Strategic plan afoot to enhance local treatment to curb medical tourism for complex diseases

Infograph: TBS

The government is set to roll out strategic measures to enhance local treatment for complex diseases like cancer, heart disease, infertility, and kidney ailments, aiming to reduce the growing trend of Bangladeshi patients seeking care abroad.

This includes a short- and medium-term national approach to fill the treatment gap in these four areas by enhancing the capacities of both public and non-profit private hospitals.

The health ministry on 15 December convened a meeting with representatives of various private hospitals, medical experts, and top government officials, where the strategies were discussed. 

Discussants at the meeting also noted the issue of recent Indian visa restrictions, which have placed patients, particularly those needing treatment for cancer, kidney failure, infertility, and certain heart diseases, in a difficult position.

Dr Sayedur Rahman, special assistant at the Ministry of Health and Family Welfare, who attended the session, told The Business Standard that they are targeting the four diseases for which patients traditionally go abroad for treatment.

"We discussed two main issues: actual technical reasons and gaps in competence. In cancer and transplantation, the issue is the shortage of equipment, such as radiotherapy machines. The public perception is that better treatment is available abroad," he said.

He further said the actual problems need to be addressed in one way, and perceptions in another. "To solve the actual issues, we must increase our capacity. In cardiology, excluding heart transplants and artificial hearts, our capabilities are on par with India. We have real issues in the other three areas."

According to the Globocan 2020 report, approximately 1.56 lakh people in Bangladesh are diagnosed with cancer each year. WHO standards recommend one radiotherapy machine for every 1 million people, meaning Bangladesh needs 300 machines, but currently, there are only 37 in both public and private hospitals, many of which are out of service.

According to data from India's tourism ministry, around 25 lakh medical tourists travel to India from Bangladesh every year, spending about $500 million on healthcare.

Proposed measures in plan

Dr Rahman said the health ministry is in talks with the finance ministry regarding tax exemptions on medical equipment and drug imports for cancer treatment. "Decisions will be made considering the broader context."

He also revealed plans for the medium-term establishment of eight cancer hospitals and dialysis centers, each with 100 beds, across eight divisions within the next 6-12 months.

He also mentioned that the government plans to fully operationalise the Bangabandhu Sheikh Mujib Medical University (BSMMMU) Super Specialised Hospital, a 750-bed facility currently operating at just 10% capacity.

Besides, starting next month, Bangladeshi specialists from the US, UK, and Australia in fields like kidney transplants will visit BSMMMU during their leaves to help with image-building and confidence-boosting efforts, particularly in kidney transplantation.

The government is also considering amendments to the kidney transplant law, he said.

Currently, under the Human Organ Transplant Act 2018, kidneys can only be donated by close relatives. This has led many patients to seek transplants abroad, often incurring high costs or falling victim to scams. 

Dr Rahman said, "We will redefine 'close relative' to facilitate swap transplants and establish a national organ bank to match willing donors."

On transplant training, he said, "We've reached out to a country for training opportunities. If they agree, they'll provide the training, or we'll send our team there. Our goal is to form 5-10 kidney transplant teams."

Meanwhile, several meeting attendees told TBS that the government has inquired about the cost differences between private hospitals in Bangladesh and those in India, along with patient outcomes, death rates, and strategies to reduce them. 

To ease pressure on government hospitals, the government is considering the introduction of two shifts, they said. 

Besides, the capacity of the Mohammadpur Fertility Center will be expanded, and public-private partnerships with non-profit hospitals, such as Gonoshasthaya Nagar Hospital, are being explored.

The government has also requested private hospitals to operate on a not-for-profit basis for at least six months during this critical period. Letters have been sent to neighbouring countries offering more affordable medical treatments.

'Doctors lack sincere communication' 

Dr Syed Abdul Hamid, professor at the Institute of Health Economics, University of Dhaka, told TBS that the government's initiatives, if implemented, will be highly beneficial.

"However, patients often travel abroad because doctors spend less time with them, lack sincere communication, provide incorrect diagnoses, or the service process is cumbersome. These problems can be addressed easily, and the government and relevant hospitals need to look into these issues," he said.

The professor mentioned that diagnostic services in government hospitals often stop after noon. He suggested that public-private partnerships could help maintain diagnostic services throughout the day. 

He further said in the short term, doctors should be given 6-9 months of training to provide cancer treatments, and in the future, they should be given priority for postgraduate studies. 

"If these initiatives are taken, the number of patients going abroad for treatment can be significantly reduced," he added.

Efforts to gain patient trust

Dr AM Shamim, managing director of Labaid Group, told TBS that  "Since patients are no longer traveling to India, we have seen a 10% increase in patients at our hospitals over the past three months." 

He mentioned that Labaid has set up 40 counseling booths across 32 diagnostic centers and four hospitals. Throughout January, Labaid will train over 4,500 staff members - including doctors, nurses, caregivers, blood collection personnel, and cleaning staff - to enhance patient trust and improve patient outreach. 

Additionally, Labaid is investing in advanced technologies, such as robotic surgery and cath lab upgrades, at its cancer hospital.

Arif Mahmud, director of medical services at Evercare Hospital Bangladesh, told TBS that during the two years of the Covid-19 pandemic, patients did not travel abroad for treatment, instead receiving care at local hospitals and from Bangladeshi doctors. 

He added that Evercare Hospital Dhaka is planning a Tk400 crore investment, which will include the construction of a new 300,000-square-foot OPD building. Currently, the OPD serves 2,000 patients, but with the new facility, it will be able to handle 4,000 to 5,000 patients. 

However, this expansion will take two to three years to complete. The hospital is also set to increase its bed capacity from 365 to 650.