Thursday, 18 August, 2022
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Why Bangladeshis Going Abroad for Treatment

Dr. Dhanonjoy Kumar

Bangladesh is a densely populated country, and the health sector of this country is relatively poor. They're being enhanced day by day. An extensive network of health services has been established to ensure equitable healthcare for every resident in Bangladesh. The infrastructure of healthcare facilities can be divided into three levels: medical universities, medical college hospitals, and specialized hospitals that exist at the tertiary level. District hospitals, maternal and child welfare centers are considered to be on the secondary level. Upazila (sub district) health complexes, union health and family welfare centers, and community clinics (lowest-level healthcare facilities) are the primary healthcare providers. Various NGOs (non-government organizations) and private institutions also contribute to this intricate network. The total expenditure on healthcare as a percentage of Bangladesh's GDP was 2.34% in 2018. In the parliamentary budget of 2017-18, only the budget for the health sector has been set at 16 thousand, 203 crore, 36 lakh Bangladeshi taka.

Medical travel is becoming a preferred social phenomenon for people globally. Bangladesh is in a losing position in this sector because many patients and their relatives are going abroad for medical treatment. They received various types of medical treatment from different countries, such as cardiovascular treatments, dental treatments, health evaluations, fertility/IVF treatments, cancer treatments, and transplant surgeries etc. The majority of patients like India for their better medical assistance. The prime reason behind it is that Bangladesh is geographically surrounded on three sides of India. India is an important neighbor, and its medical services, transportation, accommodation, etc. are relatively more-cost-effective than other medical travel destinations. There are some reasons for Bangladeshi patients receiving medical assistance from Singapore, Thailand, Malaysia, etc., because they prefer specialized hospitals, doctors, and prime quality medical services and treatments. Bangladeshi critical patients put most emphasis on some important factors for selecting foreign medical treatments, which are: availability of doctors and better service quality; sufficient medical facilities and services; medical treatment and transportation cost; and hygienic, safety, security, and attractive tourist medical places.

Most of the Bangladeshi patients are fully dependent on government hospitals because the majority of the patients don't have a decent capability to get private hospital service. Some patients who are wealthy have a decent capability to buy services from private hospitals in our country and foreign countries. It is an effort by a country to lure people from other countries by offering them not only medical benefits but also beautiful tourist destinations to enjoy and utilize their vacations in the best possible manner. For example, countries like Poland, Belgium, Malaysia, Thailand, Costa Rica, Singapore, Cuba, South Africa, and Greece are on a mission to improve their health practices and tourism to attract more people towards their services. Countries, such as Thailand, treated more than nine hundred thousand patients from the USA, Europe, the Middle East, and Asia in 2012. The major treatments that were provided by them are transplants, cosmetic surgeries, joint replacements, and dental treatments. In India, mostly patients from Bangladesh, Europe, and the Middle East come to receive cardiac treatments, Lasik, and joint replacement surgeries every year.

There are different reasons for the pursuit of increasing cross border medical tourism in Bangladesh. Most of the patients reply that the medical facilities that are available in their home country are not sufficient. A large number of patients in Bangladesh prefer to get better treatment in foreign countries for any sort of disease. Besides, routine check-ups, major surgery, and tourism were identified as other factors that influence patients' decisions to visit other countries. Most of the respondents prefer India most because of its suitable medical care. The accommodation is very easily available in India. The language, culture, eating habits, medical cost, and easy entry visa help to choose India as the most suitable medical tourism destination for Bangladeshi patients. Income has good dominating power to take foreign medical treatment decisions. The higher level, middle level, and lower level income generating patients like India for medical treatment. Out of three levels, a very small number of higher level income generating patients like Thailand, Singapore, and Malaysia for their medical treatment.

Male patients' rates of foreign medical treatment are greater than female patients. Female patients’ foreign medical treatment decisions depend on their local guardians. They will not take any decision without good consent from her family members and guardian. Cardiovascular treatments, dental treatments, fertility/IVF, wellness evaluations, and cancer treatments were identified as the major medical treatments that persuaded the patients to choose a different country. Lasik, ENT, and orthopedic treatments are also sometimes the causes. However, most of the Bangladeshi patients travel abroad for their better health. They are often encouraged and they get the necessary information regarding medical treatments at a particular medical tourism destination from friends, family and doctors. Sometimes, local medical tourism agents and the internet are used by Bangladeshi patients to collect the relevant information. Among the information sources, the patients first like their relatives' suggestions and guidelines, followed by friends and others.

Educated personalities, like service holders with a higher monthly income, have a significant influence on their preferred medical treatment abroad. Medical tourism is expanding fast globally as a profitable industry. Bangladesh is in a losing position in this sector because many patients and their relatives are going abroad for medical treatment. The patients from Bangladesh travel to different foreign countries to receive medical care. The foreign countries fix their rates on the basis of an individual's income and the nature of the disease. Most of the patients prefer to travel to India to receive better medical assistance as it is the healthy cost-effective destination for Bangladeshis. Therefore, India is the closest country to Bangladesh for the people of Bangladesh. Hence, traveling to India is the least expensive compared to other destinations. The medical facilities, accommodation, transportation, etc., in the country are relatively less expensive than most other medical tourism destinations. However, some Bangladeshi patients who are wealthy prefer Thailand, Singapore, Malaysia, etc., for receiving medical assistance due to the availability of high quality medical facilities, treatments, specialist hospitals, and doctors. The population of Bangladesh is increasing rapidly every year. However, the medical facilities in Bangladesh are not being improved to cope with this increase in the population. As a result, more and more people are travelling abroad to receive medical treatments every year. The escalation of outbound medical tourism from Bangladesh is causing huge economic losses to the country. Bangladesh was the largest foreign user of India's health services exports in 2015-16. Of the 460,000 inbound patients to Indian hospitals, more than 165,000 were from the neighboring nation.

The healthcare that is available in Bangladesh is inadequate in spite of such rapid developments in the medical sector globally. For this reason, the critically ill patients of Bangladesh seek foreign medical treatment. The patients provide the most significant feedback on some important factors for choosing foreign medical treatments, which are the availability of medical experts and better service quality, sufficient medical facilities and services, medical treatment and transportation costs, and hygienic, safety, security, and attractive tourist medical places.

Therefore, the government of Bangladesh should take stern steps urgently and make strong efforts to improve the medical industry of the country promptly. First of all, international standard hospitals, diagnostic centers, and medical colleges should be arranged so that local people can receive better medical care in the country. However, huge investments from the private and public sectors are required for medical infrastructure development and the development of human capital, i.e., doctors, nurses, and medical staff. The developing strategies of medical tourism in Bangladesh take into consideration the 7 Ps; these are product, price, place, promotion, people, process, and physical evidence. In this regard, various promotional activities and marketing campaigns such as tax holidays and trade fairs could encourage investment by both local and foreign entrepreneurs. This in turn would help to significantly reduce cross-border medical tourism from Bangladesh, which would generate a huge income for the country. However, to achieve high quality health outcomes in Bangladesh, concerted effort of all stakeholders is required. The Bangladesh government should take steps, appropriate policies, rules, and regulations immediately to boost up the health sectors. So, the responsible authorities should take appropriate policies, actions, and guidelines to induce investment by the public private partnership (PPP) and the private and foreign sectors in developing new diagnostic centers, hospitals, and medical colleges at a world class level.

                                                                                                                                                                                                                      The writer is a Professor, Department of Management, Islamic University, Kushtia, Bangladesh.

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