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Wonders of medicine remain a wonder to the poor
Syed Fattahul Alim

Medical science has undergone a tremendous transformation during the last one hundred years. At the fag end of the nineteenth century the art of medical diagnostics underwent a revolution with the discovery of x-ray that enabled an inside view of human body. Since then physicians have been peering deep into human body to know what ails a patient by taking photographs of the afflicted organs or parts of them. Similarly, invention of vaccine and antibiotics starting with penicillin provided the medical practitioners with a new array of weapons that had the power to fight micro-organisms called bacteria. But man had already invented the technology in the form of microscope to see extremely small living organisms called bacteria. That helped the science of pathology to recognise the pathogens that caused many incurable diseases in the past. But before the discovery of x-ray and antibiotics, medicine had been fighting an uneven war in the dark with an enemy whose identity was hidden behind a veil of as if an undecipherable mystery. But after these discoveries everything was light.
In the meanwhile, many more scores of years have passed. The science of healing as well as the technology associated with it has gone through qualitative jumps in all these years. But the question remains as to whether the science has also been able to reach its wonders on the doorstep of the man in the street. So far the discussion centred on the art, science and technology of healing. But the fact is that simply finding the cause of disease is not the whole story about the practical task of healing, which involves manufacture of drugs that kill the germs or eliminate the cause that develops the symptoms in a patient. The science of pharmacology also made a great leap forward in the intervening period. A branch of chemistry called pharmacological chemistry came to the aid of the science of healing to invent new wonder drugs. Discovery of new and more powerful antibiotics remained the trail-blazing events in the progress of pharmaceutical researches on this score. Add to this the manufacture of drugs having the potential to cure organic dysfunction or influence the function of the internal chemistry of the patient's body. A new era of hope dawned to protect humanity from the scourge of diseases and end the physical sufferings against which man was powerless before.
But as with other discoveries and inventions in the world of science and technology, medicine, too, still remains in large measure beyond the reach of the majority of the victims of the curse of life-threatening medical conditions. Bangladesh being one of the poorest and most densely populated land on earth, the a large chunk of its population is quite in the dark about how medicine and its curative power has undergone quite a revolution, as they are yet to get the full benefit of this science.
Drugs manufactured by multinational manufacturing companies and their local subsidiaries as well as indigenous pharmaceutical industries abound. The local manufacturers of drug now meet more than 95 per cent of the country's demand for medicine. According to an estimate, there are about 156 such manufacturing units producing drugs in the country. Though the availability of medicine in the wholesale market or at the drugstores in the retail market does not in itself determine the condition of healthcare of the common man, it is still a matter of great hope for him that medicines are after all not a rarity to them, if only they could afford them when in need. Then again, there is yet another hurdle between them and the drugstores. The cost of the services provided by the physicians and the glitzy diagnostic facilities is in a word quite forbidding. So, all the spectacle of the drugstores packed with medicines of endless varieties, the signboards displaying enigmatic specialisations of the doctors, the diagnostic houses flaunting proudly what strange and complicated medical technology and machinery they are in possession of notwithstanding, what keeps the poor patients at arm's length is their inability buy those products and services. Neither the pharmaceutical companies, nor the service providers like the hospitals, clinics or the doctors specialising in the art of healing have any consideration for the large majority of the people who are but mere victims of the impersonal force called market, which is quite insensitive to the real human needs. It all has a ring of familiarity to that age-old aphorism "water, water everywhere, but not a drop to drink." Drugs are there and in great quantities at that, but those are beyond the reach of people, who need them most.
There is talk about ethical drugs or ethical practice in the medical profession. As narrated in the foregoing, the practice whether it is in the business or in the service still exists largely in theory. True, there are some 1300 odd public and private hospitals and clinics all across the country with some 4,000 registered medical practitioners recommending courses of therapy for the patients. The patients, on their part, are free to choose from some 45,000 retail outlets to buy the prescribed drugs. To the common people, most of whom are poor and not literate, the doctors command extraordinary respect. That is not just because the doctors know more about the secrets of human body or have high degrees. In fact, the respect they draw is due to their power to heal people of their diseases. But the story ends here. The poor patients are willing to trust their doctors and are willing to obey their advice without question. They do not even question once the doctors advise them to go for a particular course of therapy. The same is true of the drugs the doctor prescribes for them. Everything would have been fine, if only the courses of medicine advised and the drugs prescribed remained within the buying capacity of the patients. One could rejoice without reservations about all the fruits of pharmaceutical research had those also been friendly to the poor patients in a Third World country like Bangladesh. The people at large could also share the pride of the growing business in pharmaceuticals and in the doctors bringing home expertise from abroad at their expense. But no, that is not be; at least not in the foreseeable future. So, the wonder drugs, their curatives powers, the strange and extraordinarily costly contraptions at the diagnostic clinics inviting the patients to get the feel of their power to see through their innards-all are but a mirage, wild goose chase to the ones who need them most.