Opportunity for Bangladesh in the Health Care Business

After nearly sixteen years, I recently travelled Bangladesh and stayed more than three weeks-travelling, meeting people and examining the immense changes in Bangladesh. I had the opportunity to view not through the eyes of a tourist, but through the eyes of an experienced healthcare scientist who felt and saw the tremendous accomplishments that Bangladesh has been made despite all negative movement. I was amazed seeing all signs of a robust and thriving economy.

What stroked me was the anxiety with the hospitals being built and their standard of services to the patients. Quality management remains an elusive dream. The cost of treatment varies very much from hospital to hospital. There was not enough historical data of what it costs for the treatment of a particular condition.

Healthcare is very expensive in western countries. Therefore, the insurance companies and private hospitals in the USA are encouraging patients to travel to India, Abu Dhabi, Thailand, Singapore, Greece and Italy for treatment. The USA based healthcare companies are now outsourcing their healthcare services in the overseas either through joint venture initiative or opening their own state-of-the-art hospital facilities. The goals are to provide comparable healthcare services to their own patients as well as to the international communities with a reasonable cost.

Like call centers and IT business; healthcare services are promising field especially the diagnostic and imaging services, cosmetic and regular surgery, and short-term treatments. It is time to act and develop clear strategies to motivate these potential healthcare companies to expand their services in Bangladesh. It will not only create thousand of new jobs but also provide better treatment opportunity to the local people. Here are few suggestions to be considered:

1. The ministry of health, doctors, nurses, pharmacists, hospitals and business schools should work together and develop clear plan for getting attention to the potential healthcare companies.
2. Send highly trained professionals to the international professional meetings and potential healthcare companies to promote our ability to the international community.
3. Revise the curriculum in medical, nursing and pharmacy schools that train healthcare professionals, so that they are trained according to the new international paradigm.
4. Encourage business schools to develop executive training programmers in healthcare, which will effectively reduce the talent gap for leadership in this area.
5. Develop and implement international standard examination by which doctors, nurses and pharmacists are qualified for employment in the Joint Commission International (JCI) accredited organisations.
6. Encourage local hospitals to evaluate their services by JCI and meet their compliances.
7. Utilise and apply medical information systems that encourage the use of evidence-based medicine, guidelines and protocols as well as electronic prescribing in inpatient and outpatient settings.
8. Develop partnerships between the western and local hospital that design newer ways to deliver healthcare.
9. The government should appoint a commission, which makes recommendations for the healthcare system and monitors its performance.

It is time to think, commence the debate, develop a clear plan and execute it. It has been done in many countries and I am confident it can be done in Bangladesh too.

http://www.thedailystar.net/newDesign/news-details.php?nid=119251
http://www.thedailystar.net/story.php?nid=65878 

Protected From Cervical Cancer

Cervical cancer is cancer of the cervix — the lower part of the uterus, which opens into the vagina. Cervical cancer is the second-most-common type of cancer that strikes women worldwide after breast cancer.

It is estimated that nearly 250,000 deaths are associated with cervical cancer globally every year. According to the World Health Organisation, there were 500,000 new cases of cervical cancer in 2005.

The tragedy of cervical cancer is that it often strikes when a woman is still young. It tends to happen in women between the age of 35 and 55 years. She may be trying to raise her family or may be she has not had children yet.

A population-based survey reported that the coverage of cervical cancer screening in Bangladesh is less than 1%. Older and poor women are at the highest risk of developing cervical cancer in Bangladesh.

Cause of Cervical Cancer
99% of cervical cancers are caused by Human Papillomavirus (HPV), which spreads through sexual contact. There are over 100 different types of HPV. The majorities of viruses are considered Low Risk and do not cause cervical cancer. However, HPV-16 and HPV-18 often referred to as High Risk HPV types are associated with more than 70% of cervical cancer cases.

The body’s immune system usually fights off the infection as a result most women never suffer from HPV infection. However, in some women the infection does not go away. When the virus remains active in the body for a long period of time, cervical cells begin to change and the risk of cervical cancer increases.

There are other factors can increase the risk that an HPV infection develops into cervical cancer:

• Sexual intercourse at an early age
• Multiple sexual partners
• Multiple full-term pregnancies
• Chlamydia, gonorrhoea, syphilis, or herpes simplex virus type 2 infection
• Cigarette smoking
• Use of oral contraceptives for a long period of time
• Weakened immune system or HIV infection • Mother or sister with a history of cervical cancer
• Low levels of folic acid (a type of Vitamin B)

Symptoms
Cervical cancer is usually a slow-growing cancer, typically takes 10-15 years before invasive cancer develops. Once cervical cells begin to change, it first becomes “pre-cancerous” a condition also known as “dysplasia” or Cervical Intraepithelial Neoplasia (CIN).

In the early stages cervical cancer often causes no symptoms. However, when symptoms do occur, they may include:

• Bleeding between regular menstrual periods
• Bleeding after sexual intercourse
• Bleeding after douching
• Bleeding after a pelvic exam
• Pelvic pain not related to your menstrual cycle
• Heavy or unusual discharge that may be watery, thick, and possibly have a foul odor
• Increased urinary frequency
• Pain during urination

These symptoms can be caused by cervical cancer, or by a number of serious conditions, and should be evaluated promptly by a medical professional.

Diagnosis
Cervical cancer is diagnosed through a series of examinations. A Pap test is most commonly used to screen and detect the possibility of a cervical cancer or dysplasia.

An HPV DNA test is used to determine the high-risk strains of HPV infection, which is most likely to lead to cervical cancer. If an abnormality is found during a Pap and HPV DNA tests, a Colposcopy is performed.

Finally, a Cone biopsy is performed by removing a cone-shaped piece of tissue from the cervix for microscopic examination. A pathologist examines the sample for confirmation of precancer or cancer cells.

Treatment
Options for treating cervical cancer depend predominantly on the stage of disease — the size of the tumor, the depth of invasion, and whether the cancer has spread to other parts of the body.

Other factors that are considered are the patient’s age and if she wishes to have children. The primary forms of treatment are surgery or combined radiation therapy and chemotherapy.

• Surgery to remove the uterus
• Radiation therapy to kill the cancer cells
• Chemotherapy to stop the growth of cancer cells

Vaccine
The vaccine is now available for prevention of HPV infection. Studies show that women who receive cervical cancer vaccine between the ages of 15 and 25 have 100% protection against the HPV-16 and HPV-18.

The vaccine is given in three shots over six-months. Centers for Disease Control and Prevention (CDC) recommended this vaccine for girl’s ages 11 to 12, although it may be used in girls as young as age 9.

Ideally, females should get the vaccine before they are sexually active. The vaccine is also recommended for 13-26 year-old girls who have not yet received or completed the vaccine series. This allows a girls immune system to be activated before she encounters HPV. Vaccinating at this age also allows developing the highest antibody levels. The higher the antibody levels the greater the protection.

http://www.healthwikipedia.com/womens-health/protected-from-cervical-cancer.html
http://health.evergreenbangla.com/get-protected-from-cervical-cancer/