Public Health as a Career: South-Asian Perspective
South Asian countries have poor health indicators. Almost every country of this region is suffering from huge burden of infectious diseases. The gradual increase in non-communicable diseases and malignant diseases are complicating the situation. Majority of the people of this area are living below the poverty-line and are illiterate. Again, due to unsatisfactory economic growth, most of the governments cannot allocate adequate budget for health sector—leading towards poor health infrastructure.
Diarrheas, malnutrition, high incidence of infectious diseases are the big challenges for this region to solve. There is considerable amount of health inequities between rich- poor and urban-rural people. So, we can certainly come to the point that, South Asian countries need more attention in public health sector and they need more and more public health experts to develop a sustainable public health infrastructure and administration which would be the key to change the present gloomy health situation of this area. Moreover, to fulfill the MDG goals we need multi-sectoral approaches by the public health experts along with other concerned authorities which will lead to an ultimate revolutionary change in the socio-economic condition, quality of life and health status of the people of South Asia.
We can’t afford the huge burden of health cost as there is high rates of incidence and prevalence of diseases and major portion of this cost is coming out from the pocket of general people whose income is already low. To minimize this burden of disease we have to start work at the prevention level through primary health education and early detection of the condition. As well as women empowerment, increasing literacy rate and health education from an earlier stage can improve the current health situation to a satisfactory level.
But, if we ask a class of 100 medical students to choose public health as a career, hardly 1 or 2 students will put their hands up. From different studies it is evident that, doctors of these countries are unwilling to pursue their career in public health. That’s why; the public health field is still underdeveloped in these countries. Most of the doctors want to be an expert clinician in future which is good indeed. But as the situation demands, we need some good doctors willing to serve in this arena. Most of the doctors come to know about public health and its aspects during 3rd or 4th year of their medical under-graduate curriculum, in the “Community Medicine” subject. But, sorry to say that, in most of the cases the teachers and the curriculum fail to motivate the students to make it as a future career. Moreover, the teachers produce a dread and fear of this subject to many of the students.
The reasons why doctors are less interested in Public health as a career are many. Firstly, most of the doctors don’t find this area fascinating and worth for trying. Secondly, overall importance and magnitude of this field are not shown to the medical students in their under-graduate curriculum. So, they have a lot of misconceptions regarding this field. Thirdly, social and peer pressure is a mammoth obstacle for switching the career to public health. Most parents think that, their children as a doctor should achieve a higher degree in the field of medicine, surgery or gynecology and practice in a private chamber. This trend also discourages the young doctors to make a career in public health. Fourthly, lack of mentors or guides is one important factor for not choosing public health as a career. And finally, reluctant to do field work and not oriented with research activities make them rigid in not choosing this career.
To improve this situation of avoiding public health, we need to encourage the medical students about this challenging profession. The undergraduate curriculum should be more students friendly and focus on making them know about the broader aspects of this sector. More and more Public health Quiz, debates, projects and field tours should be arranged to make the students more enthusiastic. Overall, we have to make them understand that it is not the only duty of a doctor to treat a patient, but also to work to prevent the disease at the community level. In our curriculum, health research is almost absent. So we have to also include medical research in the curriculum to attract the students.
Finally, the doctors should believe that an idea, a newer approach or technique, knowledge can save million lives at a time
About the Author : Md. Shajedur Rahman Shawon seeks to pursue a career in Public health and research. He is currently working as the Chairman, Bangladesh National Chapter and International working Group for Advancement of Evidence Based Healthcare (A partner organization of Journal of Pakistan Medical Students).
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