Smart health sector in Smart Bangladesh: Achievements, preparedness, prospects

At the end of the successful journey towards Digital Bangladesh, the next destination for Bangladesh is now a Smart Bangladesh. All our roads are now one-way centric path guided by the visionary and pragmatic Prime Minister Sheikh Hasina. The health sector is no exception to this overarching vision. I think anyone would agree with me that when a country embarks on a digital journey, the starting point is generally the gateway of healthcare services. In this regard, Bangladesh is somewhat an exception, maybe our health sector is a bit behind in this regard.

Starting from the elimination of black fever, Bangabandhu’s granddaughter’s landslide victory as Regional Director of the World Health Organization for South-East Asia and even before that, getting the 'Vaccine Hero' medal from the Honorable Prime Minister - these are all milestones in our health sector. But where excellence has put our health sector at the forefront of the world and made the nation proud, is our incredible success in fighting Covid-19.

Bangladesh is one of the three countries in the world that have been able to administer one dose of the Covid vaccine to one crore citizens in a day. This achievement is noteworthy considering that there are over 90 countries in the world with a population of at least one crore. The success in our healthcare sector can rival that of our two most populous neighboring nations, India and China. Furthermore, in my perspective, our success can even surpass the accomplishments in India and China because each of these two countries had multiple vaccines of their own production. We are quite unique in that area. Even though we have no vaccine of our own, we gave the covid vaccine to 1 crore people in one day. Not only that, but from the very beginning of the COVID journey, we were able to bring a significant portion of the population under the protective umbrella of free vaccines. All of this undoubtedly signifies the capability of a Smart Bangladesh in creating a smart healthcare sector.

In the context of all these achievements, a pertinent question may arise: why aren't all our hospitals digitized yet? Why is all the information of every patient from our upazila health complex to the medical university - not digital yet? When all the citizens of the country have a National ID card, when an ordinary citizen like me can scan the Bangladesh passport with an e-chip and walk straight through Narita airport immigration. So, why do I still need to sit in a medical university OPD or indoors to submit a handwritten prescription? Nevertheless, there is also another side to this story. Undoubtedly, our progress in these areas is not at all lacking in any way.

On that very day, the senior officials of the Directorate of Health and the ministry formally inaugurated telemedicine services in 100 hospitals of the country at a hotel in Dhaka. This is no small feat, much like the ongoing effort to increase the bed capacity of government hospitals from 50 thousand to 70 thousand. Simultaneously, doubling the number of specialists in upazila health complexes and upgrading each upazila hospital to 50 beds have been undertaken. Additionally, nearly every medical college in the country has established a Unit-2 in their hospitals. Any critic of the Awami League should acknowledge that, from establishing the world's largest Burn Institute to setting up national-level institutes for almost every disease, or introducing advanced medical facilities for cancer, heart diseases, and trauma care in all eight divisions of the country, and equipping every hospital in the country with state-of-the-art medical equipment – these are no small achievements. It is difficult to find a person who has not turned into a blind eye after entering the newly added super specialized hospital at Bangabandhu Sheikh Mujib Medical University campus. Moreover, in terms of infrastructure and administration, the presence of a foreign physician or a foreign hospital executive has not escaped my notice. Undoubtedly, this is no small feat.

Despite all these advancements, our healthcare sector, in the race towards a Smart Bangladesh, has not been able to fully qualify or participate in the final race. On this matter, some may perhaps agree, while others may not. Since the Prime Minister does not keep a lid on this matter, often expresses frustration, sometimes anger about the inadequacy of medical science practice in the country, so what is the need for me to cover the fish with green vegetables? The interpretation of this may vary from person to person. From my perspective, our progress in the health sector has been focused on infrastructural and physical investments. We have added modern hospital buildings one by one in the health sector and filled them with all modern equipment; But elsewhere our investment remains inadequate. It is undeniable that infrastructural development is an essential part of any development programme. But in the same way, investment in creating a healthy environment for skilled manpower and intellectual practice is also important. The Bangabandhu satellite was not made by us, nor was it launched into space; But now its management is completely in the hands of our experts. A few days later, the same thing will happen in Rooppur Nuclear Power Plant, as it happened in Dhaka Metro Rail or Rampal Power Plant and is going to happen in Matarbari Deep Sea Port or Padma Bridge and Dhaka Elevated Expressway. Why should only the health sector be lagging behind in this area, although in this sector we have more experts and highly skilled human resources than any other profession. Despite having highly skilled human resources in this field, the momentum may be hindered due to the absence of the right leadership in the right place.

Understanding the mindset, actions, and demands of a liver specialist in the field of medical science and healthcare is challenging. It is often difficult for professionals from other disciplines, regardless of their administrative skills, to grasp and handle the nuances properly in most cases. The progress in our agriculture sector from science to smart initiatives is much admired and often envied by a doctor like me. But the reason is also obvious. Every place in this sector is led by the people of the profession. He who researches agriculture is an agriculturist, so he who takes his discovery into confidence and then brings the product to the market is also an agriculturist. It is noteworthy that many of the administrative officials who oversee and implement the entire process from innovation to production in agriculture are also agriculturists.

On the other hand, in the field of healthcare, there is no such opportunity for coordination. Rather, if someone claims any innovation confidently, without verifying or selecting the truth, and sits down to celebrate the festival of false evidence before anyone else, it is our professionals in the field who suffer. My experience as the lead researcher for the development and clinical trials of the MRNA COVID-19 vaccine developed in Bangladesh is a testament to this reality. However, if I am asked or told, "How far is our healthcare system from the vision of a Smart Bangladesh? What will the upcoming Smart Bangladesh bring in terms of healthcare? Will it be just digital or also smart?" Then, with eyes closed, I will cast my vote towards the Smart Healthcare System of Smart Bangladesh. As a person with the mindset of "Sobjanta Shomsher" (a fictional character known for unbiased judgment), my perspective is not only about wandering around, but rather as a rational individual, all my reasoning guides me in this direction.

Some say that due to Covid, we have gained a lot, such as the progress in our e-commerce sector, as heard in an event where the commerce minister in an event mentioned the advancements in our e-commerce sector due to Covid. But I think our biggest achievement due to Covid is in our health sector. Almost the whole of the prime minister's two consecutive terms have been spent removing the mess of 21 years after 1975 and putting the country on the highway of development. In her third term, she has shifted her focus towards the healthcare sector in the wake of the Covid crisis. And it is needless to say that the achievements of this country have caught the attention of this noble woman beyond the borders of the country and in the international arena.

Let me share an experience of mine. Recently, I had the opportunity to discuss the initiation of liver transplantation in a hospital with the Prime Minister. Although initially allotted only 15 minutes the conversation extended well beyond the scheduled time, reaching almost an hour. I was astonished to witness how she posed diverse questions on various subjects, critically reviewed her own decisions in certain areas, and, ultimately, provided us with an excellent roadmap. Therefore, when I write about casting my vote for the Smart Health sector of Smart Bangladesh, I do so with full understanding. And who wouldn't? The entire world acknowledges this today. The most significant achievement in the health sector is 'The Sheikh Hasina Initiative.' In a historic move, the United Nations General Assembly adopted a resolution for the first time in the name of an individual. The resolution, widely discussed, explicitly advises UN member states that if they aim to achieve the Sustainable Development Goal for universal health coverage by 2030, they must embrace the concept of Sheikh Hasina's community clinics.

Author: Professor, Head of the Department of Interventional Hepatology, Bangabandhu Sheikh Mujib Medical University, and Member Secretary of Sampriti Bangladesh.