Where are the Nurses, Doctors and Technicians?

Anyone who has ever had a loved one receive treatment at a government hospital in Bangladesh has experienced: calling out for assistance and that call being met with silence. Minutes pass before an attendant appears it is at times neglect but primarily because there are simply too few nurses to answer every call. Across Bangladesh, the shortage of trained medical staff has become a quiet emergency, one that threatens the foundations of public health.

Behind the country's crowded wards lies a stark reality: Bangladesh does not have enough doctors, nurses, or technicians to meet its people's needs. According to the latest figures from the World Bank and WHO, the country has around 0.7 physicians and 0.61 nurses per 1,000 people — among the lowest ratios in South Asia. The WHO recommends a much higher workforce density to provide basic healthcare coverage. For every ten thousand people in Bangladesh, there are roughly twelve trained health workers. The imbalance is even more severe in rural districts, where one doctor may serve entire unions and where nurses and lab technicians are often missing altogether.

A workforce in motion

The scarcity is compounded by another, less visible problem: many of Bangladesh's best-trained professionals are leaving. The outflow of doctors, nurses, and allied health workers to richer countries has accelerated over the past decade. This "care drain," as experts call it, is driven by both push and pull factors — the hardships at home and the temptations abroad.

In Bangladesh, health workers cite low pay, exhausting workloads, limited promotion opportunities, and poor workplace safety as the main reasons for leaving. "We are trained professionals, but society doesn't always see us that way," said one nurse at a government hospital in Dhaka, echoing a sentiment shared by many of her colleagues. Nurses, in particular, often face social stigma and professional disrespect. "It's when people treat us as if we are nothing more than servants to doctors," she said quietly.

Abroad, the story looks very different. The same nurse could earn five to six times her current salary in the Gulf or in the United Kingdom, where hospitals actively recruit from South Asia. Better training, structured career paths, and access to modern equipment all add to the appeal. For many, migration is not a betrayal of duty but a matter of survival and dignity.

The push and pull of opportunity

Bangladesh has recently begun formalizing the export of health workers to the Middle East, including agreements to send nurses and technicians to Saudi Arabia. Policymakers argue that such programs could generate remittances while giving local workers global experience. But critics worry that these deals risk draining the already depleted domestic system.

A senior doctor at a public medical college summed it up bluntly: "We are training nurses for export while our own hospitals are half-empty." The problem is not simply about numbers; it is about balance — ensuring that every trained worker who leaves is replaced by two more ready to serve at home.

Training the next generation

The government's National Health Workforce Strategy 2024–25 acknowledges the crisis head-on. It lays out plans to expand medical and nursing colleges, modernize training curricula, and strengthen the pipeline of mid-level professionals such as medical technologists and paramedics. Universities are being encouraged to open more nursing programs and introduce postgraduate degrees to give nurses professional mobility within Bangladesh, not just abroad.

Private hospitals, too, are experimenting with their own training academies and partnerships. Some are offering continuing professional development, mentoring systems, and housing allowances to retain key staff. Yet these efforts remain fragmented and uneven, often limited to the urban elite. For every well-trained nurse at a Dhaka private clinic, there are dozens in district hospitals struggling with outdated equipment, overwork, and limited respect.

The deeper issues

Training alone cannot fix what is, at heart, a problem of value. Even the most ambitious education reforms will fail if health workers continue to face low pay, unsafe conditions, and social disregard. Research across low- and middle-income countries shows that professional dignity and a sense of belonging are as important as financial incentives in retaining workers.

Bangladesh's nursing profession remains shackled by outdated hierarchies. Nurses often have little say in hospital decisions, limited access to leadership roles, and minimal recognition for their expertise. Without cultural change — not just institutional reform — many will continue to look abroad for validation.

A health economist in Dhaka offered a sobering metaphor: "We have a leaky bucket. Every year we pour in new graduates, but without fixing the holes — low pay, burnout, lack of respect — the water will keep flowing out."

What staying could look like

There are, however, signs of hope. Some hospitals have begun redesigning work schedules to prevent burnout and improve patient care. Others are offering career ladders that allow nurses to move into advanced practice, education, or administration. International partnerships are being explored to align Bangladeshi nursing standards with global norms — a move that could simultaneously improve domestic care and open safe, regulated migration pathways.

If managed wisely, migration itself could become part of the solution. Countries such as the Philippines and Nepal have shown that exporting trained nurses can coexist with strong domestic systems — provided the government invests remittances in further training, enforces ethical recruitment, and ensures that minimum staffing ratios are met at home.

For Bangladesh, the lesson is clear: health worker migration is not the enemy, but mismanagement of it is. The goal should not be to stop people from leaving, but to make staying worthwhile.

The moral of the matter

Ultimately, the crisis of nurses, doctors, and technicians is not just about policy — it is about priorities. When a nurse earns less than a junior office clerk, or when a doctor must work thirty-six hours straight without adequate rest, the system itself becomes unsustainable.

The young nurse in Dhaka who dreamed of serving her country may soon board a plane to Riyadh or London, carrying both pride and regret. "I love my patients," she said, "but love doesn't pay rent."

If Bangladesh truly wants to heal its healthcare system, it must first heal its relationship with the people who hold the stethoscopes and syringes. That means fair pay, safe workplaces, respect, and recognition — not as charity, but as necessity.

Until then, the echo of unanswered calls in hospital wards will continue to remind us of a haunting question: where are the nurses, doctors, and technicians — and why did we let them go?