Char dwellers hardly get healthcare

26 June 2010, 18:00 PM

Mahbuba Zannat with Nityananda Halder, back from Shibchar

Sixty-year-old Mansur Fakir got extremely surprised when he was asked whether any health worker comes to his village at Fazlul Sarkarer Kandi in Shibchar, Madaripur, to provide health service. "What is health worker?" asked the elderly man who has never seen any health worker coming to his village where he has been living for 12 years. He even could not remember when he last visited a doctor. "They find it easier to suffer rather than going to the upazila health complex, as boat is the only mode of transport available for the people of this village. During eight months of a year when water level in the river remains low, people have to wade through muddy water miles after miles to get a boat," said Bazlur Rahman Sarker, chairman of Char Janajat union. Even deaths of mothers during childbirth have become commonplace in the area due to absence of healthcare facilities, he said, adding that the impoverished people in the country's char lands are the most deprived in terms of healthcare, as the health and family planning programme is almost absent here. The family planning workers who are supposed to provide primary healthcare services, medication, counselling and contraceptives free of cost at the doorsteps of the people seldom visit these remote areas by crossing the river. There are only seven workers in five Union Health and Family Welfare Centres responsible for providing healthcare services to around one lakh people living in the char lands at Faridpur and Madaripur. Only four community clinics have been established for the people of six unions recently, but they are yet to function properly. The health and family planning officials also admitted that the people living in Char Nasirpur, Diara Narikelbaria, Bandarkhola, Char Janajat, Kathalbari and Matbarer Char are almost deprived of healthcare. "To receive treatment, they have to cross the river by boat which takes hours to go to the upazila health complex," said Abu Bakar Mollah, civil surgeon of Madaripur district. Moreover, the health service delivery system at the health complex is very poor as there are only six doctors against 21 posts. The X-ray machine has been lying damaged since 2006. Almost all the families in char areas have five to eight children. They don't know that they are supposed to get free contraceptives, as no family planning workers ever visited them to provide the service. "A health worker comes to this village occasionally to vaccinate children against various diseases. But the family welfare assistants never come here," Noorjahan, a mother of five children, said, adding that she goes to Bhagyakul area by crossing the river every three months to buy contraceptive injections at a cost of Tk 40 to 60. A survey conducted by Unnayan Shamunnay in association with the Concern Worldwide in 2008 revealed that more than 50 lakh people in Bangladesh live in char lands and over 77 percent of the char dwellers are extremely poor. It also revealed that 15 percent of diseases in chars are not treated. The reason behind it is poverty in more than 38 percent of cases. More than one fifth of diseases cannot be treated due to either unavailability of treatment facilities or unaffordable facilities. The survey conducted in 1,489 households of 14 island char communities found that most pregnant mothers in chars do not receive any antenatal care and about 97 percent of deliveries take place at homes. Almost 37 percent of children under 5 years suffer from acute respiratory infection and 20 percent of them remain untreated, it added. "As per the constitution, the government is bound to provide health service to the people whether they live in char or other remote areas. If the existing infrastructure is not enough to reach out to those people, the government should think of alternative ways," said former president of Bangladesh Medical Association and President of Health Rights Movement Prof Rashid E Mahbub. "If doctors and health workers don't want to go to remote areas, the government should hold health camps there frequently," he added.