Discussants at a roundtable titled ‘Public-Private Collaboration in Expanding Integrated Healthcare’. Organised by Prothom Alo in cooperation with DRRA and CBM, the roundtable was held at its Karwan Bazar office on Sunday. Photo: Shyful IslamLack of services, trained physicians, professionals and nurses in government hospitals has kept persons with disabilities away from their required healthcare services, said discussants at a roundtable.Prothom Alo, in cooperation with the Disabled Rehabilitation and Research Association (DRRA) and the Christian Blind Mission (CBM) organised the roundtable titled ‘Public-Private Collaboration in Expanding Integrated Healthcare’.Health and family welfare minister, Mohammed Nasim, however thinks Bangladesh has come a long way in providing healthcare services with disabled people.“Without political stability, no country can go forward. As there is stability in the country and a people-friendly government in power, we achieved so many things, in treating persons with disabilities. I thank the prime minister for her kind heartedness towards disabled people,” the minister told the roundtable.The roundtable began with the opening speech of Farida Yesmin, executive director of DRRA which works with people with disabilities.“We work for persons with disabilities in three sectors—education, healthcare and employment. In doing so, we’ve seen education and employment depend much on healthcare services,” she said.“If a child is born with disabilities and isn’t provided with required healthcare services, he or she lags behind in achieving mainstream education and so loses employability,” Farida Yesmin explained.She also highlighted that children who born with disabilities need several kinds of therapy and a board of physicians including orthopaedic, physiotherapist, occupational therapists and this support is now not available in Bangladesh at a district level. “We’ve detected some 47,165 persons in Satkhira with disabilities and brought them under healthcare services. Half of them need assistive devices including special chairs, wheelchairs, callipers, but these are not available outside Dhaka,” she informed the discussants.“So, when someone comes to Dhaka from other districts for an assistive device, at least Tk 3000 is spent on travel and on average Tk 6500 for the assistive device. Persons with disabilities have to pay much more than the general people as healthcare costs. The cost increases more as the services are not available at their doorsteps, meaning at district or upazila-levels.”As her organisation conducted a survey and found that some 57 per cent persons with disabilities do not go outside of their district for healthcare services and 96 per cent want to receive them through nearby hospitals.Farida Yesmin also said, “If the hospitals want to give them the services required they will need trained nurses, psychologists, professional therapists, physiotherapists. If the government can provide the services at least at the district level, people with disabilities will be relieved of their cost burdens.”Sharing his experience, civil surgeon Khurshid Alam of Manikganj told the roundtable, “A number of people with disabilities come every day in our upazila health complexes for receiving treatment. Among them, a majority of them are women and children.”“We have limitations but if we can make maximum use of our resources, we can bring a quality change in healthcare for people with disabilities,” he added.The civil surgeon, however, said that the government has already taken some steps in every upazila health complex like registering disabled patients in hospitals on priority basis, arranging wheel chairs and beds for them, a different counter for them.“But we are yet to give disabled persons full care for their disabilities as we don’t have skilled manpower,” he added.According to Muhiuddin Osmani, joint chief at health and family welfare ministry, persons with disabilities should be ensured that they will receive preferential services in hospitals. He also stressed the need of defining persons with disabilities in light of Persons with Disabilities Rights and Protection Act 2013.Nur Mohammad, line director of Non-Communicable Disease Control (NCDC) of Directorate General of Health Services, also said, “We have to identify who is disabled. We have already started working on this. We have a problem. Sometimes we train doctors and nurses but they get transferred within a short period of time from a hospital. The government has started training physicians and nurses.”He added, “I hope the prime minister, her daughter and health minister will help us continue all our projects.”Shafiqul Islam, executive director Center for the Rehabilitation of the Paralysed (CRP), urged the authorities concerned to create posts for trained health professionals.“Treatment and rehabilitation should be given to persons with disabilities by forming panels of multidisciplinary experts through public-private collaboration. And posts should be created for health professionals in state-run hospitals,” he said.He also added that CRP graduates some 40 occupational therapists through Dhaka University and this number is very meagre for the whole country.Monowara Khatun, a woman with disabilities, shared her struggle how she became employed with the help of DRRA and CBM. CBM’s country director, Shahnaz Quraishi, also spoke on the occasion underscoring that access to health services is life changing for persons with disabilities.He said, “For example, if a child can be detected early for disabilities it may get relieved of its disabilities and also employed in its youth. We believe that persons with disabilities can live longer and live well if provided heath services.”Margub Aref Jahangir, health officer of UNICEF, talked about three goals informing 10 per cent people in Bangladesh have disabilities.“We can promote people especially children with disabilities by achieving three goals. They are mainstreaming, providing human rights and promoting their inclusion and equality,” he said.Muzharul Mannan, consultant neurologist of Bangabandhu Sheikh Mujib Medical University (BSMMU), told the roundtable, “We need to formulate a national strategy for giving healthcare services to persons with disabilities.” AHM Enayet Hussain, additional director general (planning and development) of Health Services, spoke highly of government efforts in providing services to persons with disabilities. “We did fairly well in giving health services to persons with disabilities. But rehabilitation is yet to be done. Multi-sectorial action plan can be formed and the government is committed in doing so,” he said.Former health minister, AFM Ruhal Haque, also praised government efforts. “We have to understand how far we have come in eight to nine years in this case. As the government has some limitations, the service should be given in a public-private collaboration.”DRRA executive director, Farida Yesmin, pointed out four specific recommendations in the roundtable. They include constituting a national strategy for meeting disabled people’s healthcare services, subsidy for poor persons with disabilities, assistive devices in district level and arranging training for physicians.Health minister Mohammad Nasim said he would consider all the recommendations made at the roundtable.“Five ministries are working for persons with disabilities. Despite that, we need an integration of all our works. The government cannot do everything on its own. Society has a big role to play in this case,” he said.The minister ended, “I’m hopeful of providing more services to persons with disabilities as we have a people-friendly government.”The roundtable was moderated by Prothom Alo associate editor Abdul Quayum.