No doubt, the country has, over the last two decades, witnessed a little improvement in mother and child healthcare. Still, there are reasons to be concerned over the state of affairs of the public healthcare, which has suffered a significant downslide.

It is no overstatement to say that the successive governments were not serious, despite their promises to the people to provide healthcare services at their doorstep.

Corruption, like in all other public sector, has also spread wings in the health sector. Corruption in healthcare service delivery had not cropped up during any particular regime but was a continuous process. Years of negligence, corruption and indiscipline have hampered health services, where poor patients are utterly neglected.

The achievement in the public health sector is quite negligible despite spending of a chunk of funds over the last many years. The government launched a Tk 15,000 crore, five-year Health and Population Sector Program (HPSP) on July 1, 1998 and set up 13,000 community clinics for delivering unified healthcare services to the village people.

Millions of takas was spent for training of doctors, nurses, paramedics and health and family planning field workers. The rural people, without the means to go to towns for treatment in private clinics, rush to these community clinics. But most of the time, they return home in deep frustration as there are no doctors to attend them.

Upazila health complexes, the smaller versions of state run hospitals, set up for providing healthcare services to the rural people, are also in pitiful conditions.

A total of 460 health complexes were contracted at huge costs and the government had to take loans from the donors for this purpose. The newspaper reports on the state of affairs in these health complexes revealed sad spectacles of corruption and indiscipline in varying degrees.

It is alleged quite frequently that the doctors are not available in these health complexes. Luckily by chance, if they are, then the required medicine is sure to be short of supply and the basic diagnostic tools to be out of order.

The lists of malpractices are huge and appropriate measures need to be taken to put these health complexes on the right operational track.

The recent statistics supplied by the Bangladesh Institute of Development Studies (BIDS) also exhibits an unhealthy health profile. Only 29 percent people in Bangladesh receive some kind of state healthcare services, through the per capita expenses in healthcare is $12.

There is only one doctor for 4,043 people and one nurse for 20,000 people. Having around 38,000 beds in 700 government hospitals, the bed and population ratio stands at 1:2832.

Out of a total of 4,500 unions in the country, only 1,651 unions have the community clinics, most of which are running without doctors. These figures say it all.

As for the positive sides, the country has made some advancement in surgical and diagnostic fields. But very few people are fortunate enough to avail of the modern and sophisticated healthcare services rendered by the private hospitals at inordinate costs.

The affluent people, who can afford easily, take their loved ones to various countries for treatment, the most frequent destinations being India, Bangkok, and Singapore.

It is alleged frequently that the doctors in Bangladesh are becoming devoid of values and professional ethics. They are also giving wrong treatment to their patients, sometimes causing deaths.

According to media reports, some 14 people died, allegedly because of wrong treatment and doctor negligence between January 2005 and June 2006. This is indeed making people induced to go abroad for better treatment.

Dhaka has seen alarming growth of private clinics and diagnostic centers over the past several years. New clinics and diagnostic centers have come up like mushrooms in every major roads and areas.

Most of these clinics have no competent physicians and specialists while the diagnostic centers lack technicians. Unreliable pathological reports and non-competent physicians have set off a chain of wrong medication.

Clinics and diagnostic centers have to comply with a set of rules laid down in the 1982 clinic ordinance for qualifying to operate. There are 368 private clinics and hospitals in Dhaka and 844 nationwide, many of which have been operating without approval and cheating the helpless patients.

But the Directorate of Health Services, the competent authority to mend the erring clinics, has chosen to pretend that nothing is going wrong with the healthcare system.

Nobel laureate Prof. Amartya Sen who unveiled "The State of Health in Bangladesh Report 2006" in the city on December 26, made the observation that "privatization limits the majority of people's access to basic public healthcare services."

The report revealed that 80 percent of the affluent people avail the services of private hospitals while no one from the poor segment ever availed private healthcare services.

Army-led joint forces are seizing almost everyday huge quantities of adulterated and rotten food items. It seized around 6.5 tones formalin-treated fish from three wholesale fish-markets in the city on February 24 and destroyed them. The joint forces destroyed around six tons of rotten fish seized in Patuakhali on February 26.

People are getting afflicted with various diseases for taking contaminated food items. The components that are being used in these food items include spurious spices, DDT powder, urea fertilizer, chemical coloring and many other harmful ingredients. Poisonous chemicals are being used for forced ripening of fruits.

This unholy development of food adulteration has certainly posed a fresh threat to the country's ailing healthcare system.

The Safe Food Act of 1959 needs urgent modification for tackling such health hazards of ominous proportions and also for making it responsive to needs. Existing laws are too lax and offenders find it easy to get away by paying a small fine for committing heinous crime.

The understanding about the importance of health in national and individual development has been growing rapidly across the world. But "Health for All" as articulated by WHO in 1977 still remains a pipedream for us.

Bangladesh falls much behind both in development and delivery of healthcare services compared to other developing countries.

It is obvious that each and every individual has the basic human right to enjoy a healthy life. But the sordid situation prevailing in this sector deprives seventy one percent of the people of badly needed healthcare services.

Public hospitals, the only avenue open to poor people needing treatment, are in a terrible mess. The maladies in the healthcare system, therefore, call for a hard look by the caretaker government.

ANM Nurul Haque is a columnist of The Daily Star.