THE failure of the government to meet some of the most elementary needs of rural health care — where most of the population, especially the vulnerable groups, resides — is a rather sordid affair. According to a report published in New Age on Saturday, the government has left vacant as much as 7,000 to 10,000 positions for health assistants — who carry out many vital functions for health care at the grassroots — of the 25,000 that are needed to run its service. More importantly, the number of positions for grassroots health assistants has actually not increased in 41 years since independence, even though the population has more than doubled. Health assistants are tasked with carrying out free vaccinations programmes around the country, as well as finding out pneumonia, kala azar and tuberculoses patients and supply medicines to community clinics. They are essentially a vital clog in the government’s healthcare programmes around the country. However, the manner in which they have been treated so far, sheds some disturbing light on the actual state of rural healthcare service delivery is in. According to the New Age report, health assistants are neither given transport allowance or any form of transport, even though their job involves travelling to remote areas. One wonders then, how much of the service in reality reaches all corners of the country.
In this regard, the leaders of the Bangladesh Field Workers’ Association of the health department placed a five-point demand to the health and family welfare minister recently demanding pay hike and appropriate designation (health assistants find their designation as medical assistant inappropriate), change in recruitment rules and institutional training of medical assistants so that they can become health assistants. The demand would appear quite legitimate and timely given the state of health assistants at present and, if implemented, promises to bring about at least some changes that have been long overdue. Subsequent to the meeting, the ministry, through a committee, has proposed a three to six month training followed by an examination through which medical assistants can graduate to become health assistants. This is indeed a welcome suggestion, and something the leaders of the association have also accepted, however, it still faces much uncertainty as it depends on the availability of funds from the government’s five-year development plan.           
The government and the health ministry must realise that by ignoring the needs of health assistants and the rural health care system, they are jeopardising the health and lives of the majority section of the people of this country, who in fact belong to the rural population group. Access to adequate health care is also a constitutionally-guaranteed right of the people of this country and by neglecting it, they are essentially failing to carry out their constitutional obligations. Much of the economic, social and political future of this country, as it does for all countries around the world, depends of the state of its people’s health, and there neglecting health is tantamount to neglecting the future.