New horizons for Bangladeshi doctors
By Alfred Hermida
BBC News Online in Bangladesh
Health workers in Bangladesh are planning to use CD-ROMs and online courses to show doctors in rural areas how to better treat their patients.
The country has one of the highest maternal and infant mortality rates in Asia, as some doctors have little knowledge about women's health.
"For rural doctors it is hard to close their clinics and come to a city centre for the courses. This is why they don't come to update their knowledge," explained Dr Abu Jamil Faisal of Engender Health, which promotes healthcare for women.
The organisation is one of the partners in a grand project to set up more than 300 telecentres across rural Bangladesh to educate doctors in the latest medical advances.
'Textbooks too expensive'
But persuading the medical profession to adopt new technology could prove a uphill struggle. Reaction to the first telecentre in the southern village of Sonagazi has been lukewarm.
The centre has two computers and a library of CD-Roms packed with medical information.
The aim is to get doctors in rural areas to drop in and use the discs for research. "The computer is the right tool as we can offer all these resources on CD-Rom," said project coordinator Shahid Uddin Akbar of the Information Communication Technology Development Programmer Bangladesh.
"Textbooks are too expensive for local doctors. If we have the CD-Rom with lots of journals and articles, we can disseminate it anywhere."
Lack of knowledge
In theory, doctors say they are interested in the project.
"We are working in a rural area so we are devoid of an information technology programme or any such knowledge," said Dr Nurallah during a visit to the telecentre.
But in practice, local doctors have proved reluctant to use the centre.
Despite his initial enthusiasm, Doctor Nurallah admitted he uses his computer at home rather the machines at the telecentre. Health experts say part of the problem is that rural doctors are hesitant about publicly showing their lack of knowledge.
Doctors fear that their reputation and standing in the local community could be harmed if they are seen learning how to work a computer at a telecentre.
Bangladesh health facts
Population: 131,269,860
Infant mortality rate: 69.85 deaths per 1,000 births
Life expectancy: 60 years
Death rate: 8.6 deaths per 1,000 population
Source: CIA World Factbook 2001
Official rewards
Another is simply a fear of technology.
"There is a lot of interest, even among the older doctors," said EngenderHealth's Dr Faisal.
CD-Roms can be used by anyone with a PC
"They want to know more about this technology but don't have the appropriate knowledge and don't know where to go to get it."
The backers of the project believe the answer may lie in offering private training sessions in secret for doctors, so they can learn how to use computers and the internet.
But perhaps the greatest obstacle is that the courses on offer are not recognized by the Bangladeshi Medical Council.
This means doctors are reluctant to spend time doing a course or studying a CD-Rom as they do not receive an official certificate at the end of it.
The organizers are aware of the problem and are talking with the medical authorities about gaining official recognition.
They hope that by continuing the medical education of doctors, they will be able to raise the standard of healthcare across the Bangladesh.
