$3.5b goes out of country yearly for healthcare

700,000 Bangladeshis go abroad for treatments

Rafiqul Islam Azad: Around 700,000 Bangladeshis seek treatment abroad every year, while about $3.5 billion exits the country to cover healthcare expenses for these patients. The annual per capita expenditure for those seeking treatment in various countries, including India, Malaysia, Thailand, and Singapore, averages $5,000 or Taka 550,000 in the local currency.
On the other hand, the average per-person treatment expenditure in the country is approximately $54 or Tk 5,994 in the local currency, according to the Bangladesh Investment Development Authority (BIDA). Sources state that the market size of the country’s health sector in the current year, 2023, is about $1.004 billion.
Health experts believe that this substantial amount spent on treatment outside the country highlights the crisis of trust in health management in Bangladesh. Although the infrastructure of healthcare institutions has expanded over the past years under public-private management, and the number of doctors has increased, the trust has not grown proportionately.
A significant portion of patients seeks treatment abroad because specialized services are not equally accessible in all regions of the country. Additionally, patients face challenges such as inaccurate diagnoses, a lack of specialized healthcare, and complaints of negligence in treatment.
Experts note that when common people do not receive desired services at government hospitals, they turn to private hospitals. However, when necessary services are still unavailable, those who can afford it seek treatment abroad.
Interestingly, the Department of Health in the country lacks statistics on how many citizens go abroad for medical treatment annually and the associated costs. According to BIDA’s estimation, approximately seven lakh patients seek treatment abroad, with India, Malaysia, Thailand, and Singapore being the top countries for medical services.
A study by the Institute of Health Economics at Dhaka University reveals that 21 percent of patients seeking treatment abroad have cancer, while 18 percent seek treatment for heart disease. Other reasons include reproductive complications, orthopedic treatment, gastroenterology, liver, kidney, eye, ear, and neurological treatments.
Due to high patient pressure, some hospitals from India, Thailand, and Singapore have opened offices in Dhaka. Officials from these offices, speaking anonymously, state that a majority of patients seeking treatment abroad have previously received treatment from different hospitals and doctors in the country.
Professor Syed Abdul Hamid of the Health Economics Institute at Dhaka University mentions that people initially do not seek treatment abroad. However, when the country’s medical management fails to provide necessary services, people turn to foreign countries for better treatment. He notes a longstanding lack of trust in treatment in the country, with different doctors prescribing different treatments for the same disease.
Professor Syed Abdul Hamid acknowledges the presence of foreign hospitals’ offices and manpower in Bangladesh, along with brokers influencing patients to seek treatment abroad. He emphasizes that if the money spent abroad for treatment could be invested in the country’s health management, the situation would improve.
A research paper titled ‘Determinants of Bangladeshi Patients’ Decision-Making Process and Satisfaction Towards Medical Tourism in India’ published in the Switzerland-based journal Frontiers in May this year reveals that Indian hospitals receive about 450,000 Bangladeshi patients annually. The study cites factors such as increased medical expenses, lengthy procedures, and a lack of accessible treatment as reasons behind patients seeking medical care abroad.
Public and private investment in the healthcare sector has significantly increased in the last few decades, according to Bangladesh Bureau of Statistics (BBS) data. The number of private hospitals in the country has multiplied more than 20 times since the 1990s.
Today, there are 640 hospitals of different levels, including government medical college hospitals, specialized institute hospitals, district or general hospitals, and upazila hospitals. Additionally, there are 7,854 registered private hospitals and clinics in the country, with over 179,000 total beds, including 111,000 private beds and approximately 10,000 private disease control centers. The country also has 180 blood banks.
A senior official from the Department of Health emphasizes that the increase in the number of hospitals and beds does not solely determine the range and quality of healthcare. The official states that building trust in the medical system is crucial, and doctors play a significant role in influencing public confidence.
According to a study published by the US-based scientific journal publishing company Wiley, about three-quarters of patients hold a negative perception of doctors. Factors contributing to this lack of trust include the doctor’s insincerity in providing treatment, insufficient time devoted to patients, neglect of psychological issues, failure to consider the patient’s opinion, lack of detailed explanations about the disease and prescription, and discrimination based on social status, as indicated in the study.