Originally posted in The Daily Star on 26 June 2021
The makeshift community clinic at Kochkhali char remains mostly unused due to a shortage of medical facilities and human resources. photo: Mostafa Shabuj. Photo: Mostafa Shabuj
“Around one and a half years ago, my sister-in-law, Taslima, died after suffering from post-pregnancy complications. She gave birth to a baby while still on the boat, heading towards the hospital. Unfortunately, she passed away before we made it,” shares 27-year-old Shahida Begum, a local of Kochkhali char.
“If a pregnant woman needs emergency treatment, we have to take her to the town hospital, which is 20 kilometres away from the village and takes two to three hours to reach,” adds Shahida.
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The char, located at the Fulchari upazila of Gaibandha district, has a population of 1,000 people. Most of them receive primary healthcare services from a government community clinic named Ujaldanga community clinic and an NGO-run satellite clinic. However, these health centres are suffering from serious shortage of medical equipement and human resources.
Shapla Akter, 30, another local of Kochkhali, shares, “The CHCP (community health care provider (CHCP) visited the area a few times in the last one year. When asked about this, CHCP Anju Monowara Rikta said, “I try to attend office regularly, but I cannot go there when boats are unavailable. Besides, I cannot visit the office when the weather is bad.”
When contacted the civil surgeon of Gaibandha, A.M. Aktaruzzaman, stated, “It is the basic duty of a CHCP to attend office every day. I will be contacting the local authorities regarding this.”
In the char areas of Gaibandha, over half a million people do not have proper access to healthcare services due to poor quality of roads, shortage of medical facilities and equipment, and a lack of human resources.
According to the Fulchari Upazila health administration, there are 19 community clinics in the Upazila. 12 are in the char areas, and three have been closed for years due to a lack of human resources. Among the 12 char community clinics, five were destroyed due to floods.
The char people urge the government to renovate the existing community clinics, set up more clinics and appoint sufficient human resources including health assistant, community doctor and paramedic. They suggest that shelter houses should be built in char areas where medical camps can be run to provide for this absence of improved treatment facilities. They also feel the need of organising health campaigns in char areas regularly to make people aware of various health issues particularly water-born diseases.
Selim Parvej, Chairman of the Fulchari Upazila Parishad, says, “Over 60 percent of the people from the Upazila live in 40 to 50 chars, but there are not enough hospitals for them. The government should build more healthcare facilties as well as roads to ensure proper helthcare for the inhabitants.” He also suggests that the government should train community health volunteers and provide them some incentive to address the gap of human resources in the health centres.
The central and transformative promise of the 2030 Agenda for Sustainable Development, leave no one behind, is especially applicable for people living in chars since they are much more vulnerable to flash floods and natural disasters than people living on the mainland.
If the government can’t ensure appropriate healthcare support, people will suffer from diseases and lose the ability to work since most of the poor people in char areas rely on physical labour for their livelihoods. The health issue needs to be addressed adequately as healthy lives and well beings are closely connected with the achievement of other SDGs including SDG 1 (no poverty), SDG 2 (zero hunger) and SDG 5 (gender equality).
The government must allocate more budget for char areas and provide additional support to the health system. The health service providers can be given a motivational allowance, living arrangements, security etc. The Civil Surgeon or their representatives must ensure proper and periodic monitoring of the needs and quality of services in these remote chars.
The voices of the people of the chars are also vital to moving forward. There must be a platform where the thoughts of the people can be put into effect. A citizen oversight mechanism should be institutionalised through periodical citizen-led social audit and public hearing on the services of the existing healthcare facilities. Information on health services in community clinics, thana and district health complexes need to be made available through noticeboards and other accessible means.