Zafrullah Chowdhury, people’s doctor and war hero, pioneered a public health revolution in Bangladesh

An unassuming gentleman, the life and times of Dr Zafrullah Chowdhury would be unknown to most Indians. Born on December 27, 1941, he breathed his last on April 11, 2023, and was mourned by the public health community the world over. He never quite recovered from Covid-19 complications, laying down his life in active service of the people.

After spending his early childhood in Kolkata, he completed his medical graduation from Dhaka Medical College in 1964. He trained as a general and vascular surgeon in England from 1965-1971 and passed the Primary Fellowship examination of the Royal College of Surgeons in 1970. He did not complete the final examination of the Fellowship, leaving England to join the Bangladesh Liberation War in 1971 — first as a guerrilla warrior and then as a doctor. Along with five doctors and a group of women field volunteers, he set up the first field hospital with 480 beds near Melaghar in Tripura. These volunteers had no previous training or background in patient care and they were trained to perform a wide range of medical care functions. It was this experience that would later transform Bangladesh’s public health landscape in a significant way.

Chowdhury dedicated himself to restructuring and reorganising public health services in the newly created Bangladesh. The field hospital was relocated to Savar (near Dhaka) in 1972 and went on to become the Gonoshasthya Kendra, a public trust. It grew as a people-oriented healthcare organisation providing community and institutional services in healthcare, women’s empowerment, disaster management, education, agriculture, and rights-based advocacy. It also runs hospitals, a printing press, community schools and a generic drug manufacturing plant. As early as 1972, a people’s health insurance scheme was launched at a premium of two takas a month for the poorest of families. It pioneered training paramedics in preventive medicine and basic curative medicine that was later scaled up by the government and is widely held to have made significant contributions to Bangladesh’s impressive performance in the field of maternal and child healthcare. He trained female paraprofessionals to conduct tubectomy through mini-laparotomy techniques.

As a member of the Commission for Development of Women in 1980, Chowdhury contributed significantly to framing proactive measures and policies in support of women’s development in Bangladesh. He was the chief adviser of the expert committee for Bangladesh’s national medicine policy in 1982. Framing the Essential Drugs Act, Chowdhury, played a key role in proscribing 1,700 dangerous or useless drugs.

Chowdhury was awarded the Certificate of Commendation in 1972 for his contribution to the freedom struggle of Bangladesh and the Independence Day Award in 1977, the highest civilian national award, in recognition of his contribution to the development of primary healthcare and the delivery of family planning services at the grassroots.

It is significant that in recognition of the pioneering work of Gonoshasthya work in its first two years, he was awarded the Swedish Youth Peace Prize in 1974 for its primary healthcare programme for rural communities that partnered with rural women and men in delivering healthcare.

He received the Ramon Magsaysay Award for Community Leadership in 1985 for his contribution to community development and his role in the introduction of a National Drug Policy in Bangladesh. The award citation said: “CHOWDHURY, energetic and unconventional at the age of 43, lives the simple life of service he preaches — which is shared by his wife and only child. He is now organising a new kind of medical school where the emphasis will be upon teaching holistic preventive medicine as an integral part of daily village life.”

Chowdhury had two principles as the core philosophy of people’s healthcare — participation of ordinary rural people, especially women, in the delivery of healthcare; village-level application of scientific innovations; and the transfer of knowledge of simple treatments to semi-literate persons. He pioneered “barefoot doctors”, most of them young rural women, with an aim to reach poor rural homes that lacked access to medical services, health education and essential drugs, performing minor surgeries, conducting normal deliveries, and referring as per protocols. Accepting the Right Livelihood Award, he said, “We have tried to demystify medical care and decrease the control of the medical profession and instead promote the paramedic, the village-level health worker, as the backbone of health care.”

The writer is Professor at the Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi and Editor, Indian Journal of Public Health


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