Shashtho Chaka: Driving healthcare up to the doorstep of the poor

It was a sunny day in September when we spotted the blue and white bus parked near the Shahid Minar. The sticker on the vehicle read 'Shashtho Chaka – Healthcare on Wheels'. 

More than a hundred men, women and children flocked around the bus, some going in from the back and some coming out of the front gate. A closer inspection revealed that almost all the men were rickshaw pullers. The women were mostly mothers with children. 

The bus was a mobile medical clinic founded and managed by Amader Somoyer Pratiddhani Foundation, a non-profit organisation working to provide free medical care to underprivileged people. 

That camp near Shahid Minar was organised to provide medical checkups and healthcare education to rickshaw pullers and children from marginalised and underprivileged families. 

"Most people living in slums and below the poverty line in Bangladesh consider going to the hospitals only when they're too sick. They tend to think regular checkups are a waste of money and time. So I thought, why not bring the hospital to them?" said Sanjida Bhuiyan Haque, the founder and president of Amader Somoyer Pratiddhani Foundation.  

"Health is the most important thing for human beings. How can a working population contribute to the country's economy when most people can't access proper healthcare? Mobile healthcare is a fairly common concept in western countries, and I felt that we need something like that for our people, especially those living below the poverty line and can't afford the hefty cost of healthcare," she added. 

Amader Somoyer Pratiddhani Foundation started its journey as a live programme and online doctor consultation during the Covid-19 pandemic in 2020. 

However, Sanjida felt they needed to reach out to the people and bring healthcare to them directly. With that thought, she registered her non-profit foundation with the Registrar of Joint Stock Companies and Firms. 

They started organising medical camps in different slum areas in Dhaka such as Bosila, Korail, Kamalapur, Tejgoan, Notun Bazar, Badda etc.  

Before setting up a camp, they announced the date and place by miking in the respective areas. "The announcement used to bring a huge number of people. So much so, that our doctors would have difficulty attending to that many patients," Sanjida said. 

Besides a maddening crowd, bringing all the medical equipment and medicines to the camps was another challenge. The static camps were usually held in schools. The school teachers made it a little easier by giving them a place for the medical camp. 

But the more the Amader Somoyer Pratiddhani team worked, the more they realised there was no alternative to mobile vehicles to reach patients quickly and effectively. 

The foundation launched 'Shashtho Chaka – Healthcare on Wheels' from that need in April 2022. A bus was built, roughly resembling the outpatient department of a hospital. 

The bus has two hospital beds, two consultation tables for the doctors, ECG and ultrasonogram machines and other necessary medical equipment for providing basic healthcare to the patients. 

Some basic tests can be done in the diagnosis section of the bus. Oxygen and nebulisation services are provided to the patients if necessary. 

"The Shashtho Chaka is deployed in each area per the guidelines of Bangladesh Medical Association," said Sanjida. "The facilities in the transport include a consulting room, a well-equipped lab with diagnostic facilities, medicine dispensation, areas to provide diagnostic care of blood, glucose, pregnancy testing and so on. It is also equipped to create awareness programmes for child health, geriatric and communicable diseases, and educate people on various lifestyle changes that impact their health."

A team of 10 people, including four doctors, two nurses and other supporting staff, conduct each camp. 

Who are the doctors and nurses that provide healthcare to these people? 

"Our doctors are paid volunteers. We signed an MoU with Tairunnessa Memorial Medical College and Hospital in Gazipur. They have a course on community health, which focuses on introducing graduate students to the larger healthcare scene of Bangladesh. Our doctors are usually these students," explained Sanjida. 

"One week before each camp, we announce the dates to these doctors. They volunteer according to their availability. Since they invest their time and energy for these people, we try to provide an honorarium."

Free medical consultation and health education are the primary focus of Shashtho Chaka. The mobile clinic covers diagnosis, tests and counselling, sexual and reproductive health, maternal, neonatal and child health, ear, nose and throat treatments, etc. They also provide free medicines to the patients.

Sanjida shared with us that sometimes they get patients who have never once sought medical treatment in their entire life. 

"We try to give basic health education and raise awareness among these people, along with providing basic healthcare. For example, we try to make them understand why their blood pressure or diabetes is so high and why they need regular checkups."

Menstrual health is another important aspect that the Amader Somoyer Pratiddhani Foundation covers. They provide vending machines for sanitary napkins in rural and slum areas, along with educating girls and women on menstrual health. 

"So far, we've done medical camps in remote areas, including the chars in Bhola, Barisal, Patuakhali, Sirajganj, Gazipur, Narayanganj, Mymensingh, Tangail, etc. In most of these areas, the hospitals are so far away that people can't access them easily," Sanjida said. 

"Poor people usually defer going to doctors as long as they can. When they do visit the doctors, it's usually too late. I want that to change. I want them to have access to regular checkups. This is a basic right that every human being deserves to exercise," she added. 

Since Amader Somoyer Pratiddhani Foundation signed an agreement with Tairunnessa Memorial Medical College and Hospital - a 500-bed hospital - the camp refers patients there for further treatment if necessary. 

Shahina Chowdhury, one of the volunteers working with Shashtho Chaka, said, "We have provided health services to 70 people in less than two hours in the central Shaheed Minar area this September. Most of them got free medicines as well. We usually provide healthcare services to 300-500 patients in each camp. Sometimes, the number goes up to 700 if it's outside Dhaka." 

The Business Standard asked Sanjida where she got the inspiration for founding her organisation. "My mother, Zakia Ali Bhuiyan, was always involved in charity and social work. She has been the greatest inspiration for me," she shared. 

"Besides, while studying Business at the Middlesex University, London, I did a lot of social work. When I came back to the country and saw how people living under the poverty line are suffering because of inadequate access to healthcare, I realised that if the situation is to change, the private sector must come forward. The government alone can't do all the work."

Right now, Shashtho Chaka – Healthcare on Wheels has two buses. The second one was donated by the Turkish Cooperation and Coordination Agency (Tika) recently. The foundation now plans to use one bus for the urban slums and another one for remote areas in villages.  

Sanjida said, "We will soon launch Friday Free Clinic, a campaign that aims to reach people all over Bangladesh."