What is healthcare in Bangladesh like?

Facilities and Health Information

The general level of sanitation and health care in Bangladesh is far below U.S. and European standards. There is limited ambulance service in Bangladesh and attendants seldom are trained to provide the level of care seen in the United States. Traffic congestion and lack of a modern centralized emergency services system (on par with 911 in the U.S.) make patient transport slow and inefficient. Several hospitals in Dhaka (e.g., United, Apollo, and Square Hospitals) have emergency rooms that are equipped at the level of a community hospital, but most expatriates leave the country for all but the simplest medical procedures. Hospitals in the provinces are less well-equipped and supplied. Psychological and psychiatric services are limited throughout Bangladesh. There have been reports of counterfeit medications within the country, but medication from major pharmacies and hospitals is generally reliable. Medical evacuations to Bangkok or Singapore are often necessary for serious conditions or surgical procedures and can cost thousands of dollars. See the Medical Insurance section below for useful information.

Despite government efforts, community sanitation and public health programs are inadequate in Bangladesh. Water supplies in Bangladesh are generally not potable. Typhoid fever, cholera, infectious hepatitis, giardia, cyclospora, and bacillary and amebic dysentery are only a few of the serious diseases transmitted by impure drinking water. Bottled drinking water, especially in major brands, is generally safe for consumption. Fecal-oral contamination is common; improperly prepared meat and improperly cleaned vegetables can lead to food-borne illnesses such as cysticercosis, neurocysticercosis, and campylobacteriosis plus hepatitis A, B, C, and E. Press reports indicate that fish and other raw foods are frequently treated with formalin to slow decomposition, that fruits, particularly bananas, are generally treated with chemicals to speed ripening, that milk products are adulterated with melamine, and vegetables tend to show elevated levels of arsenic due to contaminated groundwater. Washing, soaking, peeling, and thoroughly cooking food are mandatory procedures to minimize chemical, insecticide, bacterial, and parasitic contamination.

Multiple strains of influenza continue to circulate annually in Bangladesh including the H1N1 influenza A pandemic strain. Peak influenza circulation occurs during the rainy season, approximately May through October. CDC recommends a yearly flu vaccine as the first and most important step in protecting against the most common influenza viruses (seasonal flu). For more information about seasonal influenza, please refer to the CDC’s Seasonal Flu website.

Highly pathogenic avian influenza A virus H5N1 (Bird flu) has been circulating among poultry in the country since 2007 and outbreaks continue to occur nationwide. The most recent outbreak occurred in October 2012. In response to the ongoing circulation of H5N1 in the country, the government has planned to start a pilot H5N1 vaccination program among domestic poultry. There are concerns from a human health perspective about the use of poultry vaccine which minimizes signs of illness in the birds but does not confer sterilizing immunity, as we could have the silent circulation of the virus in the birds, with continued human exposure. The US Center for Disease Control (CDC) is reviewing its current surveillance platforms with a plan to increase its monitoring of H5N1 circulation among healthy-looking birds sold in markets. Although avian influenza A viruses usually do not infect humans, rare cases of human infection with avian influenza A viruses have been reported, most often following direct or close contact with infected poultry. As Bangladesh continues to be affected by H5N1, it is recommended to avoid poultry farms, contact with birds in live food markets, and to avoid consumption of poultry products that are not thoroughly cooked. For information on avian influenza (bird flu), please refer to the Department of State's Avian Influenza Fact Sheet.

Any questions or concerns about influenza or other illnesses should be directed to a medical professional. Although the Embassy cannot provide medical advice or provide medical services to the public, a list of hospitals and doctors in Dhaka can be found on the Embassy website.

Dengue fever, a mosquito-borne illness, is prevalent in Dhaka and surrounding areas, in particular from October through March, but can happen at any time of year. Prevention is key, as there is no vaccine or treatment once infected. Malaria is a problem in the surrounding areas outside Dhaka. If you are planning to travel outside Dhaka, consider starting prophylaxis medication prior to travel. Japanese B encephalitis, also a mosquito-borne disease, is a problem throughout Bangladesh, although less so in Dhaka. While there is no specific treatment for Japanese encephalitis, there is a recommended vaccine available. Chikungunya was found in Bangladesh in 2008, and this mosquito-borne illness is slowly making headway throughout the country, including in Dhaka. No vaccine or specific treatment exists for Chikungunya. In all areas, the use of mosquito repellent and bed nets are strongly recommended to help prevent mosquito-borne diseases.

In 2009 and 2010, there were multiple outbreaks of anthrax in rural communities in Bangladesh among persons who slaughtered sick animals. Individuals who avoid this activity are not at risk. Though a small risk still exists of consuming anthrax-infected meat, human vaccination against anthrax is not recommended. Rabies is a more serious problem, with several thousand dying yearly in Bangladesh from this endemic disease, generally passed on via bites from infected dogs. Seek prophylactic advice from your healthcare practitioner before coming to Bangladesh, and seek immediate medical attention if bitten by any animal.

According to the World Health Organization, Bangladesh has also seen cases of polio, Nipah virus, and Kala-Azar, (visceral leishmaniasis). Kala-Azar is a deadly disease caused by a parasitic protozoan, leishmaniadonovani, transmitted to humans by the bite of infected female sandflies, phlebotomusargentipes, which lowers immunity, causes persistent fever, anemia, liver and spleen enlargement, loss of body weight and if left untreated, kills.

Tuberculosis (TB) is a major public health problem and is endemic in Bangladesh. In 2012, the World Health Organization (WHO) ranked Bangladesh seventh among the world’s 22 high-burden TB countries. The prevalence of multi-drug resistant tuberculosis is relatively low, but a recent WHO report suggests the rate of MDR-TB is increasing in the country.

Drinking Water Source - % of rural population improved

84.4%

Drinking Water Source - % of total population unimproved

15.2%

Drinking Water Source - % of urban population improved

85.8%

HIV/AIDS - adult prevalence rate

0.1%

Hospital Bed Density - beds/1,000 population

.6

People Living with HIV/AIDS

6,300

Physicians Density - physicians/1,000 population

.36

Diseases - note

Highly pathogenic H5N1 avian influenza has been identified in this country; it poses a negligible risk with extremely rare cases possible among US citizens who have close contact with birds

Sanitation Facility Access - % of total population unimproved

43%

Sanitation Facility Access - % of urban population improved

55.2%

Sanitation Facility Access - % of rural population improved

57.8%

Infectious Diseases - degree of risk

High

Animal Contact Disease (s)

Rabies

Food or Waterborne Disease (s)

Bacterial and protozoal diarrhea, hepatitis A and E, and typhoid fever

Vectorborne Disease (s)

Dengue fever and malaria are high risks in some locations

Water contact disease (s)

Leptospirosis

Medical Insurance in Bangladesh

Medical Insurance

Uninsured travelers who encounter medical emergencies overseas often face extreme difficulties. Most medical insurance plans do not include coverage outside one's country. Getting medical treatment and hospital care abroad can be very expensive, and, if you need it, a medical evacuation back to your country can cost more than $50,000!

Your local embassy may assist in locating appropriate medical services, informing family or friends, and may even assist in the transfer of funds from back home. But ultimately, payment of hospital and other expenses is entirely your responsibility.

Check the terms of your health insurance policy, whether it’s your own, under your parents' policy, or through your school. If you are not covered while out of the country, you may need to purchase additional coverage. Many travel agents and private companies offer plans that will cover health care expenses overseas including emergency services such as medical evacuations.

Mental Health

Traveling or studying overseas is not a cure for health conditions such as depression or attention deficit disorder. Sometimes going abroad may in fact amplify a condition. One may not have adequate access to prescription medication or mental health facilities. In addition, culture shock, language barriers, and homesickness can deepen isolation or depression.

Before traveling, create a workable plan for managing your mental health while abroad. The availability and quality of mental health services differ widely from country to country. In many countries, one will find it difficult — and sometimes impossible — to find treatment for mental health conditions. With your health services provider or your school, put together a workable mental health plan before you go overseas.

If you have a medical or psychological condition that may require treatment while you are abroad, discuss this ahead of time with your doctor. A vacation or study abroad is a great opportunity to try new things but this is not the time to experiment with not taking your medicine or mixing alcohol with medicine.

Research the social culture of your destination to learn about how mental illnesses are viewed. Attitudes toward mental health can greatly vary between countries.

If you are studying abroad through your university, talk to your university about access to mental health services at overseas programs. Your study abroad office can help you decide what program would be best for you.

If currently receiving mental health services — including prescription medication — find out if those services and/or medication are available at your destination.

Consider the support system you’ll have in place while abroad. If possible, know ahead of time who you can consult about your mental health.

Prescriptions

While you’re abroad is not the time to suddenly realize you ran out of your prescription!

If you have a condition that requires regular medication, bring an extra quantity with you and pack it in your carry-on, just in case your checked luggage gets lost. Just remember to keep it in its original container and clearly labeled — you don’t want to create the impression you’re carrying drugs that haven’t been prescribed to you. In fact, you should check with the local embassy to make sure that your medication is acceptable to carry into the country. Some countries may consider your prescription medication to be illegal. Bring a letter from your doctor listing your medications and explaining why you need them. Doing your research and having a letter can help prevent any misunderstandings along the way.

Bring extras of any medical necessities you need, like contact lenses or glasses. You might want to pack a pair in both your carry-on bag and your checked luggage, just to be safe.

If you have allergies to certain medications, foods, insect bites, or other unique medical problems, consider wearing one of those “medical alert” bracelets and carry a letter from your doctor explaining the required treatment if you become ill. It might not be the coolest piece of jewelry you wear, but it could save your life.

Vaccinations

How important is it to do your research about vaccinations? It might just save your life! Make yourself aware of the different types of vaccinations and which ones you may need to travel to your destination. Schedule an appointment with your doctor at least four to six weeks before you travel to ensure you receive all important shots.

Be sure that you and your family are up to date on your routine vaccinations.

Which vaccinations you need will depend on a number of factors including your destination, whether you will be spending time in rural areas, the season of the year you are traveling, your age, health status, and previous immunizations.

Disability Access In Bangladesh

Accessibility

While in Bangladesh individuals with disabilities may find accessibility and accommodation very different from what you find in the United States. Most roads in Bangladesh do not have proper sidewalks and those that do are often in disrepair and not easily accessible by persons with disabilities. Few roads have proper crosswalks for pedestrians and those that do are large flyovers or pedestrian bridges spanning the width of the road. These flyovers are accessible only by climbing stairs and walking across; there are no ramps or elevators to assist those with disabilities. The public transportation system is overcrowded and not easily accessible by those with disabilities. Individuals with wheelchairs will find public transportation virtually impossible to use. Most public places, including buildings, hotels, and restaurants, have little to no accommodation for persons with disabilities. A handful of modern hotels built in the last few years are wheelchair accessible, but virtually no properties have been built with Americans with Disabilities Act standards in mind.

Disabled persons are legally afforded the same access to information rights as their non-disabled peers. The Ministry of Social Welfare, the Department of Social Services, and the National Foundation for the Development of the Disabled are the Bangladesh government agencies responsible for protecting the rights of persons with disabilities. Government facilities for treating persons with mental disabilities are largely inadequate. Several private initiatives exist for medical and vocational rehabilitation, as well as for the employment of persons with disabilities. Several NGOs, including Handicap International, have programs focusing on helping and raising awareness of the challenges faced by the disabled.

Disclaimer

You are responsible for ensuring that you meet and comply with foreign entry requirements, and health requirements and that you possess the appropriate travel documents. Information provided is subject to change without notice. One should confirm content prior to traveling from other reliable sources. Information published on this website may contain errors. You travel at your own risk and no warranties or guarantees are provided by us.

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