Dr Afrin Sultana on the ongoing Crisis

There have been a lot of conversations regarding the role of doctors in Bangladesh during the ongoing crisis. We caught up with one of the cancer surgeons in the country Dr Afrin Sultana to elaborate on the situation while trying to understand the circumstances from the other side of the debate.

Dr Afrin Sultana
Oncoplastic Breast Surgeon

Please tell us something about yourself?

Currently, I am working as an oncoplastic breast surgeon. We say 1 in 9 women have the risk of developing breast cancer in their lifetime. This type of cancer is mostly seen in women worldwide and also the leading cause of cancer-related death in females. The situation in our country is no different. However, if we can diagnose cancer in early-stage then it can be cured almost completely with proper treatment.
I have been working for breast cancer awareness and treatment in Bangladesh for quite some time. In our country, people tend to underestimate the quality of cancer treatment available, I want to bring a change to such mindsets.

I have been working in Holy Family Red Crescent Medical College & Hospital for the last six years. I also do private practice in the City Hospital Ltd, Lalmatia. Besides my stint as a surgeon, I advocate awareness about breast cancer and modern treatment of it, through different programs and media activities. Awareness programs are very effective in ensuring accessibility to good quality cancer treatments.

My dream is to establish a one-stop cancer centre and I have been working towards that goal. Cancer patients in our country have to go to a lot of different places for different stages of the treatment and due to lack of proper knowledge about the process makes it even more agonising for them. This is why a one-stop centre will provide the complete set of facilities required for cancer treatment from diagnosis to surgery.

Have you been involved in any other profession?

I have been involved in modeling but I have never taken it as a profession but more like a hobby. The “Boldly Beautiful” campaign by a leading soap brand is the only TVC I have been involved with. Further work related to the campaign has been currently put on hold due to the pandemic.

We are currently in the middle of a pandemic, how would you evaluate the current situation for Bangladesh?

Currently, we are not in a very good state, there has been a lack of coordination from the start. If we could maintain institutional quarantine of the returnees from abroad, things could have been much different. Unfortunately, we couldn’t do any use of that opportunity to curb the spread. Following that, we missed another chance to reduce the spread by failing to implement contact tracing. The subsequent government measures have not been effective because of the lack of enforcement. People have been moving back and forth between Dhaka and the peripheral districts resulting in a massive rise in cases. Better enforcement of the lockdown would have saved thousands from getting infected. The latest lockdown initiative from the government in Dhaka based on specified zones hasn’t also been very effective and the directives are confusing even to the people who are executing them by their own admission.

In the middle of the mayhem, how would you evaluate the service that our frontline medical professionals are providing for our country?

The frontline workers have been doing a tremendous job from the beginning. The working conditions have improved significantly compared to the early stages of the pandemic. Most of us were without proper equipment to treat patients and the general public was in panic mode that caused a lot of stress. Things have changed for the better in terms of awareness since then. Our colleagues in the health care sector have been giving everything they have to save lives despite the fragile state of our healthcare system. Initially, there was a severe lack of necessary safety equipment like Personal Protective Equipment (PPE) especially the proper mask but most healthcare professionals performed their duties risking their own lives. It is also true that there have been incidents where patients had to be turned away because health care workers could not perform their duties because of lack of equipment and treatment facilities . However, it is a management and policy issue, it is the right time to start working on a robust healthcare policy.

Has the situation improved for the healthcare workers?

It has! There was a lot of misinformation and negativity about our role in the ongoing crisis, things have improved a lot in terms of awareness and understanding on the patients’ side.

In points, what are the five shortcomings of the healthcare system that have been uncovered during this pandemic?

There are quite a few, among them the crucial ones are:

  1. The policymaking in the sector has been terrible and the situation warrants a complete overhaul of the process.
  2. Lack of coordination between different departments of the sector has proven fatal.
  3. Disputes arising from ego between different bodies have delayed the availability of crucial equipment which has contributed to the crisis.
  4. Lack of foresight and pre-planning has brought the healthcare system on the brink of collapse.
  5. The lack of security for healthcare workers both at the workplace or in social media platforms has made our work even more stressful.

How long do you think it will take to get back to our normal lives?

Currently, there is no end in sight and the situation may get worse in the coming days. Until a vaccine is developed, I do not see things improving anytime soon.

What should be our mantra for survival?

We need to motivate ourselves and try our best to weather the storm. Most importantly, we need to think about the vulnerable population of our society who cannot afford to stay out of work. If the situation prolongs they will be faced with hunger and malnutrition. I think as a society we need to come up with a strategy that prioritises their survival.