NEARLY three decades after the signing of the Chittagong Hill Tracts Accord in 1997, the healthcare system in the region still remains underdeveloped, particularly in the remote areas. In the past few weeks, in three remote villages of Baghaichari upazila in Rangamati, people with symptoms of diarrhoea and fever have been suffering with little to no access to health care. About a hundred people from the ethnic minority community in Arun Para, Tarum Para and New Thanggnang Para, located deep within the hills of Sajek Union, have fallen ill, and many are in critical condition as they did not have timely medical attention. There are no community clinics or medical centres, and the underdeveloped road network makes it extremely difficult to transport critically ill patients. The recent medical emergency recalls similar situations in 2016 and 2020, when outbreaks of diarrhoea in the same villages claimed the lives of 15 villagers, including nine minority children. In 2022, a high-level delegation of the United Nations in Bangladesh, after a visit to the CHT, concluded that lack of access and remoteness of many communities remain an ongoing challenge for minority communities. The upazila nirbahi officer too confirms that the area is extremely remote, lacks proper sanitation and access to safe water, yet they have not taken any major steps to improve access to health care.
Inequitable access to health care in the CHT has been a persistent concern. In March 2020, a measles outbreak in the hill districts revealed how the government鈥檚 immunisation programme for infants and children had failed to reach many minority children there. In 2021, when the Covid infection was wreaking havoc across the country, an increase in reported incidents of and deaths from malaria was also reported in the hill districts. In April, at a programme on reproductive health rights in the CHT, speakers from the ministry of CHT affairs and the Directorate General of Health Services observed that the rate of maternal mortality in the CHT is higher than that in the other districts due to the lack of proper doctors, midwifery services and infrastructural development. With the signing of the Accord, the three hill districts were brought under the development programmes of the government, but the changed political economic environment have helped advance the tourism industry in the region, often dispossessing minority communities from their ancestral land and leaving them without access to basic health care or education.
Inequitable access to health care is, therefore, a case of majoritarian bias in development policy that not only excludes ethnic minority communities but also often jeopardises their lives and livelihoods and the incumbents鈥� lack of commitment to a pluralist democracy in Bangladesh. The government must, therefore, immediately ensure emergency treatment for people in three affected villages in Rangamati and develop a strategy for improved health care in the CHT.
