Reason not to work outside Dhaka
Being made an officer on special duty or OSD, as it is commonly known, is not something a newly-appointed government official should be happy about. The post is usually given to someone either as a punishment for corruption or irregularities or on political grounds.
An OSD is an officer with no specific task assigned to him.
However, it’s different in the case of the doctors appointed last month through the 33rd BCS exams.
Of the total 6,151 recruitments, 1,647 physicians were made OSDs right after they joined service.
Interestingly, these OSD doctors are cheerful as they have been posted at the Directorate General of Health Services (DGHS) in Dhaka and attached to the health complexes in the upazilas either around the city or at places of their individual choices.
Whether these physicians adopted any illegal means to secure the postings remains to be investigated. But the government says it has done so as there are no vacancies for the entry level doctors at the upazila or union level at the moment.
A reality check by The Daily Star, however, reveals a completely different picture.
A number of relatively remote upazilas actually still have vacancies in the posts of medical officers, emergency medical officers and assistant surgeons. Newly appointed doctors are usually given these posts.
Take, for instance, Amtoli upazila of Barguna, a southern coastal district.
Of the 39 posts of physicians in the upazila, 35 posts had been vacant for a long time. Last month, 11 doctors recruited through the 33rd BCS were posted there but 10 joined.
There are still 25 vacancies, of which seven are at the entry level, according to Dr Ekramul Kabir, upazila health and family planning officer of Amtoli Health Complex.
Thirteen of the 27 physicians’ posts in Haripur upazila of Thakurgaon are currently vacant. Of these, five are entry level posts.
Of the total 35 posts in Kalia upazila of Narail, eight posts of medical officers are still vacant, though 18 new physicians have recently been posted there.
The Daily Star also found between two and four vacancies in the post of medical officers in Bhurungamari of Kurigram, Shaghata and Fulchhari of Gaibandha, Hatiya of Noakhali, Charfassion of Bhola and Tala of Satkhira.
There’s a completely different picture in some places as well.
Gazaria upazila Health Complex in Munshiganj had 21 posts, with five of these being vacant. Through the new recruitments, a total of 11 doctors have been posted there, six of them attached as OSDs.
Similar cases were found in Savar, Kaliganj and Gazipur Sadar where five to 10 doctors have been attached in each upazila with OSD status.
Sirajganj, the home district of Health Minister Mohammed Nasim, had 51 vacant posts but all of those were filled up with the new recruits. Additionally, 92 physicians have been attached to nine upazilas of Sirajganj as OSDs.
“Now many doctors do not even have chairs to sit on. Who knows how they will serve here,” said a physician at Sirajganj Sadar Hospital. He did not wish to be named.
These malpractices are taking place amid a precarious healthcare situation in the rural areas.
“Bangladesh suffers from both a shortage of and geographic mal-distribution of human resources for health,” says a report of the World Health Organization (WHO).
There are three physicians and one nurse for every 10,000 people. Also, there is 36 percent vacancy in sanctioned health worker positions and only 32 percent of the healthcare facilities have 75 percent or more of the sanctioned staff working there, according to the WHO.
Prime Minister Sheikh Hasina on many occasions has urged doctors to serve the rural people and even announced special privileges in this regard.
The government has formulated special guidelines that make it mandatory for physicians to serve at upazila and union levels for two years. Those who comply with the guidelines will get opportunities for higher education and better postings later.
At the same time, doctors will be given the chance to work in their home districts, and physician couples will be posted at the same place.
Even then, newly appointed doctors seem unwilling to work in remote or rural areas.
Regarding the OSDs, a newly-appointed doctor in Bhola said the government had “actually messed up” while posting a large number of doctors.
“Of course, I know a number of new doctors who resorted to hectic lobbying to get postings in Dhaka and adjacent areas,” he claimed.
Dr Rashid-e-Mahbub, chairman of the National Committee on Health Rights Movement, said those attached to upazilas around Dhaka must have been given some undue privileges. “The latest recruitment has achieved its political goal, but has not been able to ensure healthcare.”
Health Secretary MM Neazuddin rejected such allegations outright, saying, “There could be some minor mistakes. We will correct these.”
He justified the OSD doctors’ attachment to the upazilas around Dhaka by saying that these areas need more doctors because the population in these areas is higher.
“It was the prime minister’s order that doctor couples have to be posted in the same upazila. For this, there could have been some mismanagement.”
Admitting physicians’ unwillingness to work in remote areas, he said the government was planning to introduce financial incentives for those serving in the rural backwaters.
Suggesting reforms in the health system, Rashid-e-Mahbub said, “The authorities should create a pool of doctors through the BCS exam. Hospitals needing physicians will advertise and recruit locally.”
Under such an arrangement, doctors cannot help working in any location of the country they are posted in, he observed.
Porimol Palma = thedailystar