Community clinics turned into saviours of marginal people

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DHAKA, Feb 13, 2019 (BSS) – Septuagenarian Halima does not talk too much and pays little attention or no attention to what happens around her. She is ignorant of the fact that health is one of the fundamental rights of every human being and accessible health system is essential to fulfil this right.

Years with lack of medication has obviously caused severe physical impairment to Halima, a 70-year old lady who presumed to have no chance for her survival for long. She now seems enthusiastic planning to cuddle her great grandchild as she is confident to live longer than what she thought one year back.

Her disease load is exacerbated by poverty and food insecurity. This is the home of Halima. “I don’t have any money to buy medicine for me. I lost hope for my survival. But suddenly the community clinic changed the scenario. Now I can see doctors there anytime and top of that getting medicine at free of cost,” she said in a faint voice.

There is no denying the fact there is a close relationship between poverty, ill-health and limitations in access to health services. Health services, along with food, water, sanitation and education, can be considered necessary conditions for good health. In such challenging situation many lower income individuals and families lacking money turn to community health clinics for treatment.

Halima is one of the hundreds of landless women who is now an inhabitant of Dharmapur shelter project at Feni district.

“We are too poor to see private physicians. We don’t have enough money to go to sadar upazila to see a doctor even at the public hospital there. Thanks to the community clinics which come to us as saviours,” said Faizul Islam, a 56-year old man who still works as a day labourer residing in one of the houses under the shelter project.

The shelter project accommodates one Community Clinic (CC) for five thousand people of 500 families of the project. “It (CC) took just a few days to become popular. After some days the clinic was faced with handling a lot of patients. Everyday people are taking health care services standing in queues. We are too happy to get healthcare services at our doorsteps” he said.

“I have passed many days with fever without any medicine as we don’t have enough money to buy medicine,” Halima said.

Local women said they are getting maternal healthcare along with other services at the community clinic. “Now women of our shelter project are getting skilled birth attendants during the delivery,” Sakhina, a 40 year-old woman said.

Civil Surgeon of Feni district Dr Hasan Shariar Kabir said currently there are 164 community clinics all over the district becoming the prime source of primary healthcare for people specially the poor.

“The clinics remain open for six days in a week providing treatment to 50 to 60 patients daily,” he said.

The clinics are providing services like mother and children healthcare, reproductive healthcare, family planning, vaccination, nutrition, diabetics, high blood pressure and 30 kinds of primary medicines at free of cost.

“The clinics are playing important roles in ensuring healthcare services at rural level. The confidence level and reliability of rural people are getting higher day by day regarding the services of the clinics,” Dr Kabir said.

Terming the community clinic as one of the most successful innovative initiatives of Prime Minister Sheikh Hasina, he said adding “Initially there was a mixed perception of the common people regarding the community clinics. But right now the sincerity of the clinic staffs has helped the common people gain confidence,” he said.

Now community health clinics have become an integral part of the health system in Bangladesh and millions of people are getting services from the community clinics, he said.

Community Health Care Provider (CHCP) of Dharmapur Community Clinic-01 (shelter project) Maksudur Rahman said so far they conducted 10 safe normal deliveries at the centre.

“Apart from reproductive healthcare we are providing treatment to children over primary diseases like flu, fever and stomach upset … we are receiving 60 to 70 patients every day,” he said.

The CHCPs of the community clinic at Sonagazi located at South-east char-Chandia area have been passing busier time compared to other clinics of the district due to its proximity of the coastal belt.

“We are attending more patients compared to other centres as coastal people mostly fishermen and their family members don’t have that much choice rather than coming here for getting healthcare,” said Alimul Islam, one of the CHCPs of that community clinic.

“We always have got doctors here. We do come here to take treatment and free medicine whenever we fall sick,” said Salema Khatun, a 35-year mother of Purbachar Krishnajoy village under Amirabad union of Sonagaji upazila at the clinic.

Community Clinic is the flagship program of Awami League government, an innovation of Prime Minister Sheikh Hasina to extend primary health care to the doorsteps of rural people all over rural Bangladesh.

There are nearly 18000 community clinics currently in the country and the number is gradually increasing.

Community health clinics are being operated across the country to provide a broad range of services and health promotion activities to local population, particularly those who have or are at risk of the poorest health.

Community health services focus on health promotion, and disease prevention and management, which are designed to improve the health and wellbeing of local residents, as well as take pressure off the acute care health system.

Community health clinics offer affordable health care, particularly for people on low incomes. Services are available to all residents, regardless of income.