IN BANGLADESH, seeking medical attention can often feel like embarking on a journey fraught with uncertainty and frustration. The process of consulting a doctor, whether in a public hospital or a private clinic, is riddled with inefficiencies that leave patients waiting for hours, sometimes days, just to consult a doctor. This systemic failure not only undermines the very essence of healthcare but also exposes the harsh realities faced by common patients in their time of need.

Imagine a scenario where a patient, already burdened with illness, arrives at a hospital at dawn, hoping to see a doctor. The patient joins a queue that snakes around the building, a line teeming with individuals from all walks of life, each with their own pressing medical concerns. The clock ticks away as the sun rises higher, yet the line moves at a snail’s pace. Hours pass before the patient reaches the registration desk, only to be met with indifferent staff who, often overwhelmed and undertrained, treat the patients with a cold, bureaucratic demeanour.

Public hospitals in Bangladesh, despite being the primary source of healthcare for the majority, are notorious for their inefficiency. These institutions are chronically understaffed and underfunded, leading to a cascade of problems. Patients are required to arrive at the crack of dawn to secure a place in the queue, yet there is no guarantee they will be seen by a doctor that day. The overcrowded waiting areas, lack of proper seating arrangements, and inadequate sanitation further exacerbate the suffering. Doctors, overwhelmed by the sheer volume of patients, often have only a minute to spend with each one. This rush leads to cursory examinations and superficial consultations, with little room for thorough diagnosis or patient care. The system, strained to its limits, leaves doctors and patients equally frustrated.

Private clinics and hospitals, while often seen as an alternative to the public system, are not immune to criticism. These institutions, driven by profit, tend to prioritise patients who can afford to pay more, creating a stark divide between the rich and the poor. For those who can pay, the experience may be more streamlined, but for the average citizen, the story is different. Despite the higher costs, patients still face significant wait times in private clinics. The process of getting an appointment can be just as arduous. On the day of the appointment, they may still find themselves waiting for hours, as doctors juggle multiple patients and administrative responsibilities.

My personal experience at Uttara Crescent Hospital exemplifies many of these issues. My wife had been feeling unwell for several days and we opted for Uttara Crescent Hospital, hoping that a private facility would offer quicker and better service compared to a public hospital. However, our experience turned out to be far from what we had hoped for. Despite having an appointment, we were asked to wait. The hours dragged on, and our patience wore thin as we sat in uncomfortable chairs, watching the clock. After nearly three hours of waiting, we were finally called in to see the doctor. The consultation was brief and felt rushed. While he/she prescribed medication, there was little discussion about my wife’s condition or any detailed explanation of the treatment plan. This experience underscored the broader issues within the healthcare system. The inefficiencies and lack of empathy from the staff were disheartening. It became evident that even private hospitals, despite their higher costs, were not immune to the systemic problems plaguing healthcare in Bangladesh. For the common patient, navigating this healthcare maze is a dehumanizing experience. Reports of mistreatment by hospital staff are rampant. Patients are often met with dismissive attitudes, rude behaviour, and a lack of empathy. In some cases, patients have been known to wait for hours. The lack of clear communication and respect for the patient’s time and dignity is a glaring issue. Moreover, the cost of health care in private clinics is prohibitively high for many. This forces a significant portion of the population to rely on the faltering public system, creating a vicious cycle of overcrowding and inefficiency.

In private hospitals, the hidden costs — from registration fees to unnecessary diagnostic tests — can leave patients in financial distress. Out-of-pocket healthcare expenditure in Bangladesh is, in fact, the highest among South Asian countries, with patients having to bear almost 70 per cent of their medical bills. Out-of-pocket healthcare expenditures have gone to such an extent that even middle-income households appear to be just one medical bill away from poverty. According to a recent study by the Bangladesh Institute of Development Studies, at least 6.13 million people dropped below the national poverty line due to meeting their healthcare expenditures only in 2022.

The root of these problems lies in a healthcare system that is both overburdened and under-resourced. Addressing these issues requires a many-sided approach. Firstly, increasing investment in public healthcare is essential. More funding is needed to improve infrastructure, hire additional staff and provide adequate training for existing personnel. This would help reduce wait times and improve the overall quality of care. Secondly, there needs to be a systemic overhaul of the appointment and registration processes in both public and private hospitals. Implementing digital systems for appointment bookings, patient records, and queue management can streamline operations and reduce wait times. Hospitals should also adopt more patient-centric approaches, ensuring that communication is clear and staff are trained to treat patients with respect and empathy. Thirdly, regulating private healthcare providers is crucial. The government must enforce policies that prevent private clinics from prioritising profit over patient care. This includes capping fees, ensuring transparency in billing, and penalising institutions that engage in unethical practices.

The current state of health care in Bangladesh is a reflection of broader systemic failures. Patients, already suffering from illness, are subjected to indignities and inefficiencies that compound their distress. Both public and private healthcare providers have a responsibility to address these issues and create a system that prioritises patient welfare over all else. The journey towards better health care is a long one, requiring sustained effort and commitment from all stakeholders — the government, healthcare providers and the community. By addressing the root causes of inefficiency and mistreatment, we can hope to build a system where patients receive the care they need with the dignity they deserve. In the end, health care should not be a privilege for the few but a fundamental right for all.

HM Nazmul Alam is a lecturer in English and Modern Languages, International University of Business, Agriculture and Technology.