history of hospital and bangladesh

Hospital design

Contents• What is Hospital?• Types of Hospital• History of Hospital (Ancient period, Medieval period, Colonial period, Modern period, Contemporary work)• History of Hospital in subcontinent (Gautama Buddha , Caraka, King Asoka, South India, Bengal)• History of Hospital in Bangladesh (Ancient, colonial, pre independent, Bangladesh)• Government policies in Health sector

What is Hospital ?

The word hospital is derived from the Latin adjective Hospitals, which belongs to the noun hopes meaning host or guest. A hospital, in the modern sense of the word, is an institution for health care providing patient treatment by specialized staff and equipment,

and often, but not always providing for longer-term patient stays. Its historical meaning, until relatively recent times, was "a place of hospitality"

Types of Hospital

General Hospital Specialized Hospital Teaching Hospital Clinics

General Hospital

General hospitals are general in the sense that they admit all types of medical and surgical cases.

They concentrate on patients with acute illness needing relatively short-term care.

Faridpur general hospital

Types of Hospital

Specialized HospitalSpecialized hospitals, in contrast, may concentrate on a particular group of patients, such as children, or a disease, such as cancer

Dini-Townsend State Psychiatric Hospital, Reno Nevada

Types of Hospital

Teaching Hospital

A teaching hospital combines assistance to patients with teaching to medical students

Khulna Medical College ,khulna

Types of Hospital

Clinics

A medical facility smaller than a hospital is generally called a clinic

Atomic Energy Hospital ,Chitagong And Rajshahi

Types of Hospital

Ancient period

Modern period

Colonial period

Contemporary work

Medieval period

history of Hospital

Chronological development of hospital

B.C.--500 A.D.

500 –1500

1500 –1750

1750 –1960

1960 –present

Ancient period

The earliest documented institutions aiming to provide cures were Egyptian temples

The first teaching hospitalwas the Acadamey of Gundishapur in the Persian.

“to a very large extent, the credit for the whole hospital system must be given to Persia"

B.C.--500 A.D.

500 –1500

1500 –1750

1750 –1960

1960 –present


Healer god asclepious , known as AsclepieiaShrine,(about 350 b.c.) patients would enter a dream –like state of induced sleep know as Enkoimesis

View of the Askleipion of Kos, the best preserved instance of an Asklepieion..

Healer-God Asclepius

B.C.--500 A.D.

500 –1500

1500 –1750

1750 –1960

1960 –present


http://en.wikipedia.org/wiki/Kos

http://en.wikipedia.org/wiki/File:Kos_Asklepeion.jpg














(437 BC to 367 BC) earliest documentary evidence we have; Mihintale Hospital is the oldest in the world.

King asoka is said to have founded at least eighteen hospitals in 230 B.C.

The romans created valetudinaria for the care of sick slaves, gladiators, and soldiers around 100 B.C., and many were identified by later archeology.

In 325 A.D. urged the Church to provide a hospital in every cathedral town.

B.C.--500 A.D.

500 –1500

1500 –1750

1750 –1960

1960 –present


Findings

The hospital forms closely resembled the forms of the temple

B.C.--500 A.D.

500 –1500

1500 –1750

1750 –1960

1960 –present


Medieval period

The first psychiatric hospital was built in Baghdad in 705.

The public hospital in Baghdad was opened during the 8th century.

Islamic World

The Al-Qairawan hospital and mosque, in Tunisia, were built under the Aghlabid rule in 830

B.C.--500 A.D.

500 –1500

1500 –1750

1750 –1960

1960 –present


Bayezid 2 Complex, turkey

B.C.--500 A.D.

500 –1500

1500 –1750

1750 –1960

1960 –present


1

2

3

5 4

6

20 30 m1050

Educational area hospitalization

Plan of 13th century CE al-Mansuri hospital, Mamluk Cairo,

Al-Mansuri hospital, Mamluk Cairo

B.C.--500 A.D.

500 –1500

1500 –1750

1750 –1960

1960 –present


Administrator Educational area hospitalization

Medieval period Europe World

Medieval hospitals in Europe followed a similar pattern to the Byzantine

The church at Les Invalides in France

B.C.--500 A.D.

500 –1500

1500 –1750

1750 –1960

1960 –present


http://en.wikipedia.org/wiki/Les_Invalides

Findings

The rational process of thought were reflected in the plan

Order and clarity became evident

Clear patterns of circulation were delineated and attention was paid to functional groupings

The clarity was lost during the mediaeval Christian period

B.C.--500 A.D.

500 –1500

1500 –1750

1750 –1960

1960 –present


Colonial period

The oldest was the Immaculate Conception, now the Hospital de Jesús Nazareno in Mexico City, founded in 1524 to care for the poor.

B.C.--500 A.D.

500 –1500

1500 –1750

1750 –1960

1960 –present


University of Pennsylvania Health System ("Penn Health System"). Founded in 1751

University of Pennsylvania,1751

B.C.--500 A.D.

500 –1500

1500 –1750

1750 –1960

1960 –present


Findings

The rational process of thought were reflected in the plan

Order and clarity became evident

B.C.--500 A.D.

500 –1500

1500 –1750

1750 –1960

1960 –present


Modern period

In Europe the medieval concept of Christian care evolved during the sixteenth and seventeenth centuries into a secular one, but it was in the eighteenth century that the modern hospital began to appear

Guy's Hospital was founded in London in 1724 Chronological development of hospital

B.C.--500 A.D.B.C.--500 A.D.

500 –1500

1500 –1750

1750 –1960

1960 –present

Kent, Swanley, Westminster Hospital

Westminster Hospital

B.C.--500 A.D.B.C.--500 A.D.

500 –1500

1500 –1750

1750 –1960

1960 –present


The Vienna General Hospital is the University medical center of the city of Vienna

The Vienna General Hospital,veinna

B.C.--500 A.D.B.C.--500 A.D.

500 –1500

1500 –1750

1750 –1960

1960 –present



Findings

Hospital planning treated on a functional and scientific basic

Patients into small groups and ensuring natural light and ventilationFunctional requirements could be satisfied by achievements in constructions and

mechanical services

Clarity in the plan, patterns of circulation were delineated, functional groupings assembled

Over all greater respect shown for human dignity

B.C.--500 A.D.B.C.--500 A.D.

500 –1500

1500 –1750

1750 –1960

1960 –present

• The hospital from the turn of the century to the present day has seen the architectural forms of the hospital change horizontal to vertical

• The recent concept of progressive patient care

Contemporary work


B.C.--500 A.D.

500 –1500

1500 –1750

1750 –1960

1960 –present

Institute Saint Pierre Palavas-les-Flots, France architect: Jerome Brunet & Eric Sauner


B.C.--500 A.D.

500 –1500

1500 –1750

1750 –1960

1960 –present


Administrator Technical area Educational area hospitalization

B.C.--500 A.D.

500 –1500

1500 –1750

1750 –1960

1960 –present

29 of 68

B.C.--500 A.D.

500 –1500

1500 –1750

1750 –1960

1960 –present


Semi-outdoor spaces

Agatharied HospitalMunich, GermanyNickl & Partner Architecten Gmbh


B.C.--500 A.D.

500 –1500

1500 –1750

1750 –1960

1960 –present

Semi-outdoor spaces


Administrator Technical area Educational area hospitalization

B.C.--500 A.D.

500 –1500

1500 –1750

1750 –1960

1960 –present

Goutama Budhha , Sri Lanka

Bengal

South India

Caraka, King Asoka,

600 B.C. – 300 B.C.

300 B.C. –100 B.C.

1000 A.D.

1100 A.D.

1960 --

history of Hospital in subcontinent


1000 A.D.

3000 B.C. Indus Valley Civilization- Use of herbs as healing sources.

Goutama Budhha (563-483 B.C.)

First structured systematic thought about medicine- Golden Age of Ayurveda.Sick room - for formal medical care of the monks.

King Pandukabhaya (437-367 B.C.), Sri Lanka

1st Institution for the care of the sick.Mihintale Hospital is the oldest in the world.

600 B.C. –300 B.C.

300 B.C. –100 B.C.

1100 A.D.

1960 --



600 B.C. –300 B.C.

1000 A.D..

Caraka (300 B.C.)

Caraka’s compendium- a text with which classical medicine in India really begins. - a text about constructing hospitals, and how it should be equipped.

King Asoka(304 -232B.C.)

Built 18 hospitals in India, For people and animal.Ayurvedic continued to flourish in this period. Where there were no healing herbs, he ordered that to be bought and planted.

600 B.C. –300 B.C.

300 B.C. –100 B.C.

1100 A.D.

1960 --



1000 A.D..

Caraka (300 B.C.) , King Asoka(304 -232B.C.)

Asoka and caraka’s theory together made worlds first organized cosmopolitan system of institutionally based medical provision. in 300-450 A.D. Asoka’s ‘Health Hall’ was founded by excavation- 8 km from modern Patna. The building had- 4 rooms of varying size, with walls of fire baked bricks and a brick floor.

600 B.C. –300 B.C.

300 B.C. –100 B.C.

1100 A.D.

1960 --



1000 A.D..

South India (Late 11th century A.D.)

Hospital in South India was provided with 15 beds.

600 B.C. –300 B.C.

1100 A.D.

1960 --



1000 A.D..

Bengal (12th century A.D.)

Location for highly developed cultures of medical practice for a millennium.Earliest institutional medical centers in South Asia connected with Buddhist monarchies were well established in Bengal and Bihar.

600 B.C. –300 B.C.

1100 A.D.

1960 --



Ancient Bengal

Post Independence

Pre Independence

Colonial Period

1960 --

history of Hospital in Bangladesh


500 -1500A.D..1757-1947 A.D..

1947-1971 A.D..

1971 A.D.-Present

Ancient Bengal

Ayurvedic was the popular form of treatment.It was developed under the Muslim rulers.

1960 --



500 -1500A.D..

Colonial Period (1757-1947)

-After British colonized India- western form of medicine took roots. Since then it became to be recognized officially.-At the same time, Ayurvedic was popular.-From 19th century delivered health care through the local authorities.-Established dispensaries- then developed to hospitals. For example- Pabna and Serajgong hospital were first established as dispensaries.

1960 --



1757-1947 A.D..

Pre Independence

Facilities for rural poor population- established 1200 dispensaries.By 1971- eight medical colleges and specialized hospitals were established.Example- mental hospital in Pabna, Seato cholera research laboratory and hospital, etc.Established- sub divisional and district hospitals.Private sector started- Islamia Eye Hospital.

1960 --



1947-1971 A.D..

Post Independence

More hospitals were established- like Pongu hashpatal, Shishu hospital, Soharawardi hospital.More specialized hospitals were established- BARDEM, N.I.C.V.D. etc.Development in private sector to prevent people moving abroad for better health care. For example- specialized hospitals and clinics were in the country.More training facilities for health care personnel.New institute for post graduate studies, research and specialization.Support for the development of traditional medicine.

1960 --



1971 A.D.-Present

history of Hospital in Bangldesh


Name of medical college Hospital

Year of establishment

Colonial Pre Independence

Post Independence

Sir Solimullah 1875 .

Mymensingh(Lytt-on school)

1924 .

Dhaka 1946 .

Ctittagong 1957 .

Rajshahi 1958 .

M.A.G. Osmani 1962 .






Post Independence

Sher-E-Bangla 1969 .

Rampur 1970 .

Dinajpur 1991 .

Khulna 1991 .

Comilla 1992 .

Ziaur Rahman, Bogra

1992 .

Armed Forces 1999 .






Post Independence

noakhali 2008 .

Coxs bazar 2008 .

Recent Hospitals in Bangladesh

Recent Hospitals in Bangldesh


Square Hospital West Panthapath, Dhaka.

Type- General Hospital Bed No- 300

Roof top garden

Cabins

Recent Hospitals in Bangldesh


United Hospital Gulshan -2, Dhaka.

Type- General Hospital Bed No- 450

Main lobby area

Space between cabins Roof top gardens

Government policies in Health sector

50

Health care in Bangladesh

• The Ministry of Health and Family Planning was responsible for developing, coordinating, and implementing the national health and mother-and-child health care programs

• Population control also was within the purview of the ministry

• Government efforts toward infrastructure development included the widespread construction of rural hospitals, dispensaries, and clinics for outpatient care

• In the late 1980s, government health care facilities in rural areas consisted of sub district health centers, union-level health and family welfare centers, and rural dispensaries

• A sub district health center in the mid-1980s typically had a thirty-one-bed hospital, an outpatient service, and a home-service unit staffed with field workers

Health care in Bangladesh

• As of 1985 there were 341 functional sub district health centers, 1,275 rural dispensaries (to be converted to union-level health and family welfare centers), and 1,054 union-level health and

family welfare centers. The total number of hospital beds at the sub district level and below was 8,100.

• District hospitals and some infectious-disease and specialized hospitals constituted the second level of referral for health care. In the mid-1980s, there were 14 general hospitals (with capacities

ranging from 100 to 150 beds), 43 general district hospitals (50 beds each), 12tuberculosis hospitals (20 to 120 beds each), and 1 mental hospital (400 beds).

• Besides these, there were thirty-eight urban outpatient clinics, forty-four tuberculosis clinics, and twenty-three school health clinics. Ten medical college hospitals and eight postgraduate

specialized institutes with attached hospitals constituted the third level of health care.

• In the mid-1980s, of the country's 21,637 hospital beds, about 85 percent belonged to the government health services.

• There was only about one hospital bed for every 3,600 people

53

Significant progress in the health outcomes and some of the major gains have been achieved through low-cost solutions

54

Reversing past trends, women now live longer than men.

55

CHALLENGES

56

Bangladesh’s current challenge is to improve effective service delivery, health sector governance (especially in primary and maternal health services), and increase the

number of trained birth attendants.

57

Threats of HIV/AIDS, particularly from injectable drug users, pockets of malaria, kal-azar and filaria and multi-drug resistant TB are also emerging as challenges.

58

• Arsenic related diseases• Avian flu

• Childhood disabilities• Mental health problems

• Road-railway-river accidents and• Violence (particularly against women).

59

Meeting the health needs of the fast growing urban poor including the slum dwellers will continue to pose major challenge.

60

• Strategies to handle the large number of informal semi or un-qualified health care providers (village doctors, drug sellers, kobiraj, totka, herbalist, faith healers,

untrained traditional birth attendants etc)

GOVERNMENT POLICIES

62

Child Health:

• Expanded Programme on Immunization (EPI) will be further strengthened • Introduction of hepatitis B vaccine throughout the country

• School health programmes will be further strengthened. • The integrated management of childhood illness (IMCI) program will be further expanded.

63

Maternal and Reproductive Health:• The on-going national nutrition programme will continue to cater to the need of adolescents as its

special target groups.

• Comprehensive emergency obstetrical care (EmOC) facilities will be expanded by establishing such facilities in more upazila health complexes.

• More community skilled birth attendants (SBA) will be trained.

64

Control of Communicable Diseases:

• The existing programs will be further expanded and strengthened to intensify prevention and control of communicable diseases (CDs)

• Special measures will be initiated for combating tuberculosis, leprosy, malaria, filariasis and kal-azar, which are concentrated in specific pockets of the country.

Control of Non-communicable Diseases:

• Provide services for the control of unhealthy diet and lifestyle related major NCDs like – cardiovascular diseases, cancer, diabetes, mental illness, hypertension, asthma, blindness,

• NCDs will further be expanded and strengthened to increase access of all to health care services.

65

Control of Emerging Threats:

• Existing counseling and treatment services for mental health, drug abuse, avian flu, STD and HIV/AIDS, arsenic diseases, injuries, trauma sufferers, women and child victims of violence,

road-railway-river accidents, etc.

• Would be improved and introduced where not available.

• Ongoing emergency preparedness and response program will be further strengthened to manage the disasters like flood, cyclone, tornado, Sidr etc. By 2021

66

Urban Health Services: • The existing practice of providing urban primary health care (UPHC) services through contracted

NGOs for the city corporations and selected municipalities under the LG Division will continue to be pursued

• MOHFW will continue to provide Primary Health Care (PHC) services in urban areas not covered by the UPHC project.

• The establishment of an ‘Urban Health Unit’ in each Division would be considered.

67

Affordable Health Care Services:

• Existing system of affordable health care services will be further expanded and consolidated ensuring proper safety net for the poor.

• Facilities providing health care outside the public sector (but receiving government fund) will ensure that at least 30 per cent of their all types of services are kept for free treatment

for those who cannot pay.

68

Community Clinics:

• The government is committed to reactivate 10,723 community clinics (CCs) which were established during 1996-2001. The MOHFW will run at least 8,000 CCs under government

management.

• The government plans to establish 18,000 CCs in phases to deliver maternal and child health care including family planning services and limited curative care.

69

New initiatives in health governance include:• Consolidation of public-private partnership in management of health services;

• Citizens charter for health service delivery;• Better regulation of the non-public health care providers;

• Better monitoring in medical colleges and specialized hospitals for ensuring management efficiency and establishing increased attention to patients;

• Decentralization of health administration; and• Formulation of national health policy.

70

Structure, Health care In Bangladesh

Rural Community clinicsNutritionHealth educationStrategy planning for unqualified health care providersExpanded Program on Immunization Ongoing emergency preparedness and response program

Sub urban Community clinicsNutritionHealth educationStrategy planning for unqualified health care providersExpanded Program on Immunization Ongoing emergency preparedness and response program

Urban Community clinicsNutritionHealth educationMedical collegeGeneral HospitalSpecialized health careExpanded Program on ImmunizationOngoing emergency preparedness and response program

Administrative level Health facilities Cadre Level of careNational Level • National and regional training centers

• Model clinicsDG line directors, programmanagers, trainers

Tertiary

District Level • Model clinics• Maternal Child Welfare Clinics (MCWC)• district hospitals (MCH-FP clinics)• regional trainings centers

DGFP, additional Director orMedical Officer, clinicalcontraception

Tertiary

Upazila Level • MCH-FP units• MCWC

Family Planning OfficersMedical Officer-MCH

Secondary

Union Level • Union Health and Family Welfare Centers• Rural dispensaries• MCWC

Family Welfare Visitor, SACMO,Family Welfare Assistant, FamilyPlanning Inspector

Primary

Peripheral Level • Satellite Clinics• Domiciliary Services

Family Welfare Assistant Community/primary

MCWC = Maternal Child Welfare ClinicsMCH-FP = Maternal Child health-Family Planning

DGFP = The Directorate General of Family Planning

72

Structure, Health care In Bangladesh

• Child Care

• Maternity Care

• Communicable diseases care and public awareness

• Cheap medical assistance for Non-communicable diseases

• Emergency for epidemic diseases and natural disasters (like SIDR, flood etc.)

• Training facilities for family planning and Nutrition

• Treatment services for mental health, drug abuse, avian flu, STD and HIV/AIDS, arsenic diseases, injuries, trauma sufferers, women and child victims of violence, road-

railway-river accidents

73

Thank you

history of hospital and bangladesh

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