Ethnic minority elders in CHT face barriers to healthcare access: Study

Older adults from ethnic minority communities in the Chittagong Hill Tracts (CHT) face significant social, cultural, and institutional barriers in accessing healthcare for non-communicable diseases (NCDs), according to a new study led by Dr. Rajon Talukder from the Department of Public Health and Informatics (DPHI) at Bangladesh Medical University (BMU).

The study was conducted under the supervision of Dr. Md. Khalequzzaman of the same department.

The findings were presented on Thursday morning at a seminar held in the conference room of the Super Specialized Hospital at BMU.

Dr. Khalequzzaman stated, "Around 1.6 million people from ethnic minority communities live in the Chittagong Hill Tracts. Their distinct languages and cultures often act as barriers to accessing healthcare services."

He added, "All three researchers involved in this study are from ethnic minority communities themselves. They conducted the research to explore the health challenges faced by their own communities."

The event, organized ahead of the International Day of the World's Indigenous Peoples on August 9, featured the presentation of three studies on the health conditions of ethnic minorities.

This particular qualitative study focused on the Chakma, Marma, and Tripura communities in Khagrachhari. It found that despite an increasing burden of NCDs—such as diabetes, hypertension, cancer, and chronic respiratory illnesses—health-seeking behaviors among elderly individuals in these communities remain limited and complex.

Researchers conducted six focus group discussions with 36 older adults (aged 65 and above), all living with at least one NCD. The participants' responses revealed the layered challenges they face in accessing timely and appropriate healthcare.

According to the study, older individuals with educated family members had better access to healthcare due to their relatives' support and guidance. However, financial constraints led many to seek help from traditional healers, whose services are often seen as more affordable than modern medical treatment.

Diseases like diabetes and cancer were often viewed as "modern" illnesses, believed to be incurable through traditional methods. In cases where conventional medicine failed, some people turned to astrologers or traditional healers, suspecting supernatural causes behind their conditions.

In his presentation, lead researcher Dr. Rajon Talukder noted, "Self-medication is less common among indigenous people. They generally follow the advice they receive from those around them."

Institutional Challenges

The study highlighted institutional issues as well. Language barriers remain a significant obstacle, as many older patients are uncomfortable communicating in Bangla—the primary language used in government healthcare facilities. Long waiting times and the lack of patient support further discourage them from seeking treatment at public hospitals.

Although free treatment at government hospitals is an incentive, the high cost of medicines often forces patients to discontinue their treatment, adversely affecting their health.

Community-Led Malaria Prevention Efforts

Another study, titled "Malaria Prevention by Ethnic Minorities at the Community Level", revealed that ethnic minority communities in the CHT are actively engaged in malaria prevention—particularly through the widespread use of insecticide-treated nets. However, gaps remain in awareness of other preventive methods.

Conducted by Dr. Anirban Chakma and supervised by Dr. Irin Hossain of NIPSOM, the study assessed the knowledge and practices of 234 ethnic minority adults in Rangamati district.

Key findings include:

• 96.6% of respondents identified mosquito bites as the cause of malaria.

• 100% of households reported using long-lasting insecticide-treated nets (LLINs).

• 98.7% practiced environmental cleaning, and 73.1% cleared vegetation around their homes.

• However, awareness of other preventive measures was low: only 16.7% reported draining stagnant water, and just 3.4% used long, full-coverage clothing as protection.

Recommendations:

• Deploy health professionals fluent in local languages to reduce communication gaps in healthcare settings.
• Encourage family and community members to accompany older patients during medical visits.
• Reduce waiting times at public healthcare facilities.
• Reconsider the pricing of essential medicines to make healthcare more accessible for marginalized communities.