which may be funded by the gov or non profit organization. A group of non medical persons should be employed - from social welfare, behavioral science , nutritionist, biochemist, also accountant, computer specialist, banker ,clerk librarian , guard, driver, cook, gardener & Aya. Rooms for prayer (for Muslims, Hindus & Christians); also a recreation room with TV . Citizenship verification , family counseling, funds for financial support for needy pts. Elderly pt should get help by the hospital stuff all the time. A free ambulance service & local transport with a fare fixed by the hospital authority. A parking lot for visitors as well for doctors. Bus service for the staff. Food should be hygienically prepared keeping the nutritional values & maintaining the calorie- count. If possible, food nutritionist should employed. A canteen for doctors, staffs, visitors with subsidized rate. An office -which should be fully equipped & functional with daily office supply. A daily news journal published for visitors, doctors. A Library should be stuffed with computers, books, current news journals for the doctors. A bank & a pharmacy should be placed within the boundary. Good behavior & patience is expected every where . The hospital staffs are dealing every day with pts not normal person. Pt should be treated equally irrespective of their nationality, race, religion or criminal background. Surgical instruments should be cleaned by autoclave or by any modern method. Use of incineration. recyclable disposables like syringes, needles, surgical gloves, gauze & use of tissue papers should be encouraged. Bed sheets, pillows, curtains , surgical gowns, pt's gowns should be laundered daily. Floor should be mopped with detergent daily. Bathroom should be cleaned with strong detergents as most of diseases spread from wet unclean bathroom. Insecticide spray or fumigation can be use for bed bugs cockroaches , rats & nets for mosquitoes. Foreign specialists are encourage to see pt if possible provision for their place to stay in rest house. The treatment that pt will get should be free of charge. Malpractice should be strictly prohibited. Under no circumstances doctor- pt relationship should be broken. A gate out side which will screen for visitors. A beautiful garden with seasonal flower, a water fountain , a pond, a vegi garden , some coconut , banana , papaya tree may be planted behind the center. A restriction bar for the media like radio TV newspaper. A big hospital should be located outskirts from a busy city, built in a big open location & for that special grant may be funded from the government .
Practicing Medicine is a brain work profession, it's all about making some one sick better or saving someone’s life; more he does that more credits he earns, more power he gains in the world.
The Hippocratic Oath : I solemnly pledge myself to consecrate myself to the service of humanity ; the health of my patient will be my first consideration . I will maintain utmost respect of human life from the time of conception , even under threat I will not use my medical knowledge contrary to laws of humanity
This article I wrote for the people who are aware of the lack knowledge, experiences & expertise, systems shortcomings in medical science & this is only a suggestion to the people who wants some change for betterment of life, not an instruction.
