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Scourged by quacks

People in villages fall prey to fake doctors, put themselves in harm's way

BISHAKHA DEVNATH
Mohafez Rahman from Kurigram had to have both of his legs amputated from below the knee recently at Rangpur Medical College Hospital.
However, the drastic measure could have been avoided if the 30-year-old had only paid heed to medical practitioners about a month ago, instead of relying on so-called ayurvedic specialists or kabiraj.
When Mohafez began having difficulty walking, he went to a local doctor in his Dharanibari village. The doctor found it to be case of gangrene, a potentially lifethreatening situation, and advised Mohafez to amputate one of his legs from below the ankle.
Frightened by the diagnosis, Mohafez decided to visit Aminul Islam, a self-proclaimed ayurvedic doctor and magician, in Rajarhat of Kurigram.
The "kabiraj" assured him that he could cure his foot and then began a month-long “treatment" where he would dress his legs with a liquid which he claimed was concocted from herbs.
"Aminul charged me Tk 2,000 to Tk 2,500 every time I visited him. I spent almost Tk 40,000 to Tk 50,000 in total on these treatments,” Mohafez told The Daily Star during an interview a few months ago.
When the "treatment" failed to improve his condition, one of Mohafez's brothers finally stepped in. He refused to let him go see the kabiraj again, although Mohafez insisted that the herbs were working.
He took him back to Rangpur Medical. Unfortunately, by then the dead tissues had risen up to his knees and spread to his other leg as well, prompting the hospital to form a committee that eventually decided to amputate both his legs to save his life.
Hriday Ranjan Roy, an associate professor at the hospital, said, "When I saw him Mohafez [in March), he had developed septicaemia [blood poisoning). The infection began spreading upwards."
THEAFTERMATH
These days, Mohafez is bedridden.
He wishes he had listened to the doctors. If he had, he would have retained the use of one of his legs and perhaps even had a job. Nowadays, his wife takes care of him while his brothers bear his expenses.
Contacted, Aminul, the kabiraj who treated Mohafez, claimed that he had turned down requests to treat him
upon learning that the doctor had suggested amputation.
"I can provide treatment if the problem lies in the muscle. But his bones had decayed when he first came to me," he said at his Kurarpara village home in Rajarhat upazila.
He, however, admitted that he had no academic qualification to provide treatment.
Having studied up to grade eight, he worked at a brick kiln before entering this profession, he said. He learnt the tricks of the trade from another "kabiraj" who treated paralysis, arthritis and diseases related to female reproduction.
Aminul's story is not uncommon. People around the country continue seeing "kabiraj". But there are no records of such visits.
Doctors working at public hospitals across the country have numerous stories to share about people who have been to these "quacks" before coming to them.
Stories of patients being given pain injections at upazila and union drug stores during heart attack, ultrasounds carried out by non-medical persons on pregnant women, operations by Kabiraj and death of babies during deliveries, are all rampant.
However, there is no infrastructure in place to prevent such incidents.
Hriday, who specialises in surgery, said he came across four cases of maltreatment by quacks in the last six months.
He communicated the matter to the Kurigram civil surgeon through one of
his colleagues.
Civil Surgeon SM Aminul Islam on April 8 said he was unaware of Mohafez's case and he would contact Rangpur Medical to learn the details and take action.
If victims came to him with written complaints, he would bring the accused to justice after investigation, he assured.
Public health also suffers at the hands of salesmen cum village-doctors present at union and upazila bazaars.
Forty-five-year-old Nurjahan went to Sudhir Ranjon Shil, a village doctor at Adompura Bazar, Dasmina of Patuakhali, with complaints of lower back pain. Sudhir gave her an intravascular injection, from which Nurjahan got an infection.
Sudhir, had completed a course to become a rural medical practitioner, learning about selling medicines in three-six months' courses. His training was on selling medicine and not on advising treatment. He also completed a short training on pharmacy, he told our Patuakhali correspondent.
He did not charge his patients anything for treatment, but they had to buy medicine from his store, he said.
Later, when Nurjahan could no longer bear the pain, she went to the 250-bed hospital in Patuakhali in January.
Rezaul Kabir, a physician at the hospital, operated on her to remove pus from an infected boil on her lower back. She was previously given steroid injections which might have been
unnecessary, he said.
She could have been given some medicine, physiotherapy and advice to change her lifestyle, Rezaul added. WHO TO ACT AGAINST ILLEGAL
PRACTITIONERS
Mass awareness campaigns by NGOs working in the health sector and the media would discourage people from going to quacks, said Kurigram Civil Surgeon Aminul.
From the government side, mobile courts are held from time to time to fine and jail people for impersonating physicians.
However, according to Rab Magistrate Sarwoer Alam, who has led many such drives, public awareness is important in fighting such social crimes.
Registered doctors also can play a role here, he added.
"If they all mention their (Bangladesh Medical and Dental Council) registration numbers on their prescriptions, people would become cautious."
The registration numbers can be verified on the BMDC website.
BMDC Registrar Zahedul Haque Basunia said his office cannot act against unauthorised health practitioners.
He said the health ministry and the home ministry should act together to devise deterrents for illegal medical practitioners.
Until such measures are taken, quacks may continue to operate their illegal business, putting many lives at risk.