IT IS unthinkable that 3,000 physicians now take salaries without doing their duties in government health facilities. The health minister lambasted the physicians who did not want to work at health centres in rural areas. The alarming fact is that some physicians still live off stations in rural areas without notifying the authorities. The ministry has alleged that most of the physicians do not stay in upazila health complexes, ignoring the instruction of the government, which, more often than not, causes sufferings to people in rural areas. These allegations have some rationale in that they came at a time when several warnings issued by the government’s high-ups failed to keep physicians at their workplace, particularly in remote areas. The allegations are also justifiable as physicians chose to be recruited into public service being fully aware that after their appointment, they could be posted to remote places in rural areas to serve the rural population. But now the burning question is — are the upazilas replete with adequate infrastructural developments such as proper academic facilities for the children of the physicians and proper transportat system such as roads and highways which can make the physicians feel at home there? The answer should be ‘no’.
That is the reason the physicians pay up to Tk 1 millon in bribe for appointment and transfer in their jobs in Dhaka and its surrounding areas. A clear manifestation of the yawning gap between urban and rural areas is that the rich or the privileged predominantly live in urban areas while the poor or underprivileged mostly in upazilas or rural areas. That urban-rural gap in education still persists is evident in the recent results of the Secondary School Certificate, the Higher Secondary Certificate examinations and their equivalent examinations. As for healthcare facilities, although the country has one of the best public health infrastructure spread down to the rural areas, it is failing to render services in union health centres and upazila health complexes as ambulances and X-ray machines there often go out of order and in most of the cases, they are not repaired. There are about 1,400 union sub-centres and family planning centres, which are also marked by non-availability of medicines.
Staying away from duty in rural areas by doctors and bribing for appointment and transfer in their jobs in Dhaka and its surrounding areas constitute some insuperable challenges to good governance in the health sector. To reverse this decline in governance, the incumbents, at the moment, need to pay attention to the promotion of the infrastructural development of rural areas so that physicians can feel at home in upazilas and no sense of deprivation assails their psyche being posted there. Instead of doing that, the incumbents are found complacent about their attainments in the health sector and trumpeting their achievements in it.
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