Rethinking health education

Shamim Ahmed and Rajat Das Gupta 

The first public discussion about coronavirus started during December last year, and it has already been more than eight months that coronavirus has wreaked havoc on the lives of every single person in the world. This is an extraordinary event that no one could escape or ignore, and everybody suffered from either the coronavirus disease - Covid-19 or its multifaceted impacts on their lives. We have now reached such a point where vaccination is being considered as a possible prevention strategy. However, the very old public health school measures are still proven to be the best deterrence for fighting this deadly virus. 

Hundreds of possible vaccines are currently being tested at the top-notch medical labs of the world. Scientists are hopeful that by the end of this year, one of these vaccines might turn out to be effective against coronavirus. Russia has already claimed to be the first nation inventing a vaccine for coronavirus and have started applying it to their citizens at a small scale. However, scientific communities around the world have denied their claim as Russia has not followed the standard protocols usually undertaken by scientists for development and approval of any widely recognized vaccines. 

Nevertheless, even if the vaccine produced by the Russians proves to be an effective one, its two years’ validity is not good enough for fighting a virus as deadly as coronavirus. Covid-19 already affected more than twenty million people and killed around seven hundred thousand people around the globe. We need a vaccine that can work longer than 2 years. It is obvious that to produce and administer a vaccine for seven billion people alone might even take more than 2 years, let alone wiping it out from our beloved earth. 

Covid-19 pandemic has taught us many things --- one of which is to stay with the old public health school ritually. Most of the steps taken a century back to fight Spanish flu are still effective against almost all the epidemics of last two decades, such as SARS and MERS. Frequent handwashing, covering face with a mask and keeping safe distance from each other have been proven most significant initiatives to prevent the wide spread of coronavirus. 

Hundreds of possible vaccines are currently being tested at the top-notch 

medical labs of the world. Scientists are hopeful that by the end of this year, 

one of these vaccines might turn out to be effective against coronavirus. 

Russia has already claimed to be the first nation inventing a  vaccine for 

coronavirus and  have started applying it to their  citizens at a small scale

We have learned some important lessons during this pandemic which has implications on reforming medical, nursing and public health education systems of Bangladesh. Before this pandemic, rarely any of our doctors, nurses or medical professionals had specific knowledge of working in such situation. The widely used term ‘Personal Protective Equipment (PPE)’ was rarely used before.

Almost no one involved in medical care services knew how to use PPE including donning and doffing, as these were not covered in the academic trainings of the health professionals in Bangladesh. Physicians in Bangladesh are mostly taught to focus on patient management. A few of them gradually engage in research works and gain adequate knowledge of inferring a scientific article. Physicians in Bangladesh are not usually trained about the art and science to critically appraise any scientific articles. 

Covid-19 pandemic has seen real-time surfeit of information widely known as ‘infodemic’. To tackle such infodemic, critical appraisal of scientific evidences is required. Without the knowledge of understanding quality of information, an appropriate health-related policy decision cannot be made. Therefore, basic health research mechanism should be included in medical education curriculum, preferably under the banner of ‘Community Medicine’ subject. 

Covid-19 has disrupted the medical education system widely. Medical and nursing schools are closed sine die. Medical and nursing education is heavily practice-oriented that requires hands-on training, and therefore a distance learning mechanism is ineffective for these faculties. 

While many developed nations have the luxury and technology to apply stimulation for learning, this is quite impossible for a country like Bangladesh due to lack of adequate skilled manpower and poor internet connectivity. This might be a good time to develop system for continuing medical education without any disruptions even during a global pandemic. In the ‘new normal’ world, methods providing adequate clinical experience to the students will remain a key research topic. 

In addition to that, curriculum for public health needs to be updated in the context of coronavirus pandemic. As for an example, forecasting and projections have been extremely important for policymakers to decide national and global strategies for fighting coronavirus. However, these topics are mostly neglected in our public health schools. 

Moreover, medical professionals are not passably trained in qualitative and quantitative research techniques. They learn few ideas in their community medicine course, which is not enough to prepare for a pandemic like Covid-19. Although two major components of public health --- epidemiological investigations and social and behavioral health science related explorations --- have proven to be very effective in fighting communicable diseases, they are not convincingly discussed in our medical schools. These things should be given adequate importance in the coming days. 

Shamim Ahmed is a doctoral researcher in Social and Behavioral Health Sciences at the University of Toronto and Dr. Rajat Das Gupta is a doctoral researcher in Epidemiology at the University of South Carolina.