Heart disease treatment too Dhaka-centric

In Bangladesh, cardiovascular disease treatment is predominantly Dhaka centric and is prohibitively expensive. Patients have to either come to the capital or remain untreated, said experts.
The centralisation of heart disease treatment in Dhaka has led to an overwhelming burden on institutions like the National Institute of Cardiovascular Diseases (NICVD), resulting in long waiting times for surgeries, sometimes even months.
Patients often have to wait months to get heart stents or major surgeries in government hospitals. As a result, most patients seek treatment in private hospitals, where costs are significantly higher.
An angiogram that costs Tk 3,000-4,500 in a government hospital can cost between Tk 10,000-15,000 in private ones. Heart stenting, which costs Tk 20,000-25,000 in government hospitals, can cost up to Tk 1,20,000 in private facilities.
Many cannot afford these prices.
Md Rafiur Rahman is one such person. He is a 63-year-old former government employee who has two blocks in his heart.
“I had a heart attack in 2019. Then the doctors asked me to wear the ring. But I had to wait more than a month for the surgery in a government hospital. Private medical expenses are high so I didn’t go for surgery,” he said.
The 700-bed NICVD hospital always has twice as many patients. Around 1,000 patients come to the outdoor department of the hospital every day. 
A total of 130 coronary angiograms and 100 heart bypass surgeries are performed daily, with over 100 other surgeries also conducted each day, according to the NICVD.
Catheterisation laboratories or cath labs are very important in heart disease treatment. Various tests including angiogram, angioplasty, pacemaker or ICD implantation are done in this lab.
According to the Directorate General of Health Services, there are 87 cath labs in government and private hospitals across the country. Of these, 58 have been installed in Dhaka. Eight cath labs are now inactive due to a lack of manpower across the country.
DGHS data said that there are 42 cardiac care units in the country, of which 32 have cardiovascular surgery units.
Prof Nazmul Hossain, director general of DGHS, said the standard of cardiac surgery and heart treatment has increased after 2000. But the number of surgeries being performed is not high in the country.
When asked about the Dhaka-centricity of heart treatment, Hossain, said, “Initiatives will be taken to make heart disease treatment available outside Dhaka.”
This is the reality of heart treatment in Bangladesh as the world observed World Heart Day yesterday.
The World Health Organization says that more than four out of five cardiovascular deaths are due to heart attacks and strokes, and one third of these deaths occur prematurely in people under 70 years of age, according to World Health Organization (WHO).
Prof Sohel Reza Chowdhury of National Heart Foundation Hospital and Research Institute said, “Around five lakh people die of cardiovascular disease annually in Bangladesh. Premature death is seen in 40 percent of cases.”
He also said, “The country’s heart disease treatment is mostly Dhaka-centric. Even cardiologists are less interested in working outside Dhaka.”
Tobacco use, obesity, trans fat in foods, salt intake, lack of physical activity and air pollution are mainly responsible for heart disease, he said.