Truancy among doctors

It's time they made amends for it
What the World Development Report 2004 has said about doctor absenteeism in the primary healthcare centres of Bangladesh must make one sit up and take note: 74 per cent of doctors remain absent from duty. Much as the Director General of Health Services may contest the figure trying to put up a slightly better face of absenteeism by citing another statistical ratio, the truth is that an overwhelming number of medics posted to rural health centres keep away from their places of duty. They are shown on the organisational chart of a health complex alright, but in reality, many of them could be shuttling between the rural health centre and the nearby city or town, if not the capital city. Often private practice is a huge distraction.

Successive governments have tried to curb the health cadre professionals' penchant for hanging on to the cities at the expense of rural health centres. Administrative circulars fattened the files while duty dodgers among the medics were asked to explain their conduct; but when the chips came down, political will was missing.

There can't be any second opinion on the bottomline of the World Development Report: doctor absenteeism is depriving poor people of essential health services 'in access, in quantity and in quality'. Basically, what we have so far known through personal experiences or newspaper reports has now received international focus and attention. That is where lies the significance of such a high profile study as the World Development Report. The global expose of those doctors' indifference to their duties cannot be palatable to them. Now that the whole world knows about it, the truant among doctors should see themselves in the mirror and be self-enlightened to play by the book. They owe it to the nation to serve the poor patients who turn to them for relief and cure. By virtue of the Hippocratic Oath, they are a cut above others in terms of commitment to the welfare of the society and humanity. We hope the message sinks in them and they act accordingly. We know the doctors have difficulties and constraints but given the level of public expectations from them it is only desirable that they deliver. Importantly, our network of rural health complexes is reputably among the best in the developing world. But what is a healthcare centre worth if the equipment rusts and the wards and outdoors are virtually empty of patients just because the required number of doctors are not on duty.