Respect for nursing profession
ANNOUNCING a package plan to upgrade the nursing profession, the prime minister expected that the standard of the nursing profession in Bangladesh would be upgraded to international standard, enhancing the nurses' social dignity with proportional pay and status and also creating opportunities of promotion and avenues to get training abroad. This is surely a new dimension and commitment in the health care delivery system of Bangladesh, where the doctor to nurse ratio is 2:1 and patient to nurse proportion is about 8000:1, a very deplorable situation. There are about 20,000 registered nurses in the country, of which 14,686 are in government service and others are working in private hospitals and clinics or have been deputed abroad.
The government of Bangladesh has decided to upgrade the nurses to Class 11 status, and employ around 2627 nurses very shortly. There is also plan to increase the number of seats in 38 nursing institutes to 1490 from 1135, turning 4 institutes into nursing colleges, with one in every divisional headquarter awarding the of the B.Sc in Nursing degree. This is all in recognition and upholding of the image of the nursing profession in Bangladesh, where nurses are not honoured as they should be.
In fact, the nursing profession has historically been neglected in the country, without due attention to its reformation or up-gradation since the importance of trained nurse professionals could not be well understood by health managers and medical specialists. On the other hand, some opportunists involved nurses in politics, and they took to the streets to justify their demands for restoration of discipline in the recruitment, promotion and posting of nurses. Unfortunately, some health managers even now have the misconception that nursing is a menial job needing neither study nor intelligence, an idea that prevailed in Great Britain during the seventeenth century.
"The Lady with the lamp" opened the eyes of the world to the nursing services that could reduce the ailments and sufferings of a patient dramatically. In the Crimean War in 1854, with 38 dedicated women volunteers she reduced the death rate from 42 % to 2% only by nursing, care, love and affection. Florence Nightingale, a name known and honoured round the world as a symbol of health care service, was born in Italy on May 12, 1820 and expired on August 13, 1910 in Hampshire in London. King Edward V11 decorated her with the Order of Merit in 1907 and Honourary Freedom of the City of London in the year 1908.
This Anglican nun, as an innovator and a driving force for public health reform, brought significant changes in the concept of heath care services in Britain and also acted as an eye-opener to the world. She established a nursing school for the first time to generate awareness that nursing needed intensive training for capability building, and that in this profession only humanity and service to mankind should be the ideal, a role model and pattern of performance, irrespective of religion, colour, creed or nationality. International Day of Nursing is thus observed on her birthday, May 12, round the world.
Prime Minister Sheik Hasina, thus, made a clarion call to nurses: "You are doing noble work, behave and talk sweetly with patients. Your love, care and affection can remove the pains of the patients."
Bangladesh has one of the highest maternal mortality rates in the world. More than 12,000 women die annually during child birth and 700 children die in a day from diarrhea, pneumonia, and at least one neo-nate dies every 3-4 minutes. Around 70% of pregnant mothers suffer from acute anaemia, and only 34% of the women have access to ante-natal care. More than 85 % of the deliveries take place at home, where hardly 18% of such deliveries is attended by trained birth attendant. These are prime causes of obstructed labour, delayed birth, hemorrhage, sepsis, excessive bleeding, eclampsia, obstetric fistula leading to mortality and morbidity of women. In brief, acute absence of safe motherhood initiatives is prevailing in the country.
There could be a major break-through in the improvement of mother's health provided safe delivery could be ensured in the hands of trained birth attendants under the supervision of qualified nurses and physicians. There is at present acute shortage of staff nurses, family welfare assistants, family welfare visitors, paramedics, anesthesians, medical technicians etc. The government is planning to recruit on ad-hoc basis, at a large scale, all such service providers. In Sri Lanka and Indonesia, lady health visitors and midwifes have contributed much in the reduction of maternal mortality and morbidity and changed the demographic and disease profile pattern of the country.
In fact, safe motherhood initiatives are the only way to have a nation with sound health. In this mission, the nursing profession demands respect with more investment in terms of capital and capability building of human resources in near future.
In the words of Professor Mohammad Fathala: "Women are dying not because of diseases we cannot treat but because the societies have yet to decide that it is worthy to save the lives of women."
To conclude, I quote Mother Teresa: "We think sometimes that poverty is only being hungry, naked and homeless. The poverty of being unwanted, unloved and uncared for is the greatest poverty. We must start in our homes to remedy this kind of poverty."
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