“Healthcare system and socioeconomic inequities”-through the lens of developing nations

This article was exclusively written for The European Sting by Ms. Afsana Rahman Maliha, a final year MBBS student at Dhaka Medical College, Bangladesh. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

“Intersectionality” – what does this really mean? It actually refers to how multiple identities and experiences of marginalization interact and highlights how these resultant effects cannot be simply presumed to be equal to the sum of the individual inequalities e.g. socioeconomic and gender inequities. The healthcare system plays a central role in the achievement of equity in health, and implementing laws and policies that aim to foster health equity is therefore seen as a key global objective. But, what if, due to these intersectional barriers, people fail in gaining access to their healthcare system and thus “Health For All” becomes a vague slogan only?

 Since I’ve started clinical rotations in my medical college, I’ve come across many untold stories of the patients. Majority of them are poor and their last resort for treatment is our government hospital. Some of them return home with complete recovery, some go back to their families with the news of terminal illness & spend their last days with or without palliative treatment and some do not return at all. Although the treatment quality is excellent in many tertiary government hospitals, most of them lack adequate hygiene and management system. To be honest, it’s not only their fault as they’re trying their best to tackle continuous pressure of mass population each and every day. There are some specialized and super specialized hospitals in many regions, but they are out of reach for maximum people due to increased healthcare cost.

In developed countries, almost every citizen is under health insurance or other government policies, but the picture is totally different in developing nations. There’s also very weak or no referral system at all. In many cases, where multidisciplinary approach is needed, patients suffer greatly and their diagnosis is often delayed and disease prognosis is hampered on a large scale. Particularly, in case of cancer patients, although the diagnosis can be made, the treatment is very much costly for predominant number of patients. In developed countries, patients are given clinical trial drugs free of cost, but here it’s not possible at all. Most of the drugs are imported from abroad and they are much expensive and beyond the economical capacity of these people. So they don’t have any choice other than counting each day with a grievous soul & waiting for their last breath; sometimes, even without minimum palliative care.

Can this scenario be changed overnight? We know the answer. A multi-sectoral approach is needed to overcome the present situation. But once the system (e.g. proper referral, health insurance management, taking all costs into government account for routine screening of diseases having poor prognosis which can be easily prevented beforehand by taking prophylactic measures and many other inter sectoral collaborations) is established accurately, many undesirable deaths can be avoided giving our people the chance of living a healthy life & seeing more sunrises with their beloved ones for a bit longer period of time.

About the author

Afsana Rahman Maliha (afsanamaliha786@gmail.com) is a final year MBBS student at Dhaka Medical College, Bangladesh. She is the Local Committee Secretary of BMSS, NMO of IFMSA. From childhood, she’s always moved by the sufferings and helplessness of her native people regarding healthcare. She holds tremendous interest in field of cardiovascular and oncology related academic programs. She has attended many national and international workshops & completed online course “Biology of Cancer” offered by Johns Hopkins University. She believes in spiritual strength of humanity like Hippocrates said “Wherever the art of medicine is loved, there is also a love of humanity.”

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