Gonoshasthya Kendrer Golpo: The first lesson a doctor never forgot

During the lockdown in 2020, Mostaque Ahmed sat at home and watched people around him fall ill. One day he heard that Dr Zafrullah Chowdhury, the founder of Gonoshasthaya Kendra, was also unwell.

Knowing he already carried health complications, Mostaque felt a pull he had not felt in years. He picked up his pen and began to write his memories.

The first piece went up on Facebook. Then another. Then a dozen more.

His former colleagues from Gonoshasthaya Kendra noticed the posts and urged him to keep going. By the time he stopped, he had 15 chapters in hand.

Those 15 chapters made up the book 'Gonoshasthya Kendrer Golpo: Public Health Er Prothom Paatth' (The Story of Gonoshasthaya Kendra: The First Lessons of Public Health).

The book was published last year by the University Press Limited (UPL). A discussion on the book was held last Saturday at the UPL head office on Green Road in Dhaka. In that session, the author shared his memories of his time at Gonoshasthya and how the book came into reality.

Ahmed's journey to Gonoshasthaya began long before he ever worked there. As a college student he read the magazine Gonoshasthaya and books on Dr Zafrullah Chowdhury.

The pull never quite left him. During his medical college years he had also begun to think of himself as a writer, and public health, he felt, could hold both lives at once. After graduating and a brief spell at a clinic, he joined Gonoshasthaya in July 1996.

"Entering that institution felt like entering another world," he said at the launch. What he had learned in classrooms as clinical medicine looked very different on the ground.

He worked there until October 1998. In those two years he visited rural sub-centres, ran health check-ups in the Daulatdia brothel area, and helped train paramedics, including at a centre in Tripura.

From senior colleagues he picked up the institution's earlier history. He learned how its primary health care model had been discussed at the Alma-Ata Conference in 1978. This was a landmark of a conference organised by WHO and UNICEF summit that established primary health care (PHC) as the key to achieving global health equity

"For me, those experiences became the first lesson of public health," Ahmed said. He spoke of the years that followed, the formal master's degree, twelve years at BRAC, and a stint at CARE Bangladesh.

Through all of it, his connection with Gonoshasthaya stayed personal. The first lessons one receives, he said, are never forgotten. They are like a first love.

The pandemic brought that first love back to the surface. When the manuscript was complete, Ahmed sent it to Dr Zafrullah Chowdhury for comments. A few days later, the call came.

Dr Zafrullah liked it so much that he himself sent the manuscript for publication as soon as he finished reading it.

The story the book tells is not a small one. Gonoshasthaya Kendra grew out of the Bangladesh Field Hospital set up during the Liberation War to treat wounded freedom fighters.

After independence, the hospital moved first to Eskaton in Dhaka. Later, the mother of Dr Zafrullah's friend Dr Mahmudur Rahman donated land in Savar. More land was acquired with support from Bangabandhu Sheikh Mujibur Rahman. Two tents and two tin-roofed structures were how things began.

The early days were lean. Workers ate rice only once a week. On other days they survived on a single meal of flatbread. Drinking water came from distant sources, fetched in pitchers.

Speaking at the discussion, women's rights activist Shireen Parveen Haq said the institution lived by two principles from the start. The first was, "Go to the villages and build the villages." The second was, "No national development is possible without the advancement of women."

Outside China, she noted, one of the largest barefoot health worker programmes anywhere was the one Gonoshasthaya Kendra ran in Bangladesh. During the war, women trained at the field hospital assisted in surgeries. Some performed surgical procedures themselves, including removing bullets. Later they were taught to ride bicycles so they could reach distant villages.

The book also returns to the long fight over a national drug policy. Dr Zafrullah examined international costs of raw materials and packaging and pushed for a policy in line with the World Health Organization list. President Ziaur Rahman gave his approval before his assassination cut the process short. Today Bangladesh exports medicines to nearly 120 countries, thanks to Dr Zafrullah's vision.

Ahmed described the book as something that sits between forms. The aim was never a pure memoir, or an academic ethnography. He writes fiction as well, and the idea that memory, documentation, and historical truth need not always be walled apart guided him here.

"A narrative can hold them together," he said. "That is the spirit in which this book was written."