BSMMU
Day Four – 26 February, 2012
Bangabandhu Sheikh Mujib Medical
University
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The official start to the working week at the
Bangabandhu Sheikh Mujib Medical University (BSMMU) is eight thirty
in the morning on Sunday - the traffic outside where I am staying
is already at a complete gridlock and I am at risk of being late on
my first full day. Taking a cycle rickshaw seems to be the
only option to navigate the traffic and my driver takes great pride
in navigating towards the BSMMU on time.
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Dhaka is reported to have 250,000 cycle rickshaws, which
is not hard to believe when attempting to cross the cycle rickshaw
lane. On first impressions one can feel uneasy considering the low
pay, long hours and difficult conditions the drivers have to
endure. The counter-argument is that the rickshaws are a major
employer and drivers’ pay compares well to jobs of a similar skill
level. In a city where noise and traffic pollution rate amongst its
greatest difficulties, the quietness of the cycle rickshaws (well,
aside from the constant tingling of cycle bells) and their green
nature do appeal to the environmentally minded amongst
us.
The BSMMU certainly is a huge hospital. It
comprises of four blocks, each up to 17 stories high, with a range
of inpatient and outpatient facilities for the majority of medical
specialities. The department of psychiatry is on floor 11 of block
C. The BSMMU is the primary medical university in Dhaka for
postgraduate teaching and qualifications, including training for
both MD and MPhil in psychiatry, and the links it has across the
country mean it is a great starting point for setting up a Royal
College Volunteer Scheme link.
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Professor M Mullick is the
man in charge of the psychiatry department, the lead contact for
the link, and I am sure will be mentioned again in the
blog. The doctors at the BSMMU have a wider range of
clinical interests than I initially expected. The first
doctor I speak to properly is Dr Ahsan, who tells me about his
desire one day to gain experience at the Porterbrook psychosexual
clinic in Sheffield. (without knowing where I am based!)
There is definitely a strong interest in collaborative
working. I think the next three months are going to become
very busy.
When we did the previous scoping work looking
at mental health services in Bangladesh, the need to start by
establishing similarities between health systems, rather than
differences, became apparent. The BSMMU provides inpatient (both
paying and non-paying) and outpatient services.
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Patients are recommended to attend outpatients
by a community doctor or can self-refer – the model is generally
recognisable with the UK. There is, however, no real community
psychiatry, and more limited availability of psychotherapy - the
BSMMU does have a psychology arm, however. There are several other
government hospitals in Dhaka, as well as a variety of private
inpatient and outpatient services, accessible to those with greater
finances. There is a specialist child and adolescent service at the
BSMMU, although other specialities are less developed. Of course,
"Dhaka is Dhaka" as I have heard several residents say, and the
availability and set-up of services varies greatly across the
country- I hope to be able to explore rural psychiatry later in the
placement.
Briefly back to the link….As this is a new
link, the early priority is establishing clear and achievable aims
and objectives….More on this next entry….
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About this blog
Dr Adrian Phillipson is an ST5 in general adult psychiatry,
based in South Yorkshire. He is currently part way through a
year out from his training rotation, utilising the time to pursue
research and travel interests. Adrian is the first
psychiatrist to take part in a new Royal College of Psychiatrists
Volunteer Scheme Link with the Bangabandhu Sheikh Mujib Medical University in Dhaka,
Bangladesh. He hopes that this blog will provide good insight
into the link, and will encourage others thinking of taking part in
the volunteer scheme.
Adrian’s attraction to transcultural psychiatry stemmed from a
chance encounter with a local practitioner in Malawi in 2003, where
he witnessed a traditional healing ceremony for psychosis. He
has further developed his interest through completing a masters
degree in Transcultural
Mental Health Care at Queen Mary, University of London, as well as
through further overseas exposure. In 2010 Adrian made
an initial scoping visit to Bangladesh to look at mental health
services and help establish a sustainable link. A report from
this project can be found here.