The corona virus (COVID-19) outbreak has led to the pandemic which has initiated activities and widespread discussion on the clinical aspect but more on its prevention all over the world and advises, suggestions and guidance of thousands of people, including doctors, public health workers, politicians, economists and sociologists are going on every day. In this crucial moment, the insights from World Health Organization (WHO) in Geneva, Switzerland, are thought provoking and are always worthy while dealing with the coronavirus situation. The Director-General of this organization, Tedros Adhanom Ghebreyesus, has offered effective directions day in and out where the global lockdown action was described as the best second option at preventing the deadly Corona.
We have lost the first opportunity and now if we cannot utilize the second opportunity then the big and awful question is the cost of the third opportunity. He made six recommendations for this second chance to take effect. The first and the most important one, he mentioned, 'Increase the number and training of manpower in health care and public health' which seems to be very general and simple suggestion but that is the mightiest weapon to safeguard the World against every infectious disease and health crisis in the days to come.
In today's Bangladesh, most of those working from top to the community level against coronavirus have no or very little public health perspective/orientation. That is why preventing COVID-19 out of the hospital has become very challenging and we fear that very grim situation is ahead of us. This should give the Health sector leaders to think beyond medicalization and to think of simple prevention and create a health framework for the people across the country where people will have the perfect formula in their own hand not in the hands of the doctors and nurses reducing health risks, focusing on prevention and maintaining good health. This is what Ghebreyesus means to be a healthcare and public health manpower. This will certainly lead the country making health less being doctorized, less being medicinized, going back to the grandma's days of preventicizing illnesses.
Public health workers will be the ones who have specific institutional knowledge, experience and training. Do the existing educational institutions in the country have proper public health education infrastructure? A big question, of course, and the simple answer is, no. Although many reputed Universities and educational institutions have nominal public health departments and departmental activities, they are far less than what is required. Government and private medical colleges have the same situation. The public health department is always the weakest one and run or operated by relatively less talented people.
Prioritizing the advice of the head of the World Health Organization, clinical health care and public health manpower should be increased, both the disciplines should have an intertwined Public Health perspective and that would be a way-out to tackle future health problems and COVID-19 like crisis in Bangladesh. Some far-reaching and far-sighted steps are proposed here for reorganizing our Medical, Public Health, and Social Medicine education systems.
Generalized Public Health Education: During the tenure of this government, one Bengali course has been made compulsory with all the subjects studied in the universities. This is an admirable move. It is also called General Education. A full unit course named 'public health education' should be made mandatory for all subjects studied in the universities of Bangladesh.
Public Health gets intertwined in all Clinical Subjects: Make public health education compulsory at all public and private medical colleges. The BMDC, UGC and the Ministry of Education can play a leading role in this regard. Each and every doctor should receive basic Public Health education which would include bio-statistics, epidemiology, SBCC, interpersonal communication and prevention of all clinical issues.
Developing trustworthy Public Health higher level institutions: Like IEDCR, many organizations can be developed as trustworthy associates of the government. There are more than hundred public and private universities with relevant researchers including public health experts, biotechnologists, microbiologists, virologist, chemists, and pharmacists and so on. Government has to be sincere to utilize them and make a list of researchers who are skilled in this field. Such universities and institutions of the country shall have to be further developed and put into use.
Continuous development of Public Health workforce: The provision of health care and public health training should be made compulsory for all the people of this country, on the basis of age or educational qualification or knowledge requirement.
We are quite convinced that besides the panic there is a realization and determination playing in the public mind in the current situation of COVID-19. We didn't take necessary preparation as overall we did not have Public Health orientation. Within a Public Health perspective we need to have a comprehensive and long-term plan to deal with disasters so that any future health risks can be successfully dealt with. As part of this, there is no alternative to compulsory public health education and integration with clinical subjects.
Dr. Md. Tajuddin Sikder PhD, Chairman, Public Health & Informatics Dept., Jahangirnagar University
Dr. Abu Jamil Faisel, Member, EC, Public Health Association of Bangladesh