Day Four – 26 February, 2012
Bangabandhu Sheikh Mujib Medical
The official start to the working week at
the Bangabandhu Sheikh Mujib Medical University (BSMMU) is eight
thirty in the morning on Sunday - the traffic outside where I am
staying is already at a complete gridlock and I am at risk of being
late on my first full day. Taking a cycle rickshaw seems to
be the only option to navigate the traffic and my driver takes
great pride in navigating towards the BSMMU on time.
Dhaka is reported to have 250,000 cycle
rickshaws, which is not hard to believe when attempting to cross
the cycle rickshaw lane. On first impressions one can feel uneasy
considering the low pay, long hours and difficult conditions the
drivers have to endure. The counter-argument is that the rickshaws
are a major employer and drivers’ pay compares well to jobs of a
similar skill level. In a city where noise and traffic pollution
rate amongst its greatest difficulties, the quietness of the cycle
rickshaws (well, aside from the constant tingling of cycle bells)
and their green nature do appeal to the environmentally minded
amongst us. The BSMMU certainly is a huge hospital. It comprises of
four blocks, each up to 17 stories high, with a range of inpatient
and outpatient facilities for the majority of medical specialities.
The department of psychiatry is on floor 11 of block C. The BSMMU
is the primary medical university in Dhaka for postgraduate
teaching and qualifications, including training for both MD and
MPhil in psychiatry, and the links it has across the country mean
it is a great starting point for setting up a Royal College
Volunteer Scheme link.
Professor M Mullick is the man in charge of
the psychiatry department, the lead contact for the link, and I am
sure will be mentioned again in the blog. The doctors at the BSMMU
have a wider range of clinical interests than I initially expected.
The first doctor I speak to properly is Dr Ahsan, who tells me
about his desire one day to gain experience at the Porterbrook
psychosexual clinic in Sheffield. (without knowing where I am
based!) There is definitely a strong interest in collaborative
working. I think the next three months are going to become very
busy. When we did the previous scoping work looking at mental
health services in Bangladesh, the need to start by establishing
similarities between health systems, rather than differences,
became apparent. The BSMMU provides inpatient (both paying and
non-paying) and outpatient services.
Patients are recommended to attend
outpatients by a community doctor or can self-refer – the model is
generally recognisable with the UK. There is, however, no real
community psychiatry, and more limited availability of
psychotherapy - the BSMMU does have a psychology arm, however.
There are several other government hospitals in Dhaka, as well as a
variety of private inpatient and outpatient services, accessible to
those with greater finances. There is a specialist child and
adolescent service at the BSMMU, although other specialities are
less developed. Of course, "Dhaka is Dhaka" as I have heard several
residents say, and the availability and set-up of services varies
greatly across the country- I hope to be able to explore rural
psychiatry later in the placement. Briefly back to the link….As
this is a new link, the early priority is establishing clear and
achievable aims and objectives….More on this next entry….
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