I recently had my twenty four hour work shift, it went well, if you asked. The very idea of nurses calling me up in the middle of the night several times was quite annoying to a certain extent but then I knew this was the price of getting into MBBS.
I had the opportunity of being the keen observer of the hospital, starting off with various wards, which I have not been posted, yet. The very striking ward was the antenatal ward, where most pregnant women, who are close to their due dates, were getting admitted. The ward is over loaded with women and it seems that Bangladesh is a baby producing factory.
As I was being an intern and checking the vitals (that basically sums up my work), I came across a lady, she was in her early forties and she was happy to be pregnant, when enquired about her choice to conceive a baby at such an old age, she gleefully said that it was “Allah” given. Similarly, I attended a patient who will be receiving chemotherapy for cervical cancer, (she has seven children), and she gives a very similar answer.
There is no control of birth; unmet need for family planning has made things worse for those that want to keep the maternal health status high up. The maternal health condition in Bangladesh is well versed than in Nepal even though things like birth spacing and use of contraceptives when husband is away are easily missed by women.
Most women are not familiar with the term of antenatal check up. Although, WHO has made it mandatory for pregnant women to take at least minimum 3 check ups, women are still not aware of such polices, instead, they seek medical attention when their due date arrives. What is the reason for policy making when health education is in limbo?
The process of pregnancy is a very important decision that equally both partners have a say in, but most women that I have encountered were either pressurized by their family or the husband himself or the hypocritical silent society that we are a part of. Educating pregnant women about the birth process or informing her about how her body will change as pregnancy advances are keynote targets to save the extra patient load that most government institutions clearly fail to show interest.
Healthcare policy making is just a tool for the government to show that it abides by WHO, there are still patients who never get any antennal check up done, even if they did claim to get checked, its by a quack, when asked if she has done the basic investigations, she declines and even further she cannot even recall taking any iron pills!
This is the situation in hand, we live in the 21st century where neighboring countries are becoming super-giants in arms and ammunition and yet a primary care general physician has to face “Death of the patient- severe blood loss (Post-partum hemorrhage)!”