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Dr. Nargis Sultana

Chittagong Medical College Hospital , Bangladesh

Title: ‘Women’s Health Issue’-A Mixed Bag Experiences as an Ob-Gyn Consultant of Bangladesh

Abstract

Bangladesh, a small low income country of South Asia, though enriched with natural resources and beauty but plagued by poverty, illiteracy, malnutrition, over population and most importantly gender inequality which have great impact on women’s health. Women here are relatively disadvantaged and the strong patriarchal structure in the society has resulted in poor status of women in family and society in terms of their economic, social and health condition. This is reflected in restriction on women’s movement, right and opportunity, low self-esteem, poor access to healthcare, a culture of acceptance, early marriage, lack of effective family and community support structure and inappropriate allocation and utilization of resources which is further aggravated by conservatism and prejudices. So observing the indigence of women in our society, it was my long cherished dream from my childhood to be highly educated and self- reliant. I am fortunate enough to have an wonderful family where my life goal had been set up earlier and my own willpower also paved the way to become a gynecologist and to fulfill my dream of doing something better for the neglected, disregarded girls and women of our society. As a female consultant I got the chances to come across the women of different caste and category with their multiple physical and mental health related issues. I observed that all the existing adverse factors of our society are greatly responsible for increased maternal mortality, poor reproductive outcome, extreme psychological trauma, mental and physical illness , domestic and gender based violence to women. Lack of proper health education leads to reproductive morbidity such as RTI, fistulae ,uterine prolapse, inability to control urination and painful intercourse. Chronic UTI, Iron deficiency anemia, ill-health are also major problem. All these diminish women’s fertility, productivity and quality of life. In some cases women with such chronic problems may become social outcast, turned out of homes, and rejected by their husbands and families. But, I perceived as a doctor that almost all of their sufferings are preventable by appropriate counselling and health education so I focused on it and started working on preventive measure related health education by giving quality time to my patients so that they become familiar with me to share everything they want to which in turn helps me to make them well both physically and mentally in a proper way. So it became one of my main concern first being a woman then as a physician. After that as an ob-gyn consultant my main vision and mission became to working for prevention of breast and cervical cancer, the first and second leading cause of cancer death to women in our country respectively. During my long 20 years experiences, I observed keenly that most of the cancer patients were coming late in advanced stage to seek treatment when we were unable to do anything except supportive treatment. It touched my heart so I thought deeply that it should be prevented rather than treated. Regarding cervical cancer , words of hope that it’s a vaccine preventable disease as the main cause is H-P virus. So where there is virus there is vaccine. As soon as vaccine became available in our country first I took it and after that I started giving it to our girls and women for the last 15 years with the hope that it can help protect against cervical cancer. It has a wide range of scope to prevent cervical cancer , firstly due to cervix is the outer part of the uterus so it can easily be examined. Secondly, there are well designed screening programs for it and there are well recognized precancerous lesions which take long time to develop cancer and there is also well tolerated treatment protocol for precancerous lesions. All of these help to prevent cervical cancer and thus reducing cervical cancer load. At the beginning stage of vaccination against H-P Virus, it was not so easy to convince our patients. It needed huge counselling which took long time but I was equipped to overcome all the hardship and dedicated on it. Regarding Breast cancer though it is dealt by surgeon yet we ob-gyn have great scope to work on it as female patients first visit us for any of their problem and we can take it as an opportunity to make them aware regarding breast cancer screening also, as Breast is the outer part of the body too, so any abnormal changes can easily be identified by periodic examinations and investigations as a part of screening. It is a matter of hope that with each cervical cancer screening we do Breast cancer screening too even when patients come for some other reasons as our neglected women have limited access to health care facility. It’s my work of great interest in our field to work for prevention of both cervical and breast cancer as both of these killer diseases are preventable with minimum education and awareness , so I am doing it properly and will be doing since I am able. Planning, determination, taking actions on time, taking courage to keep a good head on shoulder in the phase of hardship helps anyone to do something better. During this long journey of my profession I had many experiences which taught me meaningful lessons on how to interact with the patients. Dear women- be your own support system, clap for yourself, be there for yourself and do it for yourself.

Biography

Nargis Sultana, a distinguished medical professional, holds an MBBS from SSMC, Dhaka, and FCPS in obstetrics and gynecology. With additional expertise gained through FACS in the USA, she serves as a respected consultant in obstetrics and gynecology, previously contributing as a resident surgeon at Chittagong Medical College Hospital. Health Centers (Puskesmas) and depression and cultural aspects on the quality of life of advanced stage cancer patients in Indonesia.