Prime Minister Khaleda Zia's observation, she made at a function in observance of the "Diabetic Awareness Day" on Sunday, that the health policy should be devoted to reaching medical facilities to the common people of the country deserves careful considerations This is not because there is anything new in it. rather because of the inher ent simple truth marred or undermined by repetition. Add to this the absurd pretension the international bodies and the governments have been heir to by declaring the year 2000 as the target period for achieving health for all. It seems the governments of the Third World feel inflated by Joining in such choruses sponsored by the international bodies and rich nations. Never do they take stock of their obtaining realities. The prime minister's speech was mercifully not all rhetorics: at least she cared to inform her audience that her government has actually been serious enough to reshape the health policy and the process is very much underway

Sounds quite encouraging. The autocratic regime made medical service costly and thus unreachable for the poor. Any government pledged to bring about improvement on the existing facilities will surely be most welcomed by the common people who have genuine reasons to be disillusioned by this time. But then the government committed to reform the health care system in the country will find before it an uphill task. Nobody denies the fact that the Infrastructure In the health sector can be considered reasonably expanded if not adequate. But It Is equally true that health services reach the people only in trickles. With per capita government expenditure on health and family planning amounting to as paltry as Tk 53 and the lion's share going to family planning and the big urban hospitals, the task of improving the health care delivery system — particularly to the poor — proves all the more daunting. The other figure of doctor-patient ratio of 1:6169 looks simply frightening.

Yet not everything is lost for us. If the government is serious, it can surely bring about the expected change, in the system. But first of all the loose ends have to be brought together. What really went wrong so that the delivery system could not click is to be the important question. About one thing there Is no ^oubt that we live with paradoxes and many o. our woes in the health sector, as in other areas, owe to them. A huge army of our physicians with MBBS degree are looking for employment and those already employed, almost without exception, hardly do justice to their profession and the very initiation Into It starts with a mighty hypocrisy at the Ume of the oath taking in the name of the great Greek physician Hippocrates. Otherwise It is difficult to explain the mess created at the thana medical complexes When doctors absent themselves from the places of their posting for years together and do thriving clinic business in one of the metropolitan cities drawing their salaries all the same, it is useless asking the system to run properly. Irregularities of all descrip tions are there to undermine or ditch the system.

It is against such insurmountable odds that any future health policy must be pitted. In a country where the majority of the population live below the poverty line, the health care system cannot be forbiddingly expensive, nor is there any reason that it should be as welfare-oriented as it is or were in some countries. The policy ought to be categorical in helping the poorest of the poor with free medicare. At-the same time. It will be reasonably costly for the affluent class of society. Such a mixture of the free market economy and welfare service seems to hold the key for the success of the health care system here. But the men who are charged with the responsibility of successful implementation of the policy at the grassroots level should take a careful look at our national priorities. A profession such as physicians' can reap the benefits expected of it If they discipline themselves without so much caring for the govern ment policy