Since childhood, biology was the subject to have engaged Ramisa the most, and she dreamt of pursuing a career in it. However, when faced with the post-HSC dilemma between microbiology and BBA at IBA, University of Dhaka (DU), in 2017, she chose the latter, driven by her narrow employment-focused considerations and social pressure from family and friends.
Ramisa’s case is not one-off. In fact, it is safe to assume that most students in her place will prefer IBA, or other education paths with better career opportunities, to life science. The general view of life science is not that good because it doesn’t have better career opportunities in Bangladesh.
Take the case of Tahsin, a student of DU Health Economics Institute (IHE), who has been preparing for the Bangladesh Civil Service (BCS) exam. He is not alone. In fact, more than half of his classmates are preparing to compete for this prestigious job. The government's health cadre in Bangladesh, however, does not prioritise candidates with advanced degrees in health science, not even in the primarily public health positions.
A normal picture of life science in Bangladesh
Such has been the situation in Bangladesh for decades. Parents encourage children to pursue traditional degrees like BBA, MBBS or engineering as they believe only these degrees can guarantee better jobs, social security and status. After graduation, even if a person realises that they have an inclination towards some other field, they think there is no way out. On one hand, students are compelled to make career choices on the basis of inadequate information about possible future implications, misconceptions, stereotypes and parental and peer pressure. On the other hand, careers in the health sector, other than those of doctors, are regarded as insignificant. Health sciences, particularly those relating to public health, have long been regarded as neglected fields in the country.
Rithika Dutta, a third year student of microbiology at Noakhali Science and Technology University, describes how she had spent the first two years explaining the study subject to her relatives.
“It was very difficult to explain to people that I study a subject that involves matters that are invisible to the naked eye. Now, with everyone talking about the coronavirus, the situation has improved. But people still lack a basic understanding of many facts,” she says.
The Executive Director of Public Health Foundation, Bangladesh, Dr Taufique Joarder, says the case of general view towards health sciences has always been the same. “For ages public health allied practitioners have been seen at the lowest end of the hierarchical structure in the health care sector.”
While the healthcare market of Bangladesh has always seen a mismatch between supply and demand of healthcare workers, the scenario has been different between allied public health practitioners and medical professionals.
About the barriers preventing students from pursuing careers in health sciences, Dr Senjuti Saha, microbiologist and scientist at Child Health Research Foundation (CHRF) Bangladesh, says, “There is a lack of collaboration among the scientists, researchers and health experts in Bangladesh. There also exists a lack of entrepreneurship mentality among the scientists and a perception among common people that health sciences are all about memorisation.”
But health sciences, in reality, are anything but boring. It surely is sometimes tedious, but the challenge and adventure of studying the human body and the complex living world is very intriguing.
“I constantly feel that I’m a micro detective trying to solve mysteries behind diseases, trying to find the microorganisms that cause diseases in children”, says Ms Saha.
In the past decades, it was thought that graduates from health sciences worked only in laboratory research settings. Today, students interested in public health sciences might consider various fields like epidemiology, psychology, microbiology, community planning, occupational safety and health, biostatistics, environmental health, which have excellent job opportunities in various industries. These jobs range from research to teaching and consultancy at hospitals, public health, veterinary or diagnostic laboratories, private companies, MNCs, non-profit organisations and government.
The Covid-19 pandemic has opened the world’s eyes and brought the role of public health practitioners to light. All over the world, people who have never heard of concepts like epidemiological curves and preventive or public health approach have begun to understand these concepts and there has been a collective realisation about public health.
Youths getting encouraged
This has led to a surge in public health-related careers. According to the US Bureau of Labor Statistics, employment in healthcare occupations is projected to grow 15 per cent from 2019 to 2029. A report by The New Indian Express states that the demand for microbiology courses and professionals has gone up in India during the ongoing pandemic. An article on The Nation's Health, a monthly newspaper of the American Public Health Association, reveals that careers in public health will continue to climb this century, with more public health content taught at all levels of education.
Similar trends can be seen among the youths in Bangladesh as well. Community health is a branch of public health taught at the medical colleges in Bangladesh. Arunima Barua, a third year student at Chattogram Ma-o-Shishu Hospital Medical College, shared her thoughts in this regard.
“Community health is a para clinical subject focusing on the health of population instead of individual health. As it is not a clinical subject, people often fail to understand the long term merits of this subject. But the subject helped me to understand different aspects of the pandemic better. I would like to pursue a Master of Public Health (MPH) degree in the future.”
Greater awareness of public health issues, the heroic efforts of the front-line and back-end health practitioners and major accomplishments by Bangladeshi scientists like Dr Senjuti Saha and Dr Firdausi Qadri, are inspiring the young generation to pursue healthcare careers.
As Dr Senjuti Saha went on to say, “There is a new momentum among the parents and the young generation regarding career priorities. In a country where research is seen as a fall-back option when you can’t get into med school or engineering school, I have been getting messages from young girls telling me they want to be researchers, scientists and bioinformaticians.” Just as important it is to let young people choose career of their own accord, as hard it is to let sustain this change in mentality in the long run without infrastructural reforms, she adds.
Positive outlook has to be sustained
To sustain this positive change in career preference, it is necessary to bring appropriate changes in undergraduate curricula and higher studies to make it suitable for the public health career track. An analysis showed that out of the 3850 courses offered by the DU-Coursera programme in 2020, the top 20 courses consisted of only one health-related course- introduction to psychology. This is quite unfortunate as the free Campus Program was introduced in response to Covid-19. The need of the hour is to design different health courses for physicians as well as for non-physician care providers.
Schools and primary educational institutions have a role too. Before choosing from broad streams of specialisation - humanities, commerce and science, students should be presented with practical opportunities to know more about the scope of these subjects. A child in California has access to the internet for educational purposes, and since early student life is aware of the diverse career paths and options. This has not been the case for Bangladesh, particularly among the less privileged students who often have to manage many competing priorities.
Abanti Barua, assistant professor at the department of microbiology at Noakhali Science and Technology University, believes there is a major lack of information. In this regard, she says, “A major issue is that students don’t know much about these subjects themselves, so they cannot tell their parents of their choice. A lot of Bangladeshi scientists are working all over the world. If we can let the school or college students have a conversation through digital platforms, it will encourage them.”
Children can’t be what they don’t see. So it is necessary to be more involved with them to keep up their passion for health sciences. Structural reforms are also needed to make the health sector more inclusive. We are heading towards a new crisis. The care gap during the Covid-19 pandemic and disrupted immunisation campaigns could emerge in the post-pandemic period with an increase in cases of chronic diseases and burdens of other vaccine preventable diseases. And the importance of public health sciences has never been greater. If this isn't the moment, there will never be one.
The writer is a BBA student at the Institute of Business Administration (IBA), University of Dhaka.