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The Royal College of Psychiatrists Improving the lives of people with mental illness


Day Four – 26 February, 2012

Bangabandhu Sheikh Mujib Medical University

Streets of Dhaka
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.
Streets of Dhaka
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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About this blog

Dr Adrian Phillipson







Dr Adrian Phillipson is an ST5 in general adult psychiatry, based in South Yorkshire.  He is currently part way through a year out from his training rotation, utilising the time to pursue research and travel interests.  Adrian is the first psychiatrist to take part in a new Royal College of Psychiatrists Volunteer Scheme Link with the Bangabandhu Sheikh Mujib Medical University in Dhaka, Bangladesh.  He hopes that this blog will provide good insight into the link, and will encourage others thinking of taking part in the volunteer scheme.

Adrian’s attraction to transcultural psychiatry stemmed from a chance encounter with a local practitioner in Malawi in 2003, where he witnessed a traditional healing ceremony for psychosis.  He has further developed his interest through completing a masters degree in Transcultural Mental Health Care at Queen Mary, University of London, as well as through further overseas exposure.   In 2010 Adrian made an initial scoping visit to Bangladesh to look at mental health services and help establish a sustainable link.  A report from this project can be found here.