287 zone-based public hospitals to be built in the first phase (2021-2025) of the DAP
When her minor daughter fell ill with fever and diarrhoea, apparel worker Rabeya Sultana rushed her to the Dhaka Medical College Hospital (DMCH), some 4.5km away from her home in a Hazaribagh slum.
“I had to suspend my work and spend Tk250 for a CNG-run auto-rickshaw to reach the hospital as there is no affordable healthcare facility nearby my home,” Rabeya told this newspaper at ward no 32 of the hospital.
A mother of three, Rabeya is not only worried about her daughter, but also about the financial loss she was facing as her employer would deduct her salary for being absent at work.
But there would have been a different story had there been a community-based public hospital in Hazaribagh, one of the more densely populated areas in an already overcrowded Dhaka.
“I would have arranged quick healthcare services for my daughter and saved transportation costs too, alongside ensuring my wages,” the woman said.
“Additionally, my mother could have taken care of the baby, allowing me to attend to my work,” she concluded.
Like Rabeya, Md Solaiman too brought his son, who was vomiting repeatedly, to DMCH all the way from Vatara, travelling more than 13km away from his home.
“I rushed my son here finding no other way to provide him with better treatment locally,” he said.
However, a physician at DMCH, who examined the boy, asked Solaiman not to admit his son as the latter’s medical complications were not that serious.
The two parents are symbolic of the stories of thousands of city dwellers bearing the brunt of journeying and spending extra money in bringing patients to better medical facilities. This is happening just because the bustling city is failing its residents in ensuring public hospitals, adding to the woes of the lower-middle and poor families, to say nothing of the extremely poor.
Talking to Dhaka Tribune, Saad Ahmed Tonmoy, among other on-duty doctors at DMCH, said they catered to numerous patients having minor problems, alongside those with critical health issues, every day.
A majority of the patients turn up there from different parts and even the outskirts of the city, owing to a lack of quality and affordable health services in their local areas.
Ray of hope
Despite repeated promises regarding healthcare services, successive governments have failed to take initiatives to build hospitals as required, considering the growing number of people living in the mega city.
Last year’s acute shortage of hospital beds and ICU facilities amid the Covid-19 pandemic showed it all. The same picture has resurfaced in the past few days, with people struggling to get medical help even in the healthcare facilities dedicated for Covid-19 patients.
Much to the relief of city dwellers, some town planners have devised a comprehensive zone-based plan for affordable healthcare services.
The crisis in the health sector has never been prioritized in the strategic plan for Dhaka city since the independence of Bangladesh, which is why a balanced healthcare service has remained a far cry, they said.
“For the first time, health services have been incorporated into a strategic plan--Detailed Area Plan (DAP) for the 2021-2035 period (which may be extended will 2041),” said Khondker Neaz Rahman, deputy team leader of DAP.
The plan, he said, covers 1,528 square kilometers of area, including Dhaka, Gazipur and Narayanganj cities, aimed at ameliorating the sufferings of people, with special focus on healthcare facilities.
“Around 80% of people in Dhaka have informal jobs and are mostly unable to afford the expense of private health services. So, affordable health service is very important for them,” he added.
Rajdhani Unnayan Kartripakkha (Rajuk) has been working on the plan for the last five years and it is now ready to submit the plan to the Housing and Public Works Ministry.
According to DAP Project Director Md Ashraful Islam, once the plan is implemented, it would be possible to take healthcare to the doorsteps of the people.
“If we had a zone-based health service in place by now, we could’ve avoided the ongoing crisis regarding Covid-19 treatment,” he observed.
Health services in DAP
The DAP has divided its corresponding areas into six zones and 75 sub-zones considering the density of population and age group as well as geographical factors to ensure civic facilities while health services have been given special importance.
Around 22.21 million people will stay in the corresponding areas in 2025 and 25.94 million in 2035.
The DAP suggested building 287 zone-based public hospitals in the first phase (2021-2025) of the implementation of the plan at a cost of Tk5,113.11crore. Rajuk, the City Corporations and DGHS will gradually implement the project.
The hospitals will have 50 beds dedicated for a certain group of people.
“Planning a zone-based health service is very much scientific as population density, gender and age group are being prioritized there,” said Dr. Ehteshamul Haque Chowdhury Dulal, Secretary General of Bangladesh Medical Association.
He also stressed ensuring a standard operation system in the hospitals instead of just chalking out and implementing plans related to infrastructural development.
Claiming that they were not officially informed of the DAP, some officials at the health sector said the special focus on hospitals in the plan was nevertheless praiseworthy.
Directorate General of Health Services Additional Director General Meerjady Sabrina Flora said everyone would agree that the strategic plan for a city had to incorporate health services.
“The move highlighting the health sector must be appreciated,” said Md. Saidur Rahman, additional secretary (development wing) of Health Services Division.