ICE Business Times, April 2016 by ICE Media Ltd.

a global business magazine from bangladesh

TIMES

april 2016

TK. 100 | www.icebusinesstimes.net

SAVING LIVES, PROMOTING HEALTH

“I would like to see Dhaka Medical College Hospital develop as a center of excellence. ”

Brig. Gen. Mizanur Rahman

Director, Dhaka Medical College Hospital

“Public Health Educational is recognized as the key strategy for achieving SGDs.” Professor Dr. G. U. Ahsan

Dean, School of Health & Life Sciences, Chairman, Department of Public Health North South University

Inside out

Aviation industry in Bangladesh Medical Trends

Top market trends in the health industry Tech

Understanding artificial intelligence

“Here is the opportunity. First we must ensure that the quality of our institution is on par with international standards. ” R. Basil

Executive Director & CEO of STS Holdings Limited

Contents TIMES

IBT Cover Story:

Bangladesh Healthcare Industry: An Industry Growing Faster than the Countryâ&#x20AC;&#x2122;s GDP Interviews: 18 Brig. Gen. Mohammad Mizanur Rahman Director, DMCH

22 R. Basil

Executive Director & CEO, STS Holdings Limited

26 Prof. Dr. G U Ahsan 6 8

From the Editor OP-ED by Priti Chakraborty

Chairman of Universal Medical College & Hospital Ltd., Universal Cardiac Hospital, Universal Medical College, Universal Nursing Institute

Dean, School of Health & Life Sciences and Chairman, Department of Public Health, North South University

36 Dr. Md Asadulghani

Head, Biosafety & BSL3 Laboratory, icddr,b

52 Asif Ibrahim

Vice Chairman, Newage Group of Industries; Chairman, BUILD

10 Column by Shamsul Huq Zahid

56 Md. Asadul Islam

Word of Mouth:

60 Selima Ahmad

12 State of Affairs 13 Happening 16 Events

Managing Director, ASROTEX Group President, Bangladesh Women Chamber of Commerce & Industry

64 Rabeth Khan

CEO, MACOMM and MediaAxis

68 Fakaruddin Jewel Head of NTV Online

Memorial Museum Passchendaele 1917

Contents

a global business magazine from bangladesh

TIMES

Vol. 6 No. 8 | April 2016

Publisher & Editor Director, International Publications Executive Director Managing Editor Assistant Editor Sub Editor Staff Feature Writer Designer Business Development Brand Promotion Finance & Accounts Sales & Distribution

: : : : : : : : : : : : : : :

Abul Khair Zeenat Chowdhury Nawshin Khair Tawhidur Rashid Irad Mustafa Shaikh Ashfaque Zaman Asaduzzaman Sk. Yeahhia Md. Nizam Uddin Forhad Mohammad Imran Lamina Yeasmin Effat Ara Laizu Md. Abdul Alim Md. Nazrul Islam Md. Rubel Khan

a global business magazine from bangladesh

TIMES

april 2016

TK. 100 | www.icebusinesstimes.net

SAVING LIVES, PROMOTING HEALTH

“I would like to see Dhaka Medical College Hospital develop as a center of excellence. ” Brig. Gen. Mizanur Rahman

Director, Dhaka Medical College Hospital

“Here is the opportunity. First we must ensure that the quality of our institution is on par with international standards. ” R. Basil

Executive Director & CEO of STS Holdings Limited

“Public Health Educational is recognized as the key strategy for achieving SGDs.” Professor Dr. G. U. Ahsan

Dean, School of Health & Life Sciences, Chairman, Department of Public Health North South University

Inside out

Aviation industry in Bangladesh Medical Trends

Top market trends in the health industry Tech

Understanding artificial intelligence

This issue’s Photographs by Din M Shibly Ashraf Uddin Apu Kazi Mukul Safwat Choudhury Gani

Editorial & Marketing Queries

Achieving MDGs

editor@icebusinesstimes.net, or send us a note at www.facebook.com/icebusinesstimes www.twitter.com/BusinessTimesBD

Be sure to visit our website www.icebusinesstimes.net

Features: 40 Global Health Trends 50 10 Things You Need to Know About Health Consumerism 71 Innovation Xtreme 2016 73 Fight or Flight 78 The Growing Green & Red Network 82 Innovation Next 85 Flagship Smartphones: Overrated? 87 Hello Corporate Bangladesh, Are You Getting Enough Sleep? 90 Entrepreneurial Moonlighting 92 Democratizing Global Media: One World Many Struggles 94 Capital Market Update

Published by Abul Khair on behalf of ICE Media Limited Kushal Centre, Plot 29, Sector 3, Uttara C/A, Dhaka- 1230 and printed at M.K. Printers,189/1, Tejgaon I/A, Dhaka-1208 Editorial and Commercial office: 3rd Floor, House: 4, Block: B, Road: 23 A, Banani, Dhaka 1213 Advertising, Sales, Subscription and Distribution: 01812656961, 01715732425, 01759391168, 01850824294, 01881925963, 01881925962, 01611227676 Tel: 02 55035336-8, 09666773313

FROM THE EDITOR According to health statistics there is an alarming disparity of doctors (0.26 for every 1,000 patients) with only 53.2% of the population reaching the age of 65. Also, the WHO has identified Bangladesh as one of the countries with a critical shortage in the healthcare workforce. With health determining the quality of life, it is astonishing that we aren’t seeing greater levels of investment to improve the technologies and service delivery systems required to give people the quality they deserve. The rate of the diseased state of the world’s population is increasing which is exemplified in a study that predicts the cases of diabetes to increase by 65% by the year 2035. This is only a part of a much wider problem where the economy, lifestyle changes, environmental hazards and biohazards will also be prevalent. A rather unknown cause of infectious disease and viruses - biohazards and the improper disposal of biomedical waste - have caused the dispersal of many ailments and disease states in the past and present. With tons of biomedical waste being produced on a daily basis, the containment of such toxic disposals must be managed. The rate of diseased state is increasing with the ever-growing population; however there are innovation and technological advancements that are combating these problems. Given the progression of early diagnostic and detection, digital health technology, vaccinations and pharmaceutical development, fighting these disease states have come a long way. This is apparent if we look at the treatment of HIV which enables patients to live healthy lives. We have dedicated this month’s issue to health in consideration of WHO’s World Health Day 2016: Beat Diabetes. The introductions of vaccines and immunization have made communicable disease preventable. On the other hand, life style changes have made non-communicable diseases such as diabetes much more prevalent altering the dynamics of healthcare. Education, ethical practice and training in the field of health have become integral in order to combat the new wave of diseases. Following the outbreak of cholera in 1848, the Public Health Act was passed to create a Central Board of Health in Europe. Today, Public Health has become the holistic solution for promoting health and preventing disease for a nation’s productivity will reach optimum with a clean bill of health. The time for us to utilize our potential and apply it to the healthcare sector is now; allocation of funds, proper governance and priortization of health trends have become long overdue. In this regard, we believe start-ups must become more active in terms of the innovation that they can bring to the medical science table.

AFFLICTION AND ITS ANTIDOTE / OP-ED

Standardizing the disparities of the South Asian health sector By Priti Chakraborty

outh Asia's diversity provides vast opportunities for trade, investments and economic growth. Geographically, South Asia is very wide and heterogeneous. Every year, the governments of each nation invest a significant sum of money to promote different sectors where some of those sectors have brought fruitful results and some have been lagging behind their peers. Health and education has been a persistent threat to the poverty-striken nations especially South Asia. According to the UNICEF 2014 MDG targets, South Asia is the poorest performing sub-region of Asia, and one of the poorest performing regions globally. Despite thousands of efforts taken for improvement, health and education coverage remains slow, relatively low and continues to be present as a threat for development. South Asian countries are very prone to many manmade or natural disasters, diseases, social & cultural taboos. Millions of people still live in poverty and hunger without fulfilling the basic needs (UN, 2014: WHO, 2015). UNICEF says that South Asia accounts for only 28% of global births and accounts for more than 41% of neonatal deaths. Levels of child malnutrition are the worldâ&#x20AC;&#x2122;s highest, and child mortality and maternal mortality levels are among the highest globally. 5.3 million people in South Asia are living with HIV. School enrolment and literacy rates are also low, with 42 million South Asian children not attending school. Epidemic, endemic and pandemic outbreaks are reasons for millions of deaths in this nation. Millions of people are suffering from chronic diseases; thousands of people have difficulty accessing health care facilities because of the poverty and inaccessible health care centers. In recent years, with comparison to other countries, India and Bangladesh have made improvements in health and education. Additionaly, regional disparities are larger. It is so promising to note that Bangladesh has already

been one the developing nations to meet several MDGs such as: Reducing poverty, gender equity, net enrollment rates in primary and secondary education. Nevertheless, Bangladesh still needs to achieve targets such as increasing education and improving the quality of education, health services as well. Although Bangladesh has attained significant enrollment and gender parity, there is a stark contrast between the figures from the reality to the data. Despite many successes, some demographic segments of population, the poorest and most vulnerable people are being left behind. At present, 40% of women are unaware of contraceptives, 68% of the births are unassisted by skilled providers, 53 children per 1000 die before age of 5, 14% children are not fully vaccinated, 51% of the children below 5 years are anemic, one neonate dies every 4-5 minutes, 11% of men and women are diabetics of which 65% are still unaware of it. People are dying because of hunger and millions live under poverty, thousands of men and women have elevated blood pressure, thousands of people are suffering and dying from cardiovascular and neurological diseases. And there is equal possibility of data which are still unknown and out of reach. The poor health and educational conditions in Bangladesh are attributed by the lack of healthcare and services provision by the government. The General government expenditure on healthcare and educational sectors as a percentage of total government expenditure is very low and the citizens pay most of their health care bills from their out-of-pocket expenditure as a percentage of private expenditure on health is much higher. Considering the dire situation, many hospitals in Bangladesh are committed to

work towards enhancing the health of the people with a nominal fee based on the clinical representation of the patient. Some hospitals have even ensured the referral services using a network encompassing reputed clinics and hospitals within the country and abroad. For ensuring higher degree programs, some hospitals like Universal Medical College and Hospital are now united for the programs like: Corporate Social Responsibilities, Telemedicine â&#x20AC;&#x153;Gorbini Maâ&#x20AC;? (The programs that awards the mothers of extraordinary children), and number of hospitals are united for investing in the medical college to ensure the bright future of the medical sector. In order to achieve the targets and satisfactory results in these sectors, the government and the private sectors need a collaborative approach beginning with an inclusive and transparent dialogue to envision our long term health system. The time has come for having attention on promoting intra-regional health tourism by utilizing common resources, shared culture and common physical infrastructures. Inequity in health care is significantly reduced by ensuring the accessibility of health services. Furthermore any health care facilities should be a haven where patients are treated with dignity and respect. There are various provisions, protocols, regulations formed to ensure the betterment of health and educational sectors. There is much talk about health care, the time has come for us to take a course of action.

The Writer is the Chairman of Universal Medical College & Hospital Ltd., Universal Cardiac Hospital, Universal Medical College, Universal Nursing Institute

/ Column / Cyber Theft

Cyber theft of int’l reserve: Security Holes or Insider(s) Involvement? By Shamsul Huq Zahid

angladesh’s banking sector was already reeling from the shocks of the Hall-Mark and BASIC Bank scams, but then came in a shock with a far greater dimension, quavering the Central Bank. The attempt was made to rob Bangladesh of around $1 billion out of its reserves by taking advantage of weak surveillance in the glass-walled backroom (secure transactions room) of the Bangladesh Bank (BB). However, the international

hackers were only successful in transferring $101 million. This led to the resignation of the BB Governor along with two of his deputies and a few more. More importantly, this incident which also involves the Federal Reserve Bank of New York, a few banks of the Philippines and Sri Lanka, has immensely dented the image of the Bangladesh’s banking system internationally. The BB must be considering itself rather fortunate that the Fed had stopped payments against 30 transfer orders of the hackers on its suspicion. Had the Fed executed all the fake payment orders, Bangladesh would have lost nearly $1 billion. Out the $101 million transferred successfully by the hackers $81 million entered four accounts held with Rizal Commercial Banking Corporation (RCBC) of the Philippines and $20 million deposited in an account of a non-governmental organization (NGO) in Sri Lanka. Bangladesh luckily retrieved $20 million sent to Sri Lanka simply because of misspelling of the word ‘Foundation’. However, the possibility of retrieving the

fund that has gone to the Philippines remains very slim for it has, apparently, already left the country. What is interesting is that all institutions down the chain, Bangladesh Bank in Dhaka, technology providers including Swift, New York Fed and banks in the Philippines, have denied fault in executing the ‘fake’ instructions to transfer millions of dollar from BB accounts with the New York branch of Fed. Swift has claimed its network had not been compromised and the Fed said there was no evidence that anyone had attempted to penetrate its systems in connection with the payments in question. Leaving everybody, bankers at home and abroad, politicians in Bangladesh and the Philippines, stakeholders and the common citizens eager to know how the cyber criminals executed their plan. People are also wondering whether anyone at the BB’s transactions room was also involved in this cyber heist which sent tremors around the world among banks and corporations. The malfunctioning of the printer at the transactions room of the BB detected on

$1 billion

The attempt was made to rob Bangladesh of around $1 billion out of its reserves by taking advantage of weak surveillance in the glass-walled backroom (secure transactions room) of the Bangladesh Bank (BB).

the 5th of February (Friday) last actually was the signal that the cyber criminals were transferring the fund. But the transactions room personnel did fail to read the signal and understand the fact that Bangladesh had become the victim of one of the most successful major bank robberies in the world history. The full picture of the crime emerged on 9th of February. But it was too late. The money transferred to the Philippines by the hackers made its way out of that country through its burgeoning casino industry that is exempted from anti-money laundering measures. BB officials claim that cyber thieves have somehow inserted malicious software, known as malware, into the central bank’s computer system sometime back. However, there is strong suspicion that there was ‘insider involvement’. There is no denying that the cyber theft of a part of the country’s reserve held with

the Fed has sent tremors to all levels of the government and the banking industry. But a lot of drama unraveled when the scandal became public in the early part of March. The local media first came to know from the Filipino daily, the Inquirer, about the heist. The BB kept the incident a secret and tried to hide it from almost everyone, including the Finance Minister. What remains a mystery is who were actually in the know of things from the beginning. The explanation given by the former Governor, Dr. Atiur Rahman, in support of the hiding of information about the cyber theft appeared to be untenable. The incident also had brought to light the bitter relations between the incumbent finance minister and the immediate past BB governor. Undeniably, the former had valid reasons to feel aggrieved for not being informed of the cyber heist by the latter. However, prior to any other steps, there is an urgent need to identify the people, if there were any, involved in the siphoning off the country’s hard-earned reserves through hacking. And, at the same, the BB must invest necessary funds for upgrading the cyber security systems in its transactions room to prevent the cyber thieves from making fresh attempts in the future. The Federal Reserve Bank of New York must also answer to at least one question: why did it not wait a bit for an answer from the BB’s end for the query it had made about transferring $101 million? The Fed can cite the use of the secured Swift system by the BB. But there was surely something that aroused suspicion in the

minds of Fed people. Therefore, it should have waited for some more time before transferring the money. It is difficult to predict the actions to be taken by our policymakers since they tend to forget even the gravest occurrences quickly. If they try to address it, they usually do it employing ad-hoc measures. Nevertheless the relevant authorities should take lessons from the Philippines. The central bank, senate, anti-money laundering council (AMLC) and many other relevant agencies of that country are very concerned over the involvement of a local bank, remittance company and casino industry in the laundering of such a huge fund belonging to another country. They are quizzing the top officials of the RCBC, local businessmen and relevant others rather seriously and they are talking about regulatory and legal reforms to stop the recurrence of such an incident. The same level of activity, to be honest, is not visible in Bangladesh, the lone victim of the cyber heist in question. Hackers targeted Bangladesh reserves for they detected holes in the security systems. The holes need to be plugged and the systems need to be made foolproof or else the hackers might strike again.

The writer is a senior journalist. He can be reached at zahidmar10@gmail.com www.icebusinesstimes.net

/ Word of Mouth / State of Affairs

Prime Minister Sheikh Hasina and her Indian counterpart Narendra Modi launching the bandwidth export and power import by Bangladesh through a video conference

Visiting Secretary General of International Federation of Red Cross and Red Crescent (IFRC) Elhadji Amadou Gueye Sy paid a courtesy call on Prime Minister Sheikh Hasina at her official Ganobhaban residence

Prime Minister Sheikh Hasina with the distinguished guests after inaugurating the newly constructed building of the Institute of Architects Bangladesh in the cityâ&#x20AC;&#x2122;s Agargaon area

Prime Minister Sheikh Hasina with the investors of 10 newly established economic zones

/ Word of Mouth

IT Associations organized reception for ICT State Minister Zunaid Ahmed Palak on being selected as “Young Global Leader 2016”

To celebrate the International Women’s day, EBL organized Meet the Women Leaders, an event where renowned women entrepreneurs shared their thoughts with women SMEs

“Aid to Trade: Better World, Safer Generation”

4th Global Social Responsibility Conference 2016

This year, the Global Social Responsibility Conference in partnership with the Government of Germany, Government of Bangladesh, United Nations System in Bangladesh and most prominent business conglomerates operating in Bangladesh, focused on issues like regional connectivity, environmental sustainability, and personal initiative. The 2016 Conference theme was,

“Aid to Trade: Better World, Safer Generation”. There were four major panel discussions. The first panel discussion was on Environmental Sustainability and it dealt with the relationship of environmental sustainability and sustainable businesses particularly focusing on the pharmaceutical, chemical and food sectors. The next panel on Regional Knowledge Networking for RMGs dealt with the importance of regional connectivity and how it will help build a stronger network among the entrepreneurs of Asia. The panel on Food Safety discussed the possibilities and glitches of existing food production, processing and preservation system, food adulteration and its impacts. The final panel discussed the possibilities of effective Corporate Citizenship activities driven by personal initiatives of entrepreneurs.

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/ Word of Mouth / Happening

Abul Khair, Chairman of Bengal Foundation giving his speech at the inaugration ceremony of Architecture Now! Next symposium organized by Bengal Institution for Architecture, Landscapes and Settlements

Radisson Blu Dhaka Water Garden Steps up to becoming Silver Certified by EarthCheck

â&#x20AC;&#x153;Pitch night for Founder Institute Graduatesâ&#x20AC;? was held by the Silicon Valley based institute The Founders Institute on Sunday. Shameem Ahsan was present at the event as a Chief Guest.

Robi Dhonnobad Programme brings special offer with Radisson Blu Chittagong Bay View

/ Word of Mouth / Banking Corner

Standard Chartered Bank organizes “Partnering for Success” Seminar

BRAC Bank inaugurates relocated Uttara Branch at larger space for the best in class customer service

/ Muklesur Rahman, managing director & CEO of NRB Bank, launches the bank’s Home Loan for non-resident Bangladeshis (NRBs) and Study Loan for students in Dhaka

Mutual Trust Bank Limited (MTB) has recently signed an auto loan agreement with Millennium Companies (a sole distributor of Nissan, Hyundai, Jaguar, Land Rover & SsangYong vehicles in Bangladesh)

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/ Word of Mouth / Trade & Commerce

24th US trade Show in Dhaka

Trade between Dhaka and US is rising

Food & Agro-processing Industry

Food & Agro Bangladesh International Expo 2016 Held

Bangkok Airways PCL conducted an “Agent Seminar 2016” for front line and sales staff representing 35 travel agents in Dhaka, Bangladesh on 30th March 2016 at The Way Dhaka hotel.

Three day long annual 24th US Trade show was held in a local Hotel in Dhaka from 3rd to 5th March where US company showcased their products. Commerce Minister Tofail Ahmed MP and US ambassador to Bangladesh Marcia Bernicat inaugurated the trade show. Jakson Cox, Chairman, Asia Pacific Council of American Chambers of Commerce (APCAC); Nurul Islam, President, American Chamber of Commerce in Bangladesh (AmCham); Khd. Rashed Maqsood, Director, AmChm, were present among the guests. In partnership with the US embassy in Bangladesh, the trade show had booths from 100 US businesses, showcasing American products and services available in Bangladesh. Boeing Commercial

Airlines, Coca–Cola, Ford Motors, Metlife, MasterCard International, Visa, Chevron Corporation, IBM, Cisco, Microsoft, Intel Harvard University, Johnson and Johnson, ExonMobil, Pepsico international, Islami Bank, North south University, NCC Bank participated and showcased products. Minister Commerce Tofail Ahmed MP said that despite withdrawal of duty free access, trade with US is witnessing growing trend and US market is the single destination of Bangladeshi product. Ambassador Benicate said that U.S. Trade Show highlighted the great American products available in Bangladesh. She informed that the strong partnership between U.S. and Bangladeshi businesses and bilateral trade in goods reached nearly $7 billion in 2015.

Four day long international exhibiting for Food and Beverage products held in Bangabandhu International Conference Center from 23rd to 26th March focusing on the development of food and agro Industry. Introducing Modern Technologies and showcasing Modern Food Processing Equipment’s &Machineries exhibitions were also among the agenda of the fair. Around 250 exhibitors from nine countries participated in the fair. The category of participants were diverse: Packaging Equipment & Packaging Materials, Food

Processing Equipment, Processed Food, Chilled Frozen Food, Products, Food Ingredients –Aromas/Flavors & Fragrances, Organic Agricultural Products, Agricultural Machinery &Equipment, Refrigeration Technology, Digital Technology Of Food & Agro, Tractors & Combines. Kamrul Islam, M.P., Food Minister; Humayun Rashid, Acting President of Dhaka Chamber Of Commerce And Industry (DCCI); Showkat Ali Sarkar, Vice President of American Chamber Of Commerce In Bangladesh (AMCHAM) were Present as the special guests.

Insurance Industry

Insurance Fair 2016 held

Particle Board Industry

Super Board’s Green Family Fest at Cox’s Bazar

To make people aware about insurance benefits, the first-ever Insurance Fair in Bangladesh was held in Dhaka. Finance Minister Abul Maal Abdul Muhith inaugurated the 3-day fair at the Bangabandhu International Conference Center (BICC) on 23rd March. Muhith said, “ There is no rules and regulations to guide insurance sector. The sector is dependent on individuals. It has been observed that the insurance companies lack business ethics that is the main problem of the sector.’ Bank and Financial Institutions Division secretary, Md Eunusur Rahman said, “Appropriate concept of insurance had not

One of the leading brands in Bangladesh’s particle board industry Super Board, arranged “Super Board Green Family Fest” with all their Platinum dealers along with their family members on 7th & 8Th March at Royal Tulip Sea Pearl Beach Resort, Cox’s Bazar. In this program, the

reached to people due to the insurers’ delay in repaying insurance claims.” IDRA chairman M Shefaque Ahmed chaired the inaugural function where state minister for finance MA Mannan, IDRA member Md Quddus Khan, Bangladesh Insurance Forum president BM Yusuf Ali and Bangladesh Insurance Association President Sheikh Kabir Hossain were also present. In the side line a number of seminars were held and there were huge number of visitors in the fair.

Managing Director of T.K. Group of Industries, Mr. Abul Kalam honored all the Platinum Dealers with Uttorio & Crest. Other than that, the company C.E.O, General Manager (Sales & Marketing), Head of Brand & Media, AGM (Sales) were also present in the program. Every effort were made to make this program as memorable as it can get. A cultural night along with Gala Dinner, lots of different types of games & activities, raffle draw, gifts were a significant part of this program. Keeping the success stories of their businesses aside, Women’s Day played a vital role in the program’s theme. Red Rocket Ltd. Was in charge of managing the entire event.

Left to Right: Norwegian Ambassador, H.E. Merete Lundemo; Danish Ambassador, H.E. Hanne Fugl Eskjær; Honorable Commerce Minister, Tofail Ahmed, MP; NCCI President, Shamim Ul Huq; Swedish Ambassador, H.E. Johan Frisell | At the Launch of Nordic Business Confidence Survey 2015 hosted in the Nordic Embassy in Gulshan, Dhaka. According to the Survey around 91% of Nordic Companies are considering expanding business in Bangladesh over the coming 3 years.

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/ Special Interview / Healthcare

Brig. Gen. Mohammad Mizanur Rahman Director, Dhaka Medical College Hospital

â&#x20AC;&#x153;Now with the help of the government, and proper planning, we have successfully provided treatment facilities, especially All medicines to patients who are admitted, free of cost.â&#x20AC;? Brig. Gen. Dr. Md Mizanur Rahman has earned some distinguished degrees including Masters in Public Health from BSMMU, Hospital Management from Armed Forces Medical College and Quality Management Course from Heidelberg University, Germany, which have allowed him to prosper in a number of hospital management and medical education establishments. After completing his MBBS from Dhaka Medical College, he joined the Army Medical Core in 1988. He was promoted to his current rank in 2011. During his illustrious career, Rahman has served as the Commandant and Chief Instructor of Army Medical Corps Center & School, the Director of Medical Services at Army Headquarters and Head of Medical Branch of Jessore Division. He is a two-time recipient of the Health Minister's National Award for his dynamic leadership in hospital management during his stints as the Director in Sylhet Medical College and Dhaka Medical College. He has also served in various international missions. During the UN Mission in Ivory Coast, he received a Letter of Appreciation from the Course Commander for saving the life of a soldier in the battlefield. He received another Letter of Appreciation from the Director General of Malaysian Armed Forces for his courageous role during the deputation. Rahman was entrusted to establish Army Medical Colleges and Nursing Institutes in Comilla, Chittagong, Bogra, Rangpur and Jessore, a task that he has completed with considerable success.

Quality Treatment for Everyone To solve that problem, we need to make our primary level hospitals self-reliant with adequate resources and better management. A patient from Rangpur doesn't want to travel all the way to Dhaka when he has an opportunity to get similar treatments in his home district.

What is the condition of healthcare service in Bangladesh?

We have come a long way when it comes to providing healthcare to the masses. Bangladesh is a densely populated country and the demand for healthcare is increasing by leaps and bounds. There are certain factors, which ushered the much-needed change. One of them is technological advancement. As you know, according to public health trends, communicable diseases are decreasing, making places for more non-communicable diseases. The reason behind is lifestyle choices people make these days. Since the overall economic condition of the country is better, people have more purchasing power, be it consumer goods or health services. Also, with the advent of the internet, they are now

digitally enlightened with much information about almost all types of diseases. Due to the developed transportation system, people who are affluent now travel abroad for treatment purposes. Now comes the question of how many people can actually have access to modern treatment facilities. I would say, there is definitely room for improvement, but we must acknowledge the government as well as the private sector for achieving certain milestones in the healthcare service industry. Health service is not a low hanging fruit to those who live under the poverty line. For many of them, receiving appropriate intervention on time is like reaching for the stars. The government has taken initiatives to spread the facilities from the tertiary to the community level but there are resource constraints. Private hospitals are there but not affordable to many. Therefore, the pinch of demand-supply gap has been palpable throughout the whole time.

Tell us something about DMCH. This is like a center of hope for thousands of people coming from different parts of the country. Dhaka Medical College Hospital has been rendering immense support to the ailing population of Bangladesh since its inception. There was a time when we couldnâ&#x20AC;&#x2122;t offer too many choices due to the lack of infrastructure and resources. Now with the help of government, and proper planning, we have successfully provided treatment facilities, especially medicines to almost all who are admitted, free of cost. 15-18 types of antibiotics, even expensive injectable

antibiotics are being given to our patients. When I was a student, we wanted to provide facilities like C-section surgeries for free, something which has now been made available. This is highly satisfactory. Even since I have joined, we tried to come up with a strategy that allows us to solve one problem at a time. For example, we decided that none of the patients should buy a cannula, a must-needed medical appliance for injecting fluids or medicine. We are successful in ensuring the availability of cannula for all of our patients. Similar successes have been replicated in supplying tools like gauge, infusion fluid, medicine, suture materials, etc. These initiatives require supervision as well as motivation. We wanted to remain vigilant to reduce pilferage. With the budget that has been allocated, we have managed to achieve this. The government provides me with a budget that can serve 2,600 admitted patients; whereas if you look at the charts, you will find as of today, we have 3,700 patients admitted. Since there are always an excess number of patients, sometimes we cannot provide very expensive (oncology) medicines for free. Nevertheless, we have created Patients Welfare Society with funds from charity and CSR operations from different private companies. An amount of Tk 8-10 lac is generated through that fund every month. That money is used for patients who cannot pay for their diagnostic tests or medicine. Every day approximately 8,000 patients are being served in this hospital including those who come to

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working in that area to check all the mushrooming hospitals here and there. Yet, they have been trying to render better services, within their limitations.

Where do you want to see Dhaka Medical College in future?

the outpatient departments. As a whole, this hospital experiences a footfall of 40,000 people every day. Now, in large congregations such as this, some people will have ill motives. That results in unexpected events regarding patient compliance. We are working on those issues too. Now comes the question of whether we are ensuring quality treatments to all these patients. Honestly speaking, none of the patients deserve to lie on the floor of a hospital ward; but due to space constraints, we have to accommodate them some way or the other. To solve that problem, we need to make our primary level hospitals self-reliant with adequate resources and better management. A patient from Rangpur doesn't want to travel all the way to Dhaka when he has an opportunity to get similar treatments in his home district. By doing so, we will decrease the number of referral cases and eventually Dhaka Medical College Hospital

will be able to provide quality treatment. Nevertheless, the government has realized the problem and is trying to supply all these facilities to the peripheral health complexes but it will require time. Fund allocation is another area where we need to think seriously. Only 0.7% of our GDP is allocated in the health sector. If we look at developed countries, this is 6-7%. Even if we can provide 2% of our GDP, the sector would enjoy a facelift. It was possible for us to achieve the Millennium Development Goals because those required interventions that are less expensive. Now to make them sustainable, as proposed by the Sustainable Development Goals (SDGs), we need greater funding.

Do you agree that there is a lack of transparency, resulting in corruption in your hospital? I would beg to differ. We buy products through open tender method. Wherever I

have worked, I have adhered to the regulations prescribed by the organization, and there is no controversy of this sort. However, as per the purchase guidelines, we are supposed to take it from the lowest bidder. Sometimes that puts us in a difficult position since the least expensive one may lack in quality. In that situation, we seek help from technical evaluation committee. Purchasing something, which will not serve our purpose, doesn't make any sense, and I have always discouraged for such purchases. When we reject something like this, we have always given clarification about the reason.

What about standardization of hospitals? Is there enough manpower to check and balance? The concerned departments of the government are working in this regard but we do have a lack of manpower in this sector. It's not always possible for a small group of people

I would like to see this institution develop as a center of excellence. Patients should leave this place smiling. We would like to ensure all sorts of facilities for them. The casualty department needs to be more developed. This department has been giving relentless support whenever there have been any accidents, incidents, etc. The number of patients with head injuries has increased drastically due to more frequent road traffic accidents. We have been working on a project to establish a Trauma Center and Neurosurgery Center to cater to all the patients. We have proposed to build a new establishment, which would be well equipped technically and logistically, which Prime Minister's office has approved already. This is a century old building, and hence, sewerage system cannot take the load of the excess patients. There is also a shortage of nurses as well as employees. Some of those who are working require training, as well. We have been working in that sector. For example, we have given waste management training to all those employees. Also, we have been trying to motivate our doctors and nurses, to show enough empathy that patients have no doubt about their dedication.

/ Special Interview / Healthcare

R. Basil Executive Director &

CEO of STS Holdings Limited

We have mechanisms and measurements to track everything. In Apollo Hospitals Dhaka, we not only try to solve problems, but also anticipate and work to prevent recurrences as well. R. Basil is presently the Executive Director & CEO of STS Holdings Limited, Dhaka. He has 36 years of professional management experience in various senior-level roles such as Vice-President of Wipro GE Medical Systems, Managing Director & CEO of Manipal Hospitals Group, Executive President of Apollo Hospitals Group and Honorary Advisor to St. Johns Medical College Hospital. He is also the Co-Founder of Lily White Health Consortium Pvt Ltd, Bangalore. Basil introduced some pioneering initiatives in hospital services in 2002 which later became integral parts of the healthcare industry's evolving standards in rendering a differentiating customer experience.

Ensuring Quality

First we must ensure that the quality of our institution is at par with international standards. Then we must build faith and trust amongst the people so that they have the confidence to seek specialized treatment here in the country.

Where do you think the Bangladesh healthcare system is heading? What needs to be done? Bangladesh is comparable to its neighbouring countries in the Indian subcontinent. In the last ten years, we see similar trends such as a shift from communicable or infectious to non-communicable diseases. This means that many of the diseases are linked to the lifestyle and also how the economy is progressing and the middle income group is growing in number. Another aspect to consider is that information on healthcare is widely available to the public through the internet. But there are certain inadequacies, especially with regard to Bangladesh. The

problem lies within the perception that the service in our country is not reliable. For the local people who can afford to spend on healthcare, there is a trend to seek advanced treatment from abroad. From various sources of public information, roughly 150,000 people travel abroad every year. Here is the opportunity. First we must ensure that the quality of our institution is on par with international standards. Then we must build faith and trust amongst the people so that they have the confidence to seek specialized treatment here in the country.

How do you think these changes need to be taken? For this, there needs to be a total overhaul in terms of education, be it in the private or public medical colleges. There needs to be changes in the curriculum especially in speciality subjects. The quantity and quality of the output from these institutions needs to really change â&#x20AC;&#x201C; that is a major requirement. Statistically, if you look at the average number of doctors per population of 10,000, compared with neighbouring countries, there is a huge gap, which needs to be closed. And given the context of the Bangladeshi population, the number of beds is not enough, the numbers of doctors and nurses to serve them are not enough. And to address these issues of inadequacies or gaps in infrastructure and manpower, we need a specific time-bound plan. That is what is missing here. The next focus should be on accessibility and affordability. Less than 1% has insurance

coverage with their medical treatment; and this 1% percent is only from the formal private sector. If insurance is made more widely available, it will completely change the dynamics in the medical field. If we look at the younger generation and considering that the average life expectancy of a Bangladeshi is 70, there is a great potential. Healthcare can provide for geriatric care, and treatment and insurance plans can come in a big way.

Apollo is the first hospital to be given the JCI accreditation in Bangladesh. Can you elaborate upon your continuous success? We have done some internal studies and found out that in Bangladesh, there are 34 or 35 hospitals in the country of a capacity of over 200 beds but what we find so astonishing is that none of these have gone for standardization. Standardization is absolutely crucial in creating confidence. Due to this, our Board had the vision about 8 years ago to apply for accreditation with the JCIâ&#x20AC;&#x201D;the Joint Commission Internationalâ&#x20AC;&#x201D;which is the gold standard in healthcare. This is our third consecutive term of accreditation since 2008. We faced numerous challenges when going through the learning curve for the betterment of our hospital. Initially the promoters felt there was a drastic need to bridge the gap between what the country had and what they wanted to bring in. The first year was spent in recruiting the most talented doctors within the country. Then, we began to recruit experts from abroad to

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increase our scope for specialty treatments, which in turn helped to create a multicultural environment and a culture of knowledge exchange. Over a period of time, we realized that in the interest of clinical experience, such international training and recruitment is a necessity. Adhering to the quality standards, as specified by JCI, is very tough but crucial. Here, we believe in educating the entire staff; if you talk any staff member in the hospital, they will all emphasize the necessity for patient safety and infection control. We have mechanisms and measurements to track everything. In Apollo Hospitals Dhaka, we not only try to solve problems, but also anticipate and work to prevent recurrences as well.

What are some of the parameters you have set to maintain standards?

There are approximately 4 parameters. The first would be clinical excellence where we measure the outcome, create benchmarks, compare them with the worldâ&#x20AC;&#x2122;s best outcomes after every surgery, and measure length of stay to be as short as possible. Then we focus on patient friendliness, or what we refer to as patient centricity. This is because good service is therapeutic; it accelerates the healing process and recuperation. For example, we have provided a hotline for patient inquiries; we emphasize the need of our staff to always follow up on the patientâ&#x20AC;&#x2122;s well being. We have installed micro-cameras and microphones in 130 areas of the hospital where there is no conflict with patient privacy. These areas include the billing area, ensuring that we can provide the best service and monitor and critique our own work. The most important attribute is transparency

and ethical practice because in the case of private hospitals, there is a preconceived notion of exorbitant prices and lack of transparency. We have taken the initiative to announce that our prices are predictable for certain procedures. There are approximately 150 areas where we can state that we can definitely provide a fixed price and duration of stay. Even if costs exceed the package price, the extra cost is written off. Only in the case of co-morbidity, which is in many cases is calculatable, the patient is advised that there may be some extra charges. The whole objective is to ensure predictability in pricing and inculcate confidence in our institution. Finally, the fourth parameter: efficiency. The success of an institution is based on its own sustainable performance so we need also to measure the efficiency parameters.

There is the Apollo Hospitals chain in India. Is it a challenge to keep up with the standards of the institution in India? We had certain challenges and gaps in terms of perceptions in the past. In earlier days, there was a culture to defend these. The only way we thought we could bring transformation is to accept that there are genuine areas of inadequacies. That is one of the reasons why we are encouraging feedback. It is like a mirror which reflects our image â&#x20AC;&#x201C; this is helping us a lot. We feel that these challenges welcome improvement. Sincerity and humility is most important, especially in an industry

like this. There is a system known as ACE (Apollo Clinical Excellence), which earlier had 25 parameters (now more) in clinical practices that must be followed by any of the Apollo hospitals; an apex group measures this to ensure that it is up to the necessary standard on a monthly basis. There are very strict protocols that must be maintained. For example, you cannot just decide that you will surgically remove the cancerous tissue from a cancer patient. You may have to reduce the size of the tumour through chemotherapy or radiotherapy prior to any invasive action. There are well-written clinical pathways that every doctor must follow before they undertake any action or procedure and these are implemented with the utmost discipline. There is a Board consisting of all relevant bodies that will treat the patient and they will decide on the best protocol. We have a diagnostic centre that approves the protocol before it is implemented and they must supervise the course of action. We are evolving certain standards which are not being followed in other institutions.

A vast number of patients and their families express that there is a lack of communication that leads to inadequate or faulty treatment in the ICU. How do you overcome this disparity? I agree that this is a phenomenon that unfortunately occurs however, we are taking certain measures in order to overcome it. We are continuously training our doctors. When our doctors write an MRI or CT scan, they are required to provide an explanation of why they have come to that conclusion and why they have conducted such a detailed test as opposed to a simple X-ray. We assure you that our doctors are trained to practice degrees of empathy and

understand their patients in order to alleviate any communication discrepancies. No instruction or incentive is ever given to increase revenue. You must answer an inner voice for ethical practices regardless of whether there is an audit.

As a corporate hospital, you have to balance sustainability and quality. There must be a flow of revenue with the most cost effective care. How do you balance these two? In the previous 2 years, there have been no price increases. And we have provided many health packages to promote predictability. We have focused on consumption and how unnecessarily they are utilized and found how much we can conserve. We went to the suppliers and continuously renegotiated for affordable rates. Efficiencies were achieved and there was a substantial increase in our financials because of the reduction of waste. And that is reflected against our manpower also. We work extended hours and even on holidays.

In Bangladesh, research, collaborations with public health and R&D are not commonly seen. Is this encouraged in your hospital? Due to the uncommon nature of these events, many of our doctors present their research in foreign committees or boards. Apollo has its own publications that present this research as well as what is known as Supra Major procedures in each department. When a doctor executes a particularly challenging procedure, the entire process is recorded. We have planned the procedures that we will be doing for the next three years. We have started with autologous bone marrow transplants which were planned two and half years ago; we will

start allogenic transplants and there is the prospect of bringing robotic surgery systems later on.

Are there any pledges that Apollo would like to express to the government regarding the prospect of healthcare? The first message we would like to convey is standardization. There must be a certain body that emphasizes and maintains a certain quality of healthcare. There must also be a change in the education system, when you look into the private medical education sectors, most of them are inadequate but they are still producing doctors.

According to the Board of Investment report, Bangladesh spent around $2 billion for medical tourism in the previous year. Do you have any plan to increase the medical treatment within the country? I believe that the best way to attract patients to seek treatment within our country is to show them actual case studies such as the ones run in Daily Star. This would include those who have travelled abroad seeking treatment but found the correct treatment here. We must also create awareness that there are adequate experts and technologies that are available here. Everyone feels as if treatment is better outside of the country. We must create awareness of the quality that is available within.

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/ Special Interview / Public Health

Prof. Dr. G. U. Ahsan Dean, School of Health & Life Sciences and Chairman, Department of Public Health North South University

â&#x20AC;&#x153;Public Health Educational is recognized as the key strategy for achieving SGDs.â&#x20AC;? Prof. Dr. G. U. Ahsan is the Dean, School of Health & Life Sciences and Chairman, Department of Public Health at North South University (NSU). He has also been working as a Member of the Technical Advisory Committee, World Health Organization, South-East Asia Region, New Delhi, India. He has garnered 25 years of professional experience in Public Health as an academician and researcher. He has worked mainly in NSU and some other reputed universities of North America & South East Asia along with the Ministry of Health & Family Welfare of the Government of the Bangladesh. He received his PhD in Epidemiology along with his MPHM, and DTM&H from Mahidol University in Thailand. He is considered a pioneer in establishing Public Health Higher Education program in private sector of Bangladesh. Dr. Ahsan has facilitated wide collaboration networks with a good number of reputed international universities. He has more than fifty publications both in international & national peer reviewed journals. At present Dr. Ahsan has also been working at NSU Global Health Institute (NGHI). As its Executive Director, he has drawn in a large number of international research grants from the likes of WHO, TDR, IDRC, NASA, UNDP.

Setting benchmarks Following the footstep of our success here at NSU, we now have 31 universities and institutions offering Public Health education.

What is the current condition of the public health education in Bangladesh?

Simply put, public health, as many may not know, is the health status of the ordinary people of the country. However, the academic definition of public health as prescribed by World Health Organization is much more comprehensive and includes components like the prevention of diseases and the promotion of health and life of the entire population. It involves measures, which aim to reduce the risks of disease occurrences as well as provide intervention means, which will help battle illnesses and if needed, eradicate them. To do so, public health is a domain where doctors, biostatisticians, policymakers, health workers and communities participate actively. A better public health scenario means the population as a whole is enjoying a better life. Public health education works relentlessly to ensure that.

In the context of Bangladesh, the situation is getting better day-by-day. I personally would like to thank the expansion of public health education. This has lead to educators making the policy makers more informed of the situation, the investors more equipped with data and workers more aware of the latest public health technologies and intervention methods. But in the beginning, we had only one organization, National Institution of Preventive and Social Medicine (NIPSOM), who started providing public health education in the name of a DPH degree. The one fallacy of the program was that only government medical doctors, bureaucrats and employees of government institutions could apply for the degree. After completion of my PhD, I came back and joined the Director General of Health Services. During my stint there, I have taken initiatives to establish a public health unit called Technical Training Unit which was missing since our independence. Over there, we assessed public health needs countrywide, based on which we doubled up the public health programs. That program gave me an insight about the public health condition of the country. It was evident to me that only NIPSOM could never produce enough public health professionals to meet the burgeoning need. The private sector had to come forward. I reached out to North South University, which was (and still is) immensely popular for its business administration programs. Leaving the government job, I started as the founding chairman of the School of Public Health under the School of Health and Life

Sciences. However, before joining here, I helped the State University of Bangladesh to establish their Public Health Program, which didn't go further. Today North South University has emerged as one of the best education providers in the realm of public health and preventive medicine. We have managed to achieve that reputation based on five qualities: selecting the best students for the program, attracting quality faculty members, using the global standard curriculum and methodology to teach our students and encouraging them to conduct research activities and help them hone their expertise through various internship programs. Many of our students are pursuing their doctorate and post-doctorate degrees in institutions like Harvard University, John Hopkins University, etc. Following the footstep of our success here at NSU, we now have 31 universities and institutions offering Public Health education. As I have already mentioned about the components of public health, I would like to add that this kind of program always encourage to understand the disease better and share the knowledge among the concerned professionals. Based on that knowledge, doubling up programs helps us having a better grip over the prevention of diseases, be it communicable or non-communicable. In this connection, I would like to give the example of the discovery of Oral Rehydration Solution (ORS). Before the invention of this simple solutions, millions of people died here and in many other part of the world due to diarrheal diseases. Similar result happened with

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modalities but also behavioral aspects of communication and crisis management. We also added topics that will enable them to use tech devices in a smart way. Teaching proper English, like a cherry on top of everything, has helped them go beyond borders and render their services. I am grateful to all the visionary teachers we have worked together to develop a highly trained nursing workforce at home and abroad.

Why you have started NGHI?

Expanded Program of Immunization (EPI) in Bangladesh, which saved lives of thousands of children. Our honorable Prime Minister won international recognition in battling maternal and child mortality, which, according to me is a direct outcome of expanding public health programs.

What are the challenges of Public Health sector? Ignorance about the importance of Public Health education is the number one challenge. Even at policy maker level, sometimes we face dilemmas in making them understand the significance of timely intervention. The curriculum we follow in medical education is yet to become updated to meet the need of the 21st century. There is no denying the fact that the foremost duty of clinicians is to cure diseases. Nevertheless, in the changed world order, we must admit that topics like behavioral change, moral

aspect, health statistics etc. should be learned and practiced for better understanding of the course of disease and preventive measures. The curriculum of public health education has all these components. I believe should they have studied these issues; they would have performed way better in their daily practices. This is why I urge that every clinician should take at least three courses: research methodology, communication, and hospital management. This will enable them to understand disease patterns. Bangladesh's health care system has been lauded for all the services in different levels it provides but the problem is with the governance mechanism. As I have seen in many of our foreign stakeholders critiquing our system as the best example of worst management in the world. The problem lies in the mindset, lacking professionalism. However, things will be different in

coming days. Now many clinicians have grasped the importance of studying this subject. This course will equip them with leadership qualities too, who can emerge as torchbearers of new innovation in the health frontier. Many people consider the lack of infrastructure as a problem. In my opinion, it's the strategy and implementation and skilled human resources who can pave the way forward. One has to have a vision.

You have a nursing institute also. What is the condition of nursing education here? Just like doctors, we have a sheer lack of skilled nurses for the healthcare service industry to run seamlessly. On top of that, the existing curriculum was also poorly planned. During my stint at the DGHS office, I realized the need of updating their curriculum too. We came up with study materials, which not only equip them with know-hows of treatment

In Bangladesh we have enormous public health problems which are increasing due to inefficient management, lack of research competency and practices, rapid climate change, drug resistance and increasing non-communicable, emerging and re-emerging infections in the community. In such circumstances, NGHI was launched to combat the challenges in Bangladesh and in the region. This is to be done through the enhancement of the development capacity of the providers, implementing appropriate research to discover effective technologies that are important to prevent diseases, promoting health and protecting the environment and using new public health technologies for ensuring quality of life and well-being. This is how North South University can become a centre of excellence comparable to the top ranking universities of the world namely the Harvard, Johnâ&#x20AC;&#x2122;s Hopkins, Cambridge, British Columbia and others.

/ Cover Story / Medicare

BANGLADESH HEALTHCARE INDUSTRY

An Industry Growing Faster than the Countryâ&#x20AC;&#x2122;s GDP By M Sazzad Hossain

Total healthcare expenditure stands at only 3.7% of total GDP of the economy

he healthcare industry can be termed as one of the most important sectors of the economy, since medication counts as a basic need for living and has a strong stable demand. Growth in living standards and the aging population are likely to ensure that this industry grows much faster than the countryâ&#x20AC;&#x2122;s economy. This reveals a strong correlation between income and

healthcare spending â&#x20AC;&#x201C; this is mainly due to the fact that the demand rises in response to a proportional rise in the income.

1. Levels of Healthcare in Bangladesh In Bangladesh, depending upon the type of services patients require, the level of health care can be divided into three broad categories:

Primary Care

Basic or general health care traditionally provided by doctors trained in: family practice, pediatrics, internal medicine, and occasionally gynecology

Secondary Care

The medical care provided by a physician who acts as a consultant at the request of the primary physician

Tertiary Care

Specialized consultative care, usually on referral from primary or secondary medical care personnel, by specialists working in a center that has personnel and facilities for special investigation and treatment

2. Healthcare Industry in Bangladesh Healthcare by Numbers

3.7%

37%

61%

Total Healthcare Expenditure as % of GDP

USD per Capita Healthcare Expenditure

Public Expenditure as % of Total Healthcare Expenditure

Out of Pocket Expenditure as % ofTotal Healthcare Expenditure

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Healthcare Expenditures

Currently the 57th largest economy in the world, Bangladesh has been making significant socio-economic developments in recent years. Its GDP has been growing at an average rate of 6-7% over the past decade. However, despite improving healthcare indicators, such as a decline in mortality rates and increase in average life expectancy, the health sector of the country is yet to reach its full potential. Total healthcare expenditure stands at only 3.7% of total GDP of the economy. Total Healthcare Expenditure as % of GDP Myanmar Indonesia Bangladesh Thailand Sri Lanka India Bhutan Nepal Maldives

2.0% 2.7% 3.5% 3.6% 3.7% 4.0% 5.0% 5.2%

Public expenditure on healthcare is 37% of the total healthcare expenditure in Bangladesh. Tax and non-tax revenue and foreign loans and grants are channeled by the Ministry of Finance to the Ministry of Health and Family Welfare and other ministries. Health services in Bangladesh remained predominantly financed by households’ Out-of-Pocket-Payments

% of Households' OOPP Breakdown

6.8%

Others 12%

Source: WHO Database, 2007

The major share of total health expenditure in 2007 was spent on drug retail services (46.1%) and curative care services (28.6%) followed by prevention and public health services (11.2%) (MOHFW, 2003).

Medical and Diagnostic Facilities 6%

Bangladesh ranks 3rd from the bottom in Total Healthcare Expenditure as % of GDP Index for the South East Asia region. However, when public expenditure as % of total healthcare expenditure is compared Bangladesh ranks among the top 5 nations. Public Healthcare Expenditure as % of Total Healthcare Expenditure 6.8% 11.7% 25.8% 26.5% 34.4% 45.8% 49.4% 76.3% 84.8%

Source: WHO Database, 2007

Hospitals 16%

Drug and Medical Goods Retail Outlets 66%

• Public vis-à-vis Out-of-Pocket Expenditure

Maldives Myanmar India Nepal Bangladesh Indonesia Sri Lanka Thailand Bhutan

(OOPP). Direct payment for the purchase of pharmaceuticals and medical goods is the predominant contributor to OOPP, either through self-purchase or on the advice of a formal or informal health-care provider. OOPPs are mostly direct payments made at private and NGO facilities and also to informal providers. The growing reliance on OOPP leaves the population at risk.

Source: MOHFW, 2010

Health Workforce

The size of the professional health workforce is consistently increasing over time, but not according to actual requirements. It is one of the 57 countries identified by the WHO as having critical shortages in the healthcare workforce (WHO, 2006). The recent report of the WHO suggests that there are 0.3 doctors and 0.3 nurses per 1,000 of the population and cumulatively less than 23 doctors, nurses and midwives per 10,000 of the population [Source: Bangladesh Health System Review, 2015]. At present there are 64,434 registered doctors, 6,034 registered dentists, 30,516 registered nurses, (MOHFW, 2013) and 27,000 midwives (MOHFW, 2012).

3. Bangladesh Healthcare Industry Ecosystem a. Public Sector Health Services • Organizational Hierarchy The Ministry of Health and Family Welfare has an extensive health infrastructure. The service delivery structure follows the country’s administrative pattern, starting from the national to the district, upazila, union and finally to the ward levels. It provides promotive, preventive, and curative services such as outdoor (outpatient), indoor (inpatient), and emergency care at different levels – primary, secondary and tertiary.

The recent report of the WHO suggests that there are 0.3 doctors and 0.3 nurses per 1,000 of the population and cumulatively less than 23 doctors, nurses and midwives per 10,000 of the population • Distribution of Beds in Secondary and Tertiary Public Health Organizations • Distribution of Beds in Public Sector at Upazila Level and Below

Type of Hospitals

No. of Hospitals

No. of Beds

District Hospital

7,850

Type of Hospitals

General Hospital

Upazila Health Complex

1,350

Infectious Disease Hospital

180

Medical/Dental College Hospital

11,960

Specialized Hospitals Affiliated with Post-graduate Institutes

2,300

BSMMU (Medical University)

1,212

Others

2,201

Total

126

27,053

No. of Hospitals

No. of Beds

436

18,290

Union Hospital

49 0

Trauma Center

100

Total

472

18,880

Source: Bangladesh Health Bulletin, 2013

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b. Private Sector Health Services

â&#x20AC;˘ Population per Bed in Public Sector Division-wise Population per Bed Average

5,657

Sylhet

5,780

12,696 11,599

Rangpur

6,962

Rajshahi

6,698

4,174

4,956

33,069

9,091 8,054

Chittagong Barisal

18,563

7,300

Khulna Dhaka

11,092

19,842

8,772

Secondary and Other Tertiary Care Hospitals

Medical College Hospitals

As the GDP will increase, wealth increases, peopleâ&#x20AC;&#x2122;s healthcare spending thus is also likely to increase. On the other-hand the population is also increasing, which will further increase the demand for healthcare.

In the private sector, providers can be grouped into two main categories. First, the organized private sector (both for-profit and nonprofit) which includes qualified practitioners of different systems of medicine. Secondly, the private informal sector which consists of providers practicing in rural areas without any formal qualifications such as untrained allopaths, homeopaths and kobiraj. According to Asia Pacific Observatory on Public Health Systems and Policies, there are 2,983 private hospitals and clinics registered as of 2013. The total number of beds provided by the private sector is 45,485 (as of 2013).

c. Diagnostic Centers Along with private clinics and hospitals, the number of diagnostic centers in the private sector is growing. In 2012, approximately 5,122 laboratories and other diagnostic centers were registered with the Ministry of Health and Family Welfare (MOHFW, 2012). In the private for-profit sector, there are some large diagnostic centers in the cities (Lab Aid, Ibn Sina, Popular and Medinova) providing laboratory and specialized radiological tests. Some of these facilities maintain a high standard. In the nonprofit private sector, there are centers like the International Centre for Diarrhoeal Diseases and Research, Bangladesh (ICDDRB), which has a modern laboratory providing research facilities and extends laboratory services to the general community.

d. Donors, NGOs and Professional Groups Bangladesh is known worldwide for having one of the most dynamic NGO sectors, with 2,471 NGOs registered with the NGO Affairs Bureau working in the population, health and nutrition sector (as of 2014). NGOs have been active in health promotion and prevention activities, particularly at the community level, and in family planning, maternal and child health areas. In 2007, 9% of total health expenditures were managed by NGOs. Multiple donors, both multilateral and bilateral, have been actively engaged in health-care financing and planning. The main bilateral donors to the health and population sector in Bangladesh are the governments of Australia, Belgium,

Canada, Germany, Japan, Netherlands, Norway, Sweden, the United Kingdom and the United States. The multilateral donors include the World Bank, European Union, UNICEF, ADB, Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), and the GAVI Alliance. Moreover, in Bangladesh there are a number of professional organizations who address the rights of medical professionals at different levels, such as the Bangladesh Medical Association (BMA), Bangladesh Private Medical Practitioners Association (BPMPA), Public Health Association of Bangladesh, Bangladesh Pediatric Society and the Nephrology Society of Bangladesh. However, there is no organized body, either in the public or private sector, for overseeing the interests of patients. The Consumers Association of Bangladesh is an NGO addressing the rights of consumers in general, and does not have a separate agenda on health focusing on the rights of consumers as patients (Consumers Association of Bangladesh, 2014).

4. Sectoral Challenges

The health system in Bangladesh is characterized by a massive shortage of skilled health workers clustered disproportionately in urban areas. On top of that, rural facilities are overburdened, understaffed and insufficiently equipped. According to the Asia Pacific Observatory on Public Health Systems and Policies, a number of factors played important roles in hindering expected improvements in the overall health status of the country: Challenges

Description

The Complexity of the Mixed Health Systems and Poor Governance

The existing structure and management of health organizations fail to make the health system accountable to its stakeholders, leading to high absenteeism rates among doctors, corruption, as well as poor service quality

The Complexity of the Mixed Health Systems and Poor Governance

Despite a very fast-growing private sector, the number of existing hospital beds is not adequate to meet current demand. There is a critical shortage of trained health providers and an inappropriate skill mix.

Inadequacy of Health Resources and Impact on Quality of Care

Due to a critical shortage of qualified healthcare providers and the costs of medical care, a large proportion of poor patients seek treatment from informal untrained providers.

Inadequate and Uneven Health Service Coverage

Due to lack of linkages and coordination across ministries delivering health services, vertical programs and specialized services adopted by the Ministry of Health and Family Welfare do not necessarily get translated to urban health systems.

Healthcare Financing through Massive OOPP by Households

The high levels of OOP payment combined with informal payments for health services at public sector facilities are impoverishing millions of households annually. Financial risk protection remains a major challenge.

Inequitable Access to Health Services Hindering Universal Health Coverage

Most of the primary health facilities provide basic health care and thus do not have the capacity to support inpatient care or emergency medical care.

5. Governmentâ&#x20AC;&#x2122;s Role and Future Potential

As a mean to minimize this burden for the people, the Bangladesh government has examined ways to adopt a universal medical health insurance. The government aims to achieve universal health coverage by 2023 that will pay 70% of the medical expenses instead of the 26% paid currently. The average GDP growth rate of Bangladesh stands at around 6% which is expected to rise. As the GDP will increase, wealth increases, peopleâ&#x20AC;&#x2122;s healthcare spending is also likely to increase. On the other-hand, the population is also increasing which will further increase the demand for healthcare. Moreover, treatment advancement and government initiatives to increase medical services access should drive the sector expansions at a higher rate. At the same time, the pressure to reduce cost is also rising. Due to this opposing pressure, many of the existing business models might not suffice in the future. In order to maintain growth stability suppliers should adapt to the market forces with the appropriate transformations and digital innovations. Apart from these, the government needs to account that a large proportion of the population is unable to receive proper medication and requires easier access to healthcare services. Provided the existing problems are addressed, the sector has a bright future ahead.

M Sazzad Hossain is a Co-founder and Assistant Vice President at LightCastle Partners. He can be reached at sazzad.hossain@lightcastlebd.com. For the purpose of writing this article he was assisted by Mahir Abrar, Junior Associate at LightCastle Partners. Contents from Bangladesh Health System Review from Asia Pacific Observatory on Public Health Systems and Policies were used as healthcare secondary data is not widely available.

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/ Special Feature / Medical Waste

Magnifying the microscopic danger with a prodigious effect. By Sohana Nasrin

M 36

Battling Biohazards edical waste is defined as any solid or liquid waste that is generated from treatment of human beings in a hospital or clinic, from clinical diagnosis and pathological testing and from medical research, compromising of sharps,

bodily fluids, dressing materials surgically removed body tissues, chemicals, pharmaceuticals, medical devices and radioactive materials. Although we are often too busy to realize it, the microorganisms from bodily

fluids that are left in the pathology lab, can be more devastating than any weapon of mass destruction. Yersinia pestis is a disease causing bacterium that has killed as many as 75 to 100 million people during the Black

Plague The death toll, overall damages, and economic cost will undoubtedly conclude that biohazards are the biggest threads to human kind. Given that, even health-professionals have difficulty comprehending the dynamics, the general population has never been bothered. Infectious diseases outbreaks are an everyday occurrence from avian influenza virus, HIV, Hepatitis viruses, Norovirus (Norwalk virus), Salmonella typhimurium, Mycobacterim tuberculosis, Vibrio cholera, MRSA superbugs, Plasmodium vivax and hundreds of other bacteria

While stating the limitations, Dr. Asadulghani informs that Bangladesh is not manufacturing waste packaging materials, which are expensive and requires a long lead-time to purchase from abroad.

and viruses. According to World Health Organization (WHO), a bulk of 18.4 million people died worldwide from non-communicable diseases caused by bacteria, viruses and parasites. Pathogens still infect billions of people, with trends indicating a rise in their numbers and lethality in developing countries. Unplanned urbanization, poor sanitation, scarcity and poor planning in waste management, broken water infrastructure, reduced food safety, globalization, international travel, extreme weather and rising cost of new drugs, vaccines and antibiotics have made all developing countries vulnerable to biohazards due to the lack of biorisk management initiatives. A comprehensive biosafety and biosecurity program with efforts to sensitization and raise awareness against unacceptable manner of dealing with with biohazard is absolutely pertinent in developing countries. Dr. Asadulghani is a researcher and a biosafety professional who has been working in the field of Molecular Microbiology for more than 23 years. He suggests that biomedical waste can be divided into two categories: infectious waste and non-infectious waste that includes pharmaceutical waste. According to him, indiscriminate use of antibacterials and their release into the environment develops antibiotic resistance bacteria in the environment, which eventually has hazardous impacts on our environment. In his opinion, the situation will continue

to deter unless and until we specially focus on medical waste management. According to Dr. Asadulghani, 100 to 200 kg of waste is produced in icddr,b facilities alone on a daily basis. He mentions PRISM, which is an entity, funded by Japan International Cooperation Agency (JICA), authorized by the Environmental Ministry. Operating in Dhaka City Corporation provided land, it is the only specialized common biomedical waste treatment facility (CBWTF) in Bangladesh. According to PRISM, they receive 6 to 7 tons of biomedical waste that is produced by diagnostic and research laboratories and health care facilities, which is only a portion of the waste generated throughout the whole city. For total management of medical waste, we need to expand this biomedical waste treatment capacity largely for the whole nation. Dr. Asadulghani has participated in the train-the-trainer program for Biosafety professionals organized by NIH in association with the Singapore REDI center. Being a certified trainer and biosafety professional in the Asia-Pacific region to biosafety professionals, scientists, researchers, and diagnosticians, Dr. Asadulghani, is currently working to develop and implement policies and procedures of biosafety and biosecurity in labs and field activities of icddr,b and in Bangladesh, as well. He informs icddr,b has the MoU with PRISM, to manage biological waste. He also informs that PRISM is the only CBWTF for treating and

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managing all biomedical waste in Bangladesh. Dr. Asadulghani supports a centralized system to manage biomedical waste; it is a common and cost effective trend worldwide to manage the waste through CBWTF to minimize the risk of spreading infectious diseases by minimizing the number of treatment sites. Starting his career as a researcher in 1993 with the isolation and characterization of extracellular protease, Dr. Asadulghani received MSc in Biochemistry and Molecular Biology in 1995. While working at icddr,b (1995-2001), under the supervision of renowned Scientist Dr. Shah M. Faruque, he discovered the satellite filamentous phage RS1 in Vibrio cholerae (V.c.)genome and explained the molecular mechanism of horizontal gene transfer among V.c. strains. He contributed substantially in the demonstration of a novel mechanism of how pathogenic V.c. originates from non-pathogenic progenitor strains and received MPhil in the field of Molecular Microbiology in 2001. During his PhD program (2001-4), with of Professor Dr. Hitoshi Nakamoto, at Saitama University, Japan, he analyzed posttranscriptional regulation of Heat Shock Protein (HSP) genes and discovered the role of light in the modulation of HSP gene expression. During his postdoc and while working as an Assistant Professor (2004-9) at the Faculty of Medicine, University of Miyazaki, Japan, with Professor Dr. Tetsuya Hayashi (Chairman, Microbial Whole Genome

Sequencing Group, Japan), he demonstrated the novel mechanism of disseminating virulence genes by defective prophages. While stating the limitations, Dr. Asadulghani informs that Bangladesh is not manufacturing waste packaging materials, which are expensive and requires a long lead-time to purchase from overseas. However, packaging of segregated waste is the crucial part of medical waste management. Dr. Asadulghani informs that icddr,b is going to pilot a project to combat this matter where they are planning to produce locally low-cost waste packaging materials like biohazard bags and sharp containers. The organization will distribute the containers to different hospitals, free of cost, and negotiate with the government for advocacy at the same time. He sheds light on medical waste management activities and says that there are two major ways of treating biomedical waste autoclaving and incineration. Autoclave is a high temperature and pressure treatment machine, which is used for sterilizing. Treatment with chemical like sodium hypochlorite is also effective and acceptable; however, consideration should be given in the type of waste being treated that otherwise may lead to a false sense of sterility. Sufficient incubation period is necessary to release the chlorine from sodium hypochlorite to avoid its unwanted effect. Additionally the chemical is corrosive and can damage pipelines if disposed before an insufficient incubation

period. Incineration also demonstrates its strength and weaknesses, which deter its usage by the developed world. Incineration is popular in countries with limited natural resources. According to Dr. Asadulghani, incineration is a waste treatment process that involves the combustion of organic substances contained in waste materials. Incineration of waste materials converts the waste into ash, flue gas, and heat. The ash is mostly formed by the inorganic constituents of the waste, and may take the form of solid lumps or particulates carried by the flue gas. Thus inside the incinerator we are losing organic substances and concentrating heavy metals and right now we have no way of managing this heavy-metal-waste properly. Additionally, combustion of plastics containing chlorine may produce highly toxic chemicals known as dioxins and furans at 300°C to 500°C temperature. These reactions are an important consideration to dispose of chlorinated plastics such as polyvinyl chloride (PVC). Thus, consideration should be given to segregate all chlorinated plastics materials before incineration. Although Dr. Asadulghani is a researcher and educator in the fields of Molecular Microbiology, Biotechnology, and Genetic Engineering, right now he is investing his full time in the advancing Biosafety and Biosecurity status at icddr,b and for the whole nation as well. He is managing the Biosafety and Biosecurity

program in all the eight divisions in Bangladesh. The program is supported by Centers for Disease Control and Prevention (CDC), Atlanta and Biosecurity Engagement Program (BEP), United States Department of State. He is closely working with the International Federation of Biosafety Associations (IFBA). Under his leadership, Bangladesh Biosafety & Biosecurity Association (BBBA) was formed in November 2011 and he worked as “Pro Tem President” for the association until December 2012. He was given the responsibility to run the BBBA for 2013-4 as the President. After the successful completion of the first term, he was selected for the second term until December 2016. Let’s hope that under his leadership, Bangladesh can develop a strategy where the biomedical waste management is the most effective, both resource and finance wise, and least hazardous to the environment. Best of luck Dr. Asadulghani.

With contribution from Dr. Fahad Hossain & Irad Mustafa.

Special Feature / Global Healthcare

The Global Healthcare Lifeline By Irad Mustafa

Evaluating the health care trends around the world. As governments and private sector stakeholders strive to deliver effective and efficient healthcare, they do so in an ecosystem that keeps undergoing dramatic and fundamental changes in business, and operating models. This shift is being fueled by aging and growing populations, the rise of chronic diseases, increased focus on care quality and value, evolving quality regulations and financial conditions, more informed consumers and the development of innovative treatments and technologies. All of these factors are leading to rising costs and an increase in expenditures of healthcare, infrastructure improvements, and technological innovations.

Demographic Shifts:

An ageing population and growing middle class are changing healthcare priorities. People are getting older. Ageing populations in both emerging and developed nations are leading to higher healthcare demands. According to the United Nations, the worldâ&#x20AC;&#x2122;s population is expected to increase by one billion people by 2025. 300 million of that billion will be people aged 65 or older, as life expectancy around the world continues to rise. Without additional healthcare resources and service innovations, the prospects of being able to deliver long-term care and chronic disease management services to this rapidly increasing senior population will become increasingly difficult. At the same time, developing countries are observing significant growth in their middle classes. The Brookings

Institute estimates 65% of the global population will be in the middle class by 2030. This can only lead to accelerated urbanization and access to middle-class comforts which will result in sedentary lifestyle changes that will inevitably increase the likelihood of diabetes, obesity, and other costly health conditions. Rising middle classes and ageing populations will fuel the increasing demand for more health options. As such, effective partnerships between public and private sectors will be required to meet these expectations. Technology and analytics are ushering in new ways

of disease prevention and providing patient-centric care. These advances need to be properly utilized by both private players and governments, as they bring greater precision to predicting patient behavior and detecting and diagnosing diseases. Different parts of the world will be impacted differently by the demographic and societal shifts. To achieve successful and sustainable change across the globe, flexible and adaptive models will be required to fit the new health economies.

Figure1: Patient-centered health care provider operating model

FROM

Department- and specialty-driven organization of care

Multidisciplinary-, multispecialty-driven organization of care

Episodic and high-acuity focus

Disease and cross-continuum focus

Provider-centric experience

Patient-centric experience

Individual physician or specialty orientation to care delivery

Team orientation to care delivery that involves multiple specialties, APPs, social workers, etc.

Management of the high-acuity portion of care

Collaboration with external partners to optimize site and level of care

Source: HBR, â&#x20AC;&#x153;The Strategy that Will Fix Healthcareâ&#x20AC;?

Figure 2: Countriesâ&#x20AC;&#x2122; GDP and per-capita health care spending, 2013 Health care expenditure varies greatly around the world

Netherlands $6,145 U.K. Germany $3,598 $5,006

Canada $5,718 U.S. $9,146

ME (SA, UAE, Qatar) India $61 $1,473

Mexico $664

China $367

Japan $3,966

Brazil $1,083 Australia $5,827

Health expenditure per capita (current US$) $12 $9,146

Source: DTTL Global Life Sciences and Health Care (LSHC) Industry Group analysis of The World Health Organization Global Health Expenditure database (see http://apps.who.int/nha/database for most recent update)

The Proliferation of Chronic Diseases:

Costly chronic and communicable care needs are exerting considerable demand on healthcare systems. The ageing population and changes in societal

behavior are contributing to a steady increase in chronic diseases and conditions, worldwide.This will push obesity rates and cases of diseases such as diabetes, cardiovascular diseases, hypertension, and dementia upward. According to the World Health Organization, chronic illness prevalence is expected to rise by 57% by the year 2020. Developing nations will be hit the

hardest, as population growth is anticipated to be more significant in the emerging markets. This increased demand on healthcare systems due to chronic disease has become a major concern. The current number of people with diabetes is 387 million globally, and that figure is expected to increase to 592 million by 2035, according to the International

Diabetes Federation. Another rising health concern is global pandemics. The epidemics of the past decade have demonstrated the speed at which infections can spread across the globe. Ebola, SARS, MERS, and H1N1, and so on, all demand coordinated and agile healthcare responses. Fortunately, research into treatments is generating promising results, and new delivery models are emerging. The Pharmaceutical Research and Manufacturers of America (PhRMA) estimates that 180 new diabetes drugs are in late-stage development. Seven new treatments have secured U.S. Food and Drug Administration (FDA) approval in the past two years. New immune-oncology drugs are showing great promise against cancer, as well. Efforts to reverse the rise in obesity have also gained momentum, particularly initiatives to influence consumption patterns. Technology will play a vital role. Advancements in

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FIGURE 3 Share of Health Expenditures in Africa by Disease 10.0% 25.0%

7.0%

12.0%

4.0%

16.0%

22.0%

HIV/AIDS Malaria TB Other Infectious

4.0%

Cardiovascular Injuries Neuropsychiatric Cancer & Other NCDs

Source: 2016 Global Health Care Outlook (The Carlyle Group)

precise detection and diagnoses of diseases will be instrumental in reducing the costs of treating chronic conditions. New entrants into the healthcare market are helping the system evolve in this regard. With the health sector placing greater emphasis on preventive and patient-centric care solutions, new avenues will be opened for industries such as retail, telecommunications, technology, wellness and fitness. These industries must use these openings to come up with innovative solutions to chronic disease prevention and management issues.

Informed and Empowered Consumers:

Consumers are taking advantage of the easier access they have to information and using it to become more diligent and informed about their health. Todayâ&#x20AC;&#x2122;s consumers are better informed, and more financially responsible for their health care decisions. They also have higher expectations regarding the services and products they receive. More and more consumers are defining their ideal health care experience by including

convenience, amenities and service quality to the traditional clinical elements. Providers, health plans and governments are slowly adapting to these evolving expectations by focusing on consumer-centric strategies and service enhancement schemes. These changing consumer attitudes are prompting the health sector stakeholders to invest more in newer customer engagement capabilities. Both public and private providers who wish to retain existing patients and engage new ones need to invest in improving the overall consumer experience by training employees to be more customer-focused and utilizing technological advancements to make services and information more accessible.

The Evolving Financial Condition: FIGURE 4 Share of Health Expenditures in Europe by Disease 1.0%

0.0%

1.0% 1.0%

25.0% 36.0%

15.0% 21.0%

HIV/AIDS Malaria TB Other Infectious

Cardiovascular Injuries Neuropsychiatric Cancer & Other NCDs

Source: 2016 Global Health Care Outlook (The Carlyle Group)

The public sector will face challenges in their efforts to meet the needs of their growing and aging populations. A large portion of the global healthcare industry is funded by government expenditure. However, challenging economic conditions are making it difficult for governments in some regions to devote the necessary finances to cope with expanding healthcare demands especially when they’re being accompanied by ever-rising costs. Looking at some of the global economies, the U.S. is faring well, but some of the others are struggling. Russia is besieged by sanctions and falling oil

prices; the economy in Japan is stagnating; China faces rising debt levels, significant growth slow-down, and currency devaluation; and Latin American countries are battling inflation and recession. Health system expansions are typically accompanied by public and private sector partnerships to control costs and encourage more efficient resource utilization.

Income and Spending Correlation:

The positive correlation between income levels and household expenditure on healthcare means growing economies will experience higher healthcare spending. A brief glance at expenditures by different countries reveals a high correlation between income levels and health costs. According to the World Health Organization’s Global Health Expenditure Database (2015), advanced economies like the U.S., Europe, and Japan spend around twice as much of their income (12% of GDP) on health care as emerging markets and developing economies (6% of GDP, on average). Overall, about two-thirds of the $8 trillion in global health care spending occurs in advanced economies, with the U.S. accounting for $3 trillion, or 40% of the total. Consumer expenditure on health varies with income levels for two reasons. First, health care is a “superior” good, so its demand rises more than

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TABLE 5 Share of Total Health Care Financing in Select Economies Out-of Pocket

Public

Private Insuranc e

EM Economies

35.8

52.5

11. 5

Asia Ex-Japan

34.5

54.9

10. 4

China

33.8

55.8

10. 3

Latin America

32.1

52.6

15. 1

India

58.2

32.2

9. 5

Advanced Economies

14.7

61.1

24. 1

U.S.

11.8

47.1

41. 1

Euro Area

14.1

76.1

9. 7

Source: 2016 Global Health Care Outlook (The Carlyle Group)

proportionately with income. As countries become wealthier, households are naturally more willing to forego consumption on other goods for medical advances capable of improving the quality of their health. Secondly, advanced economies also tend to be older societies. Their share of the population over 64 years of age is equal to about 24% of the population between 15 and 64.

Medical Advances and Digital Innovations:

Keeping the industry afloat while battling cost issues. Advancements in the field of medicine and healthcare have been fundamental to the sector’s development for decades. However, medical innovations come with a high price tag as advances in health technologies drive up costs in all markets. For example, four new drugs have been approved in the U.S. to

treat and possibly cure hepatitis C patients. In addition, the new treatments can save further costs in the long-run by decreasing the risk of liver failure, cancer, and the need for possible transplants. However, the costs of these drugs are considerably high, and some state Medicaid programs and other

insurers have placed strict restrictions on their availability. The demand for value and increasing competition are prompting healthcare organizations to find new and more efficient ways to improve service delivery. This includes making services more accessible and potentially less expensive through innovative ideas which can allow connectivity “anytime and anywhere.” Five areas in digital health — telehealth, mHealth, electronic patient records, wearables, and social media — are growing rapidly and hold considerable implications for the advancement of the sector. Advancements in digital health technology are leading to advancements in connected health. Data being acquired by wearable devices, mobile health apps (mHealth), and from social media platforms are being

Figure 6: Examples of how wearables might

transform information and understanding of people’s health status

Contact lenses that monitor glucose levels

Smart pills that monitor medication -intaking behaviors and body response

Hearing device to boost hearing Heart rate monitor patch Wrist bands that monitor heartbeat, blood pressure, calories burnt

Insole sensor that measures weight bearing, balance and temperature Source: Healthcare and Life Sciences Predictions 2020: A bold future? U.K. Deloitte Centre for Health Solutions, 2014

used to transform aspects of health care. For example, developing nations who lack adequate healthcare resources and infrastructure, especially in the rural areas, are bridging the gap by exploring the use of digital care delivery models. Health IT is the fastest growing segment in India, where digital health’s potential benefits were particularly compelling in a country which has a large proportion of its population living in rural areas, with poor affordability and limited access to health care services. The size of the global digital health market comprising of wireless health, EHRs, Electronic Medical Records (EMR), mHealth, and telehealth, and so on was $60.8 billion in 2013 and expected to increase to $233.3 billion in 2020.

Conclusion

Rising living standards and aging populations in emerging markets make the healthcare sector an attractive destination for capital expenditures. A passive approach to the industry from its stakeholders will fail to take advantage of the coming shifts in spending patterns and market shares. Alternatively, investors should invest strategically. That is the only way they can capture the opportunities and openings being created by rapid emerging market health infrastructure growth and the incoming era of innovation and cost consciousness in advanced economies.

/ Advertorial

The pied piper of lifestyle estate

Sarwat Siraj

Managing Director, Leisure Bangladesh Real estate might be a key sector of the economy, given the ever rising population and housing needs, but it also is one of the most challenging investment choices. The choice is particularly difficult for someone with an illustrious law career to compromise, having the likes of Citibank NA, Price Water House Coopers, Gillette, Kodak, Proctor & Gamble, Unilever, Reckitt Benckiser, Asian Development Bank, and so on up the sleeves as clients. With no other precedence of a woman leading a real estate venture here; Sarwat Siraj, Managing Director, Leisure Bangladesh, made history by putting her first step into the industry.

And today, three years later, Sarwat’s Leisure Bangladesh, is easily one of the standout property sellers in the country. When Sarwat entered the property arena 2011 with the Leisure Kaalmegh Villas and Country Club project, the horizon was dominated by vague promises, frauds, and signboard-based companies. Buyers have never been so confused. Colourful brochures promised to build Londons in 10 years and New Yorks in 15 years. But in reality, most are nothing more than signboards standing like scarecrows in the middle of low-lying marsh and paddy fields. “I never wanted to be just another property seller. In fact, I never wanted to sell

property at all. I wanted to sell lifestyle,” said Sarwat, a Lincoln’s Inn Barrister-in-Law and a law graduate from the University of Hertfordshire in UK. “So, I couldn’t just cheat people with marshlands and paddy fields. I had to show them some real developed estate, show them the land that they were actually going to buy and not something that exists only on papers. “There is not even a square inch of land in any of my projects that does not belong to LeisureBD. First we bought properties to make them undisputed, developed land and only then are we putting them up for sale,” added Sarwat, who began her law career in Bangladesh in 1998 and has dealt with many land disputes since. The Kaalmegh Villas and Country Club were an instant hit. Country clubs are not very common in this neck of the woods. But Sarwat chose the woods of Gazipur Bhawal Forest to built the first ever country club and purchasable resort-like villas in Bangladesh. She has already sold 12 of her 32 villas - ranging in price from Tk2-4 crore each and 3080-5088 sq-ft in size. “People with money can overcome any odds. But the middle class doesn’t have that luxury. But they are the ones who crave the most more than the rich and the poor - for having a piece of land of their own. So, I decided to bring this

segment within my target group,” Sarwat said. “The first thing I had to do was make things convenient. The middle class do not have the money like the owners of the Kaalmegh villas. So, when I developed the Leisure Merina and Sports Village project, I took out the booking money concept out of the equation. Paying every installment means paying a part of the actual value of the property,” she said. “A second point of convenience is possession. Once a customer pays the first installment, Leisure Merina hands them over the possession of the land, not after paying all the EMIs.” Real estate companies do their EMI (equalled monthly instalment) calculations based on future values which means that they charge the customers the value that a piece of land is going to be worth in, let’s say, five years time. Sarwat’s Leisure Merina offers present value to prospective buyers. It is more like a fixed deposit in a bank. The price is current market price, but at the end of the payment term, the property value increases manifold. So, if a customer wants to sell it off after handover of ownership at the end of EMI payments, they can sell it at an instant profit. This is true for all her real estate projects - Kaalmegh, Woodland and Merina. Sarwat pioneered these concepts in Bangladesh’s real estate sector and she was told in the beginning that she was making a huge mistake. Needless to say, the success and ever-increasing popularity of LeisureBD’s projects have shut all critics down.

Kaalmegh Village and Country Club Nature Unleashed Who can define the pleasure and joy, the peace of mind and soft serenity among the green hills and rich woods, of an inland village! Who can tell how scenes of harmony and stillness sink into the minds of pain-worn dwellers in close and noisy places, and carry their own freshness, deep into their exhausted hearts! Well, urban dwellers are rarely aware of such existence, but for the first time, in the outskirts of Dhaka city, Leisure Bangladesh have built such a sanctuary called, “Kaalmegh Village and Country Club” for all those who have forgotten the pleasure of being in the company of nature itself. We, who have lived in crowded, constrained streets, through lives of toil, and who have never wished for change; we, to whom custom has indeed been second nature have come almost to love each brick and stone that formed the narrow boundaries of our daily walks have been known to long for one short glimpse of Nature's face before the darkness of demise falls. So, for all those urban escapists, away from all the chaos of the city, “Kaalmegh Village and Country Club” offers four categories of duplex villas, Super Luxury Villa of 5088 Sq. Ft., Luxury Villa & Luxury Plus Villa of 3080 Sq. Ft. and

Premium Villa of 1960 Sq. Ft. This nature friendly lifestyle resort and club ensures the tranquility of living in the suburban silence with international facilities and standards, established by an international company. Each of them has all types of modern facilities including private swimming pool, outdoor bar-b-q grill etc. They also have kid’s playground, basketball court, tennis court & restaurant with an exclusive complementary membership free with every villa. Leisure Bangladesh has genuinely set a one of its kind’s example of premium living, influencing the urge to revive the glory of nature. Kaalmeghis adorned with the most vivid colors of nature. Anyone can revive the splendor of nature as they set their foot on the terrace of each villa. The interior of each is uniquely designed to be in sync with the mass of green surrounding it. With international standard tiles, marble stones, teak wood and imported locks, this place will give shelter to the imagination of every young and old. The proficient and modern management of Kaalmegh set this place according to the need of its fine owners. The owners can not only enjoy this drop of heaven but can also rent it out

to tourists throughout the year. Each room can be rented separately making it a rather profitable and sensible investment. Mrs. Zeenat Ameen, a former Singaporean airlines employee is enthralled by this project, as she believes that such a place in the suburbs of the city can be a refreshing experience for her and her family. She also seems impressed by the smart rent plan, which is very lucrative and opportune for all the three parties (owners, management & tourists) involved in it. On the other hand, Mr. Rajib Hasan, Finance Advisor, British High Commission foresees this project as a unique one, as he wants his children to be in the company of both nature and nurture. As a financer, he also states, the plan of Kaalmegh being very keen and progressive with a positive forecast for value of money. In the need to be within the refuge of nature, Mr. Ahmed Kabir, Country Manager, Arla Foods, Dano, has rather a different insight to the project, where he mentions this to be a reliable project with international standard country club facilities introduced first time in Bangladesh. However, Dr. Lutful Aziz, Sr. Consultant, Apollo Hospital, Dept. of

Anesthesia, being a man of science has a rather poetic outlook to this lifestyle scheme. He plans this kingdom of greenery to be his retirement house, where he would love to count the end of his days with his wife on one arm and nature on the other. It is an obvious that in the serene surroundings of Kaalmegh, the mind will lose all its perspective; time and space will become trivial and unreal, echoing of a forgotten prehistoric past, beating relentlessly upon the enchanted consciousness of human mind. This place certainly seems like a piece of poetry worth living and investing on. No wonder Kaalmegh has achieved the Best Holiday Home Award. It is definitely a place, where man loses himself in the alluring realm of nature. 1. Project name is Leisure Kaalmegh, Villas and Country Club 2. In Sreepur, Gazipur 3. On the edge of Kaalmegh reserve forest 4. 52 bigha land, secured walled community 5. First ever country club in Bangladesh 6. No hills are there 7. The words free and contemporary have the same meaning, wrongly used 8. Winner of Asia Pacific property award and awardee of Bangladesh Brand Forum 9. EBL is our financial partner, loan facility and easy installments for buyers 10. Property will be managed by Unique Luxury Hotels of Thailand 11. The features has excessive focus on customers less on Kaalmegh 12. Two hours’ drive 13. Helipad 14. Ambulance, Pool car

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/ Feature / Health Consumerism

Things You need to Know about Health Consumerism By Sohana Nasrin The word consumerism is not really a conventional fit for the word health, and you might be thinking I am beating around the bush, but let’s not kid ourselves; “health consumerism” is a real thing. Although previously, the word consumerism has been historically used with words like retail or technology, recently, the scenario has started to change. The patient’s interaction with the healthcare system is changing from merely being episodic to more of an ongoing communication, around the clock, which sort of makes health consumerism compulsory for the big players in the industry. Since this is a relatively new and unexplored phenomenon, here are some of the vital things that you need to know about health consumerism:

1. THE HEALTH CARE CONSUMERISM HAS ARRIVED: MAKE NO MISTAKE; the experts have declared that we have entered into the era of health care consumerism. Paddy Padmanabhan, CEO of Damo Consulting, a management firm that works with healthcare management and technology says that we are still in very early stage, and most of the health care consumers are still unaware of all the choices that are available.

2. TECHNOLOGY AND DATA-ANALYTICS WILL TAKE CENTER-STAGE: In the new world of healthcare consumerism, technology and data analytics will be instrumental in determining the efficacy of patient engagement. Understanding healthcare consumers will require healthcare companies to have access to comprehensive information about their medical and non-medical data, including non-traditional data such as, from social media and wearables.

3. MORE CHOICES FOR THE CONSUMERS: With the ongoing shift to high deductible health plans and expensive facilities, consumers are kind of forced to shop around and make informed decisions about where and how they are going to receive healthcare and from whom. Those who don’t plan well to cater to the patient’s needs might face a blow.

4. HEALTHCARE IS JUST LIKE ANY OTHER INDUSTRY: When it comes to providing services, healthcare is no different from any other industry. It is a myth to think that customers don’t bring the same expectation about customer experience to healthcare that they bring to retail or technology companies. Survey results suggest that when it comes to customer focus, both healthcare and non-healthcare companies are expected to provide excellent customer support. Other qualities identified are delivering on expectation, making life easier and offering higher value.

5. CONSUMERS DON’T MAKE FACT-BASED DECISIONS: Yes you heard it right; consumers don’t make researched decision when it comes to the healthcare industry. Many of them are not aware of the critical factors that they need to consider to be able to get the most out of the healthcare providers. Previous positive

experiences play a bigger role in choosing the healthcare provider.

6. EVERYONE’S USING TECHNOLOGY: You do not see the whole picture if you think that it's only the young demographics that use technology to manage their health and healthcare needs. A considerable number of people from different age groups are also dependent on social media and technology to share their ideas of wellness.

7. EASE OF ACCESS IS KEY: It is not rocket science to try to understand why ease of access is critical when it comes to healthcare. If you or your loved one needs medical attention, you want to make sure that you have easy access to the services.

8. CONSUMER SEGMENTATION IS VITAL: Segmenting patient population seems like a smart idea since patients

approach healthcare with varied levels of sophistication. Taking lessons from the retailers, healthcare companies should invest in a well-defined consumer segmentation to address specific needs and perspectives across a customer base.

9. EDUCATED CUSTOMERS MIGHT BE HELPFUL: As mentioned previously, the consumers do not really make a research-based decision while thinking of healthcare. It might be a good idea and useful for a business to try and educate the consumers by familiarizing them with the recent data and analytics so that they can make a more rational decision.

10. TRUST IS VITAL FOR ANY INDUSTRY, EVEN HEALTHCARE: Building a trustworthy relationship with the consumers is the mantra of many retail industries. The same thing can be applied to the healthcare industry too, even to a greater degree.

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/ Special Interview / SDG

Asif Ibrahim Vice Chairman, Newage Group of Industries Chairman, BUILD

successful in achieving significant progress in the MDGs, it is expected to make an early start for the SDGs as well. Born in Dhaka in 1965, Asif Ibrahim is the Vice Chairman of Newage Group of Industries, a business house which specializes in the manufacture and export of ready-made garments, textiles and plastic products. He received his formal education from the University of Delhi (India) and the University of North Texas (USA). The Ministry of Commerce in Bangladesh awarded him the Commercially Important Person (CIP) status in the year 2007 & 2012 for his contribution to national exports. Asif Ibrahim is a former President of the Dhaka Chamber of Commerce and Industry (DCCI), the largest trade body of Bangladesh, from 2011 to 2012. He is currently the Chairman of Business Initiative Leading Development (BUILD), a public-private dialogue platform to expedite the policy reforms to enable private sector led economic growth of Bangladesh. He is in the board of Federation of Bangladesh Chamber of Commerce and Industry (FBCCI) and is the Chairman of the Privatization Standing Committee of FBCCI. Ibrahim is a member of the Executive Committee of Bangladesh Employers Federation (BEF) and also the Director (Operations) of Bangladesh Philippines Chamber of Commerce and Industry (BPCCI). He is also the former Chairman of the research cell of Bangladesh Garments Manufacturers and Exporters Association (BGMEA).

Helping Create a Better Investment Climate

We have had eight meetings with the PSDPCC since 2013 and we have been able to submit a significant amount of reform proposals some of which have been accepted by the government which has helped with compliance and cost-saving issues for the private sector.

What are your thoughts on our Sustainable Development Goals?

Bangladesh’s performance in terms of the Millennium Development Goals (MDG) was remarkable. The Sustainable Development Goals (SDG) are slightly different and were designed after several sessions of consultation with various stakeholders including Governments, CSOs and representatives from the private sectors, worker groups and labor unions. It has been developed on a bottoms-up approach and it is a commitment that has been signed by all the governments of the world. Since Bangladesh was so successful in achieving significant progress in the MDGs, it is expected to make an early start for the SDGs as well. A national committee will be formed very soon to follow up on the implementation of the goals. The private sector’s involvement will also be encouraged so that the implementation process along with the follow-up and monitoring processes are done smoothly.The sector will play a key role in ensuring we reach our targets, particularly from the components of financing and investing.

How can governance, transparency, innovation and inclusiveness help us with the SDGs? The four key pillars will be governance, transparency, innovation and inclusiveness. As I had mentioned earlier it has to be a

combined effort from the Government and the private sector stakeholders. Everybody has to be engaged to make sure that the goals are met. Due to this proper governance will be a key factor from the Government’s side. Transparency must also be ensured in terms of the rule of law and in terms of establishing proper check and balance in the overall structure of procedures. If this can be maintained then the proper monitoring and implementation of the goals can be achieved. Every country’s private sector will have to make massive investments and Bangladesh is no exception in that regard. In the 7th Five Year Plan it has been projected that around 77% of the investment must come from the private sector and the balance will come from the public sector. This is where innovation and inclusiveness will play an integral role. Over the last fifteen-twenty years we have gone through major changes in terms of industrialization and have consistently achieved 6-6.5% growth. However, for us to move forward, we have to reduce income inequality. Over the next fifteen-twenty years, if we are to see even more prosperity for the country, the marginalized people or the people below the poverty line must be lifted out of that state. This will only be achieved by creating meaningful employment opportunities through innovations in the Small and Medium Enterprises (SMEs). The SMEs will play an important role in coming up with small scale innovative technology based projects such as infrastructural projects or projects through social media campaigns which will greatly help the country and its people.

Is the idea of the SDGs clear to our business community? What is required for them to get associated with the development sector? The private sector must realize that in order for the SDGs to be met, we must have a change of mindset. I feel that the private sector can indeed be the champion in terms of this changed mindset by coming forward and settinga few examples. Something that can be used as an example, although it was mandatorily applied, is the post Rana Plaza remediation measures that have taken place in the Ready Made Garments sector. This example can be replicated in other industries, especially in the textile industry, which is a big polluter. I feel that the industry leaders must come forward on their own set up the effluent treatment plants and water treatment plants to ensure that the environment is not damaged while they are setting up their factories. We have to set up these industries and create employment as every year there are three million people coming into the workforce in Bangladesh but we must make sure they are green and environment friendly. Also, in order for this to happen there has to be adequate sources of financing made available, at low rates of interest, to the private sector. Here the donors can come forward and encourage people to make the right investments. We talk about the Green Climate Fund (GCF) but we need to ensure the proper matchmaking between the people with the fund and the field level entrepreneurs. The GCF is available but the people who can properly utilize it do not know how to access it or aren’t aware of it.

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conditions and employment. It also looks to address the issue of the development of a common platform for labor law reforms. The existing labor laws in many countries are very poor. However, Bangladesh has reformed its labor laws so it is trying to serve as an example for other nations. In the future we want to shape this into a SAARC chamber so that migration and labor law issues can be properly assessed on a regional level and not just on the national level.

Since most of these funds come through bureaucratic systems and the government offices, proper governance and transparency will play a major role. Public-private dialogues must take place for us to solve these problems.

How does BUILD set itself apart from its contemporaries? BUILD is the first public-private dialogue platform in Bangladesh. It is a joint initiative of the Dhaka Chamber of Commerce and Industry (DCCI), Metropolitan Chamber of Commerce and Industry (MCCI) and Chittagong Chamber of Commerce and Industry (CCCI). BUILD has been set up to use the public-private dialogue platform to make policy reforms to create a better investment climate in Bangladesh. BUILD has four thematic working groups. First is the Trade and Investment working group, then we have the Financial Sector working group. Next we have the Taxation working group and finally, we have the SME

Development working group. Businesses, associations and chambers bring forward their agendas of policy reforms into the working group meetings. These issues are discussed in details after which BUILD takes up the responsibility of conducting research along withmapping and reverse engineering the processes in the bureaucratic offices. It then creates reform proposals, which try to identify cost-saving and timesaving avenues for the entrepreneurs so they can move forward and create that better investment climate. Once these reform proposals are prepared, they are then presented to the Private Sector Development Policy Coordination Committee (PSDPCC). The PSDPCC is a high level committee set up in the Prime Minister’s office and chaired by the Principal Secretary of the Prime Minister. All the secretaries and agencies who are relevant for private sector development are members of that committee along with private sector

representation from FBCCI, DCCI, CCCI, etc. We have had eight meetings with the PSDPCC since 2013 and we have been able to submit a significant amount of reform proposals some of which have been accepted by the government which has helped with compliance and cost-saving issues for the private sector. This initiative is different from the traditional advocacy of chambers and associations as the public body is also involved in the overall structure, which makes the process a lot more inclusive.

What has organizations like SAFE being doing to improve the conditions of migrant workers? The South Asian Federation of Employment (SAFE) is an employer’s organization, which is represented by members from Bangladesh, India, Pakistan, Sri Lanka and Afghanistan. The organization and its representatives have been meeting over the past three-four years to find a common ground whereby we can address the issues of migration, labor

What sort of policy level actions would you suggest to improve the level of skill development of our workforce? There is the National Skill Development Council (NSDC) in the Prime Minister’s office. The NSDC’s plans and programs need to be followed up in a much more planned and efficient manner. The committee needs to meet on a regular basis and their efforts need to be strengthened in terms of addressing technical and vocational training. There is a tremendous need for it and I think it can be done sectorally. The government and the private sector can work on this in a much closer manner, as well. We from the Bangladesh Employers Federation will be organizing an international summit for skill development at the end of this year where we will be addressing issues such as upgrading the skills of our migrant workers. Their technical skills need to be developed so it would give them the ability to remit greater amounts.

/ Interview / Apparel Industry

Md. Asadul Islam Managing Director, ASROTEX Group

You see, entrepreneurs like Bill Gates or Professor Yunus did not establish themselves in one day. By the dint of their hard work and perseverance, they have built their individual empires. Md. Asadul Islam is at the helm as the Managing Director of ASROTEX Group. ASROTEX is a vertically integrated knitwear solution provider and has manufacturing units in Gazipur and Narayanganj. The group started its journey in 1995 and now has 7 units, 175 productions lines and a workforce with 14000 people. Its exports amount to around $140 million worth of knit apparels across the world with a product basket encompassing all premium quality products for all market segments. It is an ISO certified company where the entire value chain is compatible. ASROTEX Group aspires to become a $500 million company by 2021. In line with the vision, garments will contribute $400 million, and $100 million will be from other components such as Agro and FMCG.

Adhering to Ethical Practices

No matter what our business was, we always paid full attention to the compliance issues. We learned the business practices from a practical point of view and implemented the standard operating procedures on our own.

Tell us about how you began your business. Being born in an extended family I enjoyed a great childhood. However, growing up in the 70s introduced me to the ugly face of poverty among the people in my surroundings. During that time, Bangladesh was a new nation mostly dependent on aid. This gave me an early impetus to do something for my fellow countrymen. So after completion of my Masters in Economics from Dhaka University, I engaged myself in building my business. It was the early 90s and the apparel industry was in its teething stage. I have had my ups and downs but I didn’t allow my mistakes to pull me back. Today I can proudly say that around 15000

families are dependent on the earning from our business, and that gives me a great sense of pride.

You are a successful businessman, driven by ethical business practices. Where did you get it? Like many other fellow businessmen, I had a humble beginning. Starting as a petty supplier, I have brought my group to this position over a span of two decades. As it grew, we ventured into the real estate, FMCG and energy sectors. No matter what our business was, we always paid full attention to the compliance issues. We learned the business practices from a practical point of view and implemented the standard operating procedures on our own. For example, we came up with our consumption procurement ordering process, which is less time consuming. I am grateful to our IT department for that. The zeal to innovate and be compliant has to be embedded in the DNA of one’s company from the very beginning. That’s what pushes us forward.

What are your suggestions to encourage other people to engage in entrepreneurship? You see, entrepreneurs like Bill Gates or Professor Yunus did not establish themselves in one day. By the dint of their hard work and perseverance, they have built their individual empires. I am hopeful about the youth of our country who are innovative and industrious. Some, however, lack proper funding and guidance. From the government’s side, creating a favorable ecosystem for startups is very

much needed. On the other hand, businesses should also understand what the government expects from them. If we do business, a lot more taxes will be deposited in the national exchequer. It is also found that in the time of crisis, in Malaysia and Thailand, governments came to help businesses. Even during the recession, the Australian government began to support people by providing funds to raise their purchasing power. For the economy to move forward, a concerted effort will be needed.

What are the challenges in garments sectors? Recently, Transparency International Bangladesh (TIB) has raised some issues of corruption by the private sector. You must understand that the apparel industry here is a part of a massive global supply chain. There are multiple scopes for anomalies. If there is a system, there is also a provision for a counter system. Every company has their scope and profit target. Definitely there are some loopholes but isn’t that prevalent in every other sector? The apparel industry is fast changing, and heavily dependent on fashion trends. Productions depend on what kind of buyers we are catering to: there are basic attires for brands like Wal-Mart as well as high-end products for Zara or H&M. Another trend is becoming popular: online sales. One thing requires reminding that July-September is a lean period for Bangladesh in doing business with the USA and European market where

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marketing people who understand the international trends better since market dynamics vary around the world. What works for Chinese buyers may not work for their Western counterparts. Even our local fashion market is going through changes to cope with which, we have to have market analysts and trend pundits. All of these will require a workforce that is trained in proper schools in respective fields and have experiences. The industry is therefore looking forward to employing more of such people who have honed their skills and can add new value. Business, as usual, will not do anymore.

What is the rewarding side of being an entrepreneur and what is your next business plan?

we have taken a different strategy to penetrate in South Africa and Australian market and this period there is summer. As RMG is a labor-intensive industry and Bangladesh has a vast working force, we expect to employ more people in days to come. In addition, to rev up the production processes, adoption of the latest technology will help us remain on par with the changing horizon of the RMG sector. We are facing price pressures, which is critical to note here. Besides, there are also environmental challenges and the Bangladesh bank is also leveraging funds for green industries in single digit arrangements.

There is still a massive shortfall in case of skilled manpower in the apparel industry. Whatâ&#x20AC;&#x2122;s your take on that? Skill development is one area where we still have a long way to go. As the Bangladesh apparel industry goes up the value chain, we are receiving work orders to produce more and more world-class products. Gone are the days when we were just making t-shirts or vests. Now we make dress shirts or designer lingerie. To perform better and in a sustainable way, we need to understand the importance of skill development of our designers, managers and workers. We need to have

I firmly believe that an entrepreneur is a maker of his own fate. This is the most rewarding factor. Throughout my life, I have learned it the hard way from practical experiences. Nevertheless, the hardship of being an entrepreneur has consistently pushed me to try harder. My success in the apparel industry has encouraged me to venture into a new project, where I am trying to create accommodation for our employees and staff, which is a big problem for many of them. At the same time, I would like to expand my business in the future to ensure better brand visibility of my company.

/ Interview / Women in Business

Selima Ahmad President, Bangladesh Women Chamber of Commerce & Industry

Since its inception we have been working in the BWCCI to help facilitate the greater emergence of female entrepreneurs in Bangladesh. Selima Ahmad is a renowned business personality. As a successful businesswoman with longstanding experience in the private sector, Selima took the initiative to form the Bangladesh Women Chamber of Commerce (BWCCI) devoted exclusively to facilitating the advancement of women entrepreneurs. She is also the Managing Director of Nalita & Company Ltd., the Vice Chairperson of the Nitol Niloy Group of Industries and the Global Ambassador of the International Alliance for Women (TIAW). She is the recipient of numerous accolades which include the 6th CACCI Local Chamber Award 2014, the Jean J. Kirkpatrick Award 2013, and the 2010 TIAW World of Difference 100 Award.

offices in seven divisions. Since its inception we have been working in the BWCCI to help facilitate the greater emergence of female entrepreneurs in Bangladesh.

From your years of experience in the field, how has the progression of women developed? How are you contributing to their development?

Safety and Security

In our country there is a lack of safety and security. A simple example of this is the fact that women are wearing veils for protection as opposed to religious purposes.

What was the driving force that propelled your involvement in business? I was continuously involved with the mainstream of the business world. I was elected the director of the Federation of Bangladesh Chamber of Commerce & Industry (FBCCI) twice but I resigned during my second term to organize a chamber of commerce and industry for women, the BWCCI. After obtaining a temporary license for seven years, we grew into an organization of 6,000 members from all sectors with

Our state has given equal rights to men and women and in the future this will lead to greater facilities for the latter. The constitutional laws for women are helping the cause for equality but there is still a great deal of ethical progress that needs to occur. The external pressures that are imposed by our society and backdated mindsets hamper the equality of women as contributors to our society. A womenâ&#x20AC;&#x2122;s development into an entrepreneur and leader starts with education. I am currently working to build academies in Gazipur and my hometown, Comilla to help with the development of women.

What are some of the requirements for women to advance? In our country there is a lack of safety and security. A simple example of this is the fact that women are wearing veils for protection as opposed to religious purposes. There needs to be greater implementation of laws which help women in these regards along with the proper punishments being applied to the offenders. The incidences of torturing women and claiming dowry are still matters of great concern and these practices must be eradicated. We must realize the economic contribution that women can create if they are given equal

opportunity. In the next three years, we will ensure that 9,000 female entrepreneurs will know their rights and responsibilities. The Prime Minister and the government have taken the initiative and now it is time for women to raise their own voices.

You are working on creating better democratic rights. What is the status of this field? How are you working for this cause? Democratic rights and development go hand in hand. Business development is a significant component in this. We need to develop human resources in order to progress a society. I am currently working on the methods through which the private sectors can contribute to society. I also believe that we must raise awareness of the rights that have been given to women. They are unaware of the laws that are in their favor and their fundamental rights. We are also working on sources of that are environmentally friendly and sources of renewable energy. In Haiti, we have built environmental facilities through which women are making traditional products to market in the mainstream. These projects need to expand throughout the world especially in developing nations.

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/ Interview / Agency

Rabeth Khan CEO of MACOMM and MediaAxis;

Managing Director at Creinse Limited

Brands - to agencies are like patients to doctors - each patient is different, and so is each brand. Rabeth Khan is the Chief Executive Officer of MACOMM (Official Affiliate of Dentsu in Bangladesh), MediaAxis (Official Affiliate of Carat/Dentsu Aegis Network in Bangladesh) and the Managing Director of Creinse Limited. He is the recipient of the Bonze Ward at Adfest in 2010 and 2011. Rabethâ&#x20AC;&#x2122;s company received the Jury of Asiaâ&#x20AC;&#x2122;s Most Promising Brand in 2012 and 2013. Over the years, he has built up a diverse work portfolio comprising of advertising, brand communication, entertainment and international music events.

Changing Perceptions We wanted to change how clients and brands perceive ways to get closer to consumers. Additionally, we wanted to modify the ways how consumers engage with brands.

Your company focuses on six areas of marketing and advertising communications. How do you maintain an organization that serves so many purposes? Given our ten years of experience, we have witnessed that the advertising industry has shifted from any agency side of one point in which there are multiple specialized agencies to one company with collated services abilities. We have experienced the change in the dynamics which has allowed us to adapt to the various aspects of marketing and advertising communication. We have numerous sectors that cater to specialized requirements. MACOMM, the initiating

force of our aspiration specializes in brand management, creative services, brand architecture and events. MACOMM has recently become the official affiliate of Dentsu in Bangladesh. MediaAxis, the official affiliate of Carat/Dentsu Aegis Network is the media planning, media buying and digital arm of the group with independent operations and team resources. Under the integration with Carat/Dentsu Aegis Network, MediaAxis also represents the digital verticals of the Dentsu Aegis Network companies such as Isobar and i-Prospect.

Your business’s perception is “Changing Perspective”, what does this mean for your company? The mantra, “Changing Perceptions” has been around since the business was born in 2005. We wanted to change how clients and brands perceive ways to get closer to consumers. Additionally, we wanted to modify the ways how consumers engage with brands. There was always the aspiration to become a change maker in the field of advertising and brand management.

MACOMM and MediaAxis are concerns that handle international brands and clients, what are the challenges in attracting and keeping these clients in Bangladesh? As our agencies are aligned with one of the best advertising and communication agency groups in the world, the challenge to perform consistently is the key. International brands and clients expect international

levels of work capability and transparency from us. These perspectives are a part of our core value and ensure continuous success.

You are the official affiliates of Dentsu in Bangladesh. What impact has this made on your company? With MACOMM being the Official Affiliate of Dentsu in Bangladesh and MediaAxis being the Official Affiliate of Carat/Dentsu Aegis Network, the international collaborations and affiliations have transited us to new levels of exposure and learning regarding the international standards and practices of global advertising. The business has one of the best teams on a global scale, pitching for the world’s best businesses and brands and obtaining these clients for our agency. And with Dentsu being the strongest Japanese origin agency handling more than 75% of the top 100 brands of Japan, we have the added advantage of knowing the Japanese ways better than anyone else

Are there are any other interesting collaborations for MACOMM we should know about? As an agency, we have aspirations to expand out of

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advertising agencies are equally talented and competent as the individuals in other sectors. I disappointed about the way the banks and financial institutions regard the business of advertising agencies. Advertising and agencies together churn out more than Tk 2,000 crore of revenues annually. However, banks list us in their nonpreferred categories and do not give us any form of financial assistance other than a simple personal loan worth Tk 10 lac maybe. There are no financial business schemes or work order financing for us either.

the country, and we already have started conducting some projects in Singapore and Sri Lanka. We want to consolidate further in this area. In 2 years time, we also want to become the best digital agency in the market in areas of planning and execution of digital campaigns. Experiential and events are also high focus areas for us, as they provide opportunities for stronger consumer engagement and innovation.

Your agency handles clients who wish to advertise numerous products. Are there particular protocols for each type of product? Each brand or product needs individual analysis, insights and strategizing. Brands - to agencies are like patients to doctors - each patient is different, and so is each brand. Under our agencies, we have handled product categories such as

tourism, consumer electronics, telecom brands, mobiles phones and notebook PCs all of which have different branding structures.

Given that the bulk of your company’s turnover is from foreign clients, is there any particular ad agency that you have learned from? When I started my agency, I had the clear intention to focus on working with international brands. There were a few reasons for that – working with international brands help you to learn the international best practices faster. Also, I felt the international clients value the efforts of agencies better in terms of appreciation and financial returns and international clients, in most cases, stay with agencies for a prolonged duration if agencies deliver them with

efficiency and results.

What are some of the barriers and challenges that you face with advertising that is particularly prevalent in Bangladesh? Honestly, when I started my agency, I thought the advertising industry as a whole had fewer challenges than other sectors. As I grew I was proven wrong. A majority of the local clients still perceive agencies as vendors and suppliers and have a tendency to dominate agencies. I strongly feel if the client has a brand manager, then the agency should also have a brand manager as both works for the same brand and manages the same brand. Socially, families and relatives still feel that working in advertising agencies is not the same as working in other sectors. A perception that needs to change. People in

You have started a company from nothing, what has been your inspiration throughout your journey as an entrepreneur? What advice would you give to those starting a new business? I have indeed started my business out of nothing from the balcony of my house. I have taken some great strides but there are still many more miles to go. To become an entrepreneur, one needs to set their goals, work towards their goals with the ability to endure failure, have an endless amount of patience, have a fearless and uncompromising attitude and have the ability to work 25 hours a day. One more aspect of today’s added struggle to stay afloat as an ethical entrepreneur is to have the energy to battle unethical ways and corruption. My motto is to dream, to dare, to do – practicing it will help one to reach closer to his/her goals.

/ Interview / Media

Fakaruddin Jewel Head of NTV Online

We’ve created a user-friendly website, where people can find everything. Fakaruddin Jewel’s career in journalism began through the Prothom Alo. During his 12 years of experience as journalist, Jewel has worked in various departments. In 2011, he took over the responsibilities of Prothom Alo’s online news section. In 2014 he joined NTV and initiated NTV Online. In February 2015, NTV Online was launched. In the first year, NTV gained 4th position among the Bangladeshi online portals. According to Socialbakers, the organization which investigates the mechanisms of social media, NTV’s page is the fastest growing page in Bangladesh. After 11 months of launching NTV Online, Google announced them as their executive partners.

Formidable Social Media Presence We are present in Reddit, Viber, Pinterest, Linkedin, as well as Youtube. We are firmly connected to each and every social media that is part of the global trend.

lot of opportunities in this line of news, and while working for it, I got completely drawn in. You can accommodate everything through social media; as a result, I was able to introduce online journalism to NTV as well.

How did you help establish NTV’s online news system? The trend of online news began with Prothom Alo back when social media or Facebook wasn’t used frequently by the masses. We would share the news via Facebook which resulted in a fan following of around 530,000 people. Now that we’ve joined NTV, we managed to form a web team here as well. Members of the team must share news on time, monitor the fan base (i.e. likes on Facebook) and keep tabs on the feedback we’re receiving. We always keep a record of all these activities in softcopies and hardcopies.

What major differences have you observed between the two forms of media?

How did you decide to make the transition from print media to electronic media? During my 12 years at the Prothom Alo, I had worked in all the departments starting from being the Shift In-Charge, National Desk Chief and going through the reporter’s copies. I also looked after one of the most difficult tasks of designing the layouts for their first page which I did for one and half years. Those who had to work their way up to get the position of News Editor must also perform that duty at some point. After that, I was the second man of Prothom Alo’s online news section for three years. I was quite fond of that position because the medium of work was rather interactive. There are a

There is a vast difference between online and print media. There are a lot of web portals in Bangladesh for electronic media which are replicas. Unlike replica based news media, we opt for legitimate portals which provide quality videos. Viewers should not have trouble believing the story we air particularly because it is substantiated with a video. That is why our viewers continue to follow us for the authenticity of our news. We also prioritize photography in this context. Hence, we’ve subscribed to ten international services for photographs. If you go

through our photo catalogs, you will see that there isn’t a single celebrity who hasn’t done a shoot for us. They were enthusiastic enough to take out the time to be a part of these shoots. We also provide circulation of photos; so if you’re going through one particular segment of pictures, you’ll be able to view a reel of pictures. Our photograph and video quality are what sets us apart from basic online media.

What can you tell us about the content on your website? We’ve created a user-friendly website, where people can find everything. Our content is such that it caters to everyone; be it religion, entertainment or lifestyle. We have videos to go along with our news, but that’s not the only thing that keeps it running. Same applies to the photograph and news section. www.icebusinesstimes.net

How do you decide on the relevance of the content you display on your website or Facebook pages? Over the years, you gain experience to understand what qualifies as news. We also look at the readersâ&#x20AC;&#x2122; interests as well. Using Google Analytics helps us greatly in finding out what content our readers or viewers are most interested in. After a certain point, going through these analytics gives you the experience of knowing what content our followers will find most attractive.

The NTV Facebook page is nearing 4,000,000 followers. How have you maintained such a massive fan base?

Our content is interdependent on one another.

What changes can we expect in 2016? Weâ&#x20AC;&#x2122;ve had a lot of changes, such as the availability of Netflix in Bangladesh. There will come a time when TV and news will be available online. There are endless opportunities in the digital space considering that Facebook and internet users have increased drastically. I noticed that

there 1.5 million users on Facebook, but on websites, there are only around 30 lac users. Most of these people use Facebook more than they read the news. There are 50 lac users who, despite having internet connections, refrain from visiting news websites. We have already established some free WiFi enabled areas such as Karwan Bazar, TSC and near Dhaka University. The introduction of 4G this year will have a massive impact as well.

We are present in Reddit, Viber, Pinterest, Linkedin, as well as Youtube. We are firmly connected to each and every social media that is part of the global trend. The more traffic we have in our sites, the more revenue we generate. 30% of this traffic depends on Facebook; however, on the days we didnâ&#x20AC;&#x2122;t get Facebook, we managed to keep our ranking intact as we are present in other social media outlets as well.

What kind of business model are you using? We follow a global business model. It is impression based. We use CPM-cost per mille, CPC-cost per click and CPA-cost per acquisition. These models are running in Facebook. CPM determines revenue every time the audience views your content.

/ Special Event / Next Big Thing

Innovation Xtreme 2016

“Bangladesh: The Next Tech Frontier” March 19th, 2016 saw the return of the highly successful Innovation Xtreme platform with a new theme, Bangladesh: The Next Tech Frontier. SD ASIA, one of the largest content and event making platform for Bangladeshi tech startups, organized the second installment with the country’s largest telecom

operator, Grameenphone, as the lead sponsor. This year’s Innovation Xtreme had Microsoft as its Gold Partner, along with IPDC, top-of-mind, The Daily Ittefaq, Tech in Asia, and Facebook as the event partners. The event had a diverse group of participants, including students, developers, academics, corporate, international organizations, and local & international media. It brought over twenty five local startups and twenty five renowned industry experts under one roof, at Radisson Blu Water Garden Hotel. Representatives from Google, Facebook, Microsoft, MasterCard, Uber, Top Of Mind, Fenox (Venture Capital), BASIS Razor Capital, Segnel Ventures, IMJ Investment Partners, Chaldal.com, GoBD, BDJobs and numerous others were present at the event. www.icebusinesstimes.net

Representatives from Google, Facebook, Microsoft, MasterCard, Uber, Top Of Mind, Fenox (Venture Capital), BASIS Razor Capital, Segnel Ventures, IMJ Investment Partners, Chaldal.com, GoBD, BDJobs and numerous others were present at the event.

This year’s sessions were designed to promote Bangladesh as the next tech hotspot with expert guidelines being provided by the people making it happen. It saw attendees directly plug into the burgeoning tech ecosystem. With a focus on networking, interactivity and access to high-profile ecosystem participants, attendees were encouraged to interact with each other, share ideas and form potential investment partnerships. Attendants who flocked in from various areas of the business spectrum were exposed to over three hours of guided ‘networking’ time throughout the day to help them seek out the right opportunities. It provided the startups with a platform to delve into their products with experts, potential investors, corporate buyers and customers. The event was divided into twelve interactive sessions, where local and international industry experts reflected upon the promising future of Bangladesh’s tech startups. They also discussed how investors could help Bangladesh’s startup

ecosystem grow further to be able to perform on the global stage. The speakers also talked about the challenges tech startups face under the Bangladesh’s socio-economic system, and the ways big corporations and the government can improve it. Innovation Xtreme kicked off with opening words from the founders and co-founders. Mustafizur Rahman Khan, CEO & Founder of SD Asia, said, “Through this one-day event, we will showcase the potential of existing innovators and entrepreneurs in Bangladesh. By bringing both international and local investors along with other entrepreneurs and businesses under one roof, the event works as a catalyst to deepen the interest about the Internet-based local economy.” Fayaz Taher, Co-Founder and CFO of SD Asia, went on to state, ‘This year’s Innovation Xtreme is much bigger than the first time we organized it, because now we have more entrepreneurs and investors who are interested in Bangladesh’s startup ecosystem.’ Samad Miraly, Co-Founder of SD ASIA said, “Tech is fun because it’s new. It changes the way we do things for the better. And Innovation Xtreme is the best place to experience tech in Bangladesh”. After the opening speeches, Zarif Munir, Partner & Managing Director of Boston Consulting Group stepped in with his keynote speech in which he said, "We are in the era of ‘me’. This era revolves around social networks and is about looking at the world around you and creating a network that is powerful, strong and economic. If you are in the business of technology in Bangladesh

then you will know that these are the words that define the future." Next Shameen Ahsan, President of BASIS went up to speak about the growth of the ICT sector and his vision for its future. “Our vision is to be among the top five global destinations. As such, we are inviting global players to invest in Bangladesh and become a part of this glorious journey.” With the theme of ‘Bangladesh: The Next Tech Frontier’, the event was aimed towards showcasing Bangladesh’s entrepreneurial ecosystem and giving a platform to local startups to meet the investors. Therefore, the objective of this year’s Innovation Xtreme event was to highlight the technological and economic potential of Bangladesh in front of a diverse community. Representatives from globally recognized firms such as Google, Facebook, Microsoft, Uber, Fenox (Venture Capital), Segnel Ventures, MasterCard, IMJ Investment Partners were present during the panel discussions. They were involved in panels which discussed investments in startups as well as the role of global tech giants in the of promotion local startup communities in countries like Bangladesh. The event also had investor speed-dating and networking sessions where local startups had the chance to pitch in front of investors. All the participating tech startups received Microsoft’s BizSpark/YouthSpark packages (worth $10,000). The top six startups (Tripooly, Let’s Eat, Sheba, LightCastle Data, Repto and CHALO) won the Facebook Start-up packages, worth approximately $50,000 USD.

Fight or Flight

/ Special Report / Aviation Industry

By Debojit Saha

Kaizen CRS takes an expanded look into the Aviation Industry.

The aviation industry is defined as the global transportation network that carries goods and passengers by air. While air travel became possible in the early 20th century, the aviation industry now generates billions of dollars in annual revenue. It also provides essential

services to numerous other industries, from medicine and national defense to tourism and sports. In this report, the primary focus is on the commercial flights that carry passengers only. Though aviation as an industry is fairly new, it has made some rapid technological progress over the years as the world opened up to travelers for leisure trips, education, business,

adventure, medical tourism, religious travel and so on. If we look at how the number of air passengers have changed globally from 1972 to 2014, we see that over the years more and more people are choosing to fly. Despite the maturity of the industry in 1972, this year marked the start of necessary innovations that would transport the frequency and availability or air travel. The average industry growth rate for global passengers is around 6% and in 2014 the industry served 21,493 million passengers which is a 102% increase from the year 2002 (a decade ago) when it served 10,656 million passengers.

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TraďŹ&#x192;c of Global Air Passenger 2.5E+10 2E+10 1.5E+10 1E+10 5E+09 0 1972197419761978198019821984198619881990199219941996199820002002200420062008201020122014

Figure 1: Traffic of Global Air Passenger; Source: http://data.worldbank.org Note: Air passengers carried include both domestic and international aircraft passengers

TraďŹ&#x192;c of Air Passengers From Bangladesh 3500000 3000000 2500000 2000000 1500000

Figure 2: Traffic of outbound passengers in Bangladesh Source: http://data.worldbank.org Note: Air passengers carried include both domestic and international aircraft passengers

1000000 500000 0

Air Passengers From Bangladesh

In order to understand the air travelers of Bangladesh, Kaizen CRS conducted a survey among 200 respondents who have travelled at least once in last six months and the survey generated some interesting insight. The survey aimed to examine a travel destination mix for air passengers in Bangladesh and according to the survey, 33% of air passengers in Bangladesh are domestic travelers and 66% of them travel for international destinations. The domestic destination preferences are depicted in the following chart: 38% 40% 30%

25% 18%

19%

20% 10% 0%

Chittagong Cox's Bazaar Sylhet

Figure 3: Choice of domestic destination for air passengers

Jessore

A similar trend can be observed in Bangladesh as well. Air passengers were very minimal after the Liberation War and the numbers remained negligible until 1972. However, since then there has been a gradual increase in the number of air passengers in Bangladesh as well. Figure 2 explains the trend of air passengers in Bangladesh. In 2014, the aviation industry of Bangladesh served 3.1 million passengers which is 103% increase from 2002 when the total air passengers in Bangladesh was around 1.5 million. The average growth of the industry in Bangladesh is around 5% which is comparable with global industry growth rate. Figure 2 shows that since 1972, the number of air passengers have always increased except for the 2007-2008 period when there was a political crisis in the country. Following that period, the absolute number of passengers is growing and the aviation industry in Bangladesh looks very promising.

The purpose of air travel varied among the respondent groups. The most common reasons were tourism, business, travel for job/training, religious activities etc.

Tourism

21%

25%

Business

5% 1% 47%

Study

Religion Service Others

Figure 4:Purpose of travelling by air

The chart on travel purpose explains the reason for the popularity of Chittagong in terms of air travel. Chittagong as a destination caters to wide range of audience from business to service, to sports &tourism and therefore is the most popular spot. Additionally, there is high frequency of flights and airline choices for flying to Chittagong making it a more accessible destination. Additionally, this factor increases the popularity of the city.

Choice of Airlines: Airline evaluation criteria

Air passengers base their travel choice on a number of factors related to available air routes and flights as well as other elements involved in business or leisure travel choices. In specifically choosing between airlines, passengers balance the trade-off between the following: - Travel Cost: The combination of airfare and the cost of getting to and from origin and destination airport. - Travel Time: The total time between origin and destination points including ground access to and from the airports, flight time and airport processing inclusive of any anticipated delays. - Comfort and convenience: The value of travel time in air is affected by factors such as the class of air service, the type of aircraft, the differential preference between time spent on road, in air craft and airport. In short the cost of travel time is compared with how time is spent on the journey. - Risk/Reliability: The choices of flights vary depending on the trip comfort level, previous experience of flight cancellation, airport congestion, response to bad weather etc. - Additional features include ease of booking flight, corporate deals with office, etc.

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The weight of the evaluation criteria of airline as deduced from the survey is given below:

Travel Cost (Price) 33%

Travel Time 20%

Comfort & Convenience 30%

Risk & Reliability 13%

Others 4%

Price is the key issue for air passengers, therefore the study tried to gain insight on what are the sources of fund for the air travel and the results are as follow:

20%

Note: Air passengers whose flights are sponsored by their offices or other external entities seldom have control on the choice of flights and therefore corporate deals with these offices dictate which airline transports the passenger. However, the data shows that a large part of air travels are still self-financed either by the traveler him/herself or by their families.

42%

Family Self Financed OďŹ&#x192;ce

38%

Respondents Profile: Total Number: 200 Male: 52%

Female: 48% 2% 35+ Age

Age Group

19% 20-25 Age

79% 25-35 Age

38%

29%

Executive 27%

Professionals example Lawyer, Doctors 21%

31%

Businessperson 19% Student 10%

Housewife 2%

ONLINE SEARCH

Brand Switching Characteristic of air passengers:

35% 21%

I am ok with ﬂying in anyairline as long as I get ticket

I like to experiment

SUGGESTION FROM TOUR OPERATOR

Key Takeaways

Air passengers gravitate to the a preferred brand as the survey revealed that 40% of the passengers tend to remain loyal to their preferred choice of airlines but the composition of the remaining 60% of passengers seem to offer promise of grabbing market share for any airline. Around 35% are satisfied with travelling in any airline which means ease of booking and level of brand awareness play a key role in winning these passengers. On the other hand, 21% of passengers are open to different ideas therefore unique deals or packages may entice these travelers’ decision.

I always ﬂy with my preferredairline

People are gradually relying on their individual search for airline options. Ease of booking through websites and suggestions from tourism/frequent travelers in online communities are becoming the primary sources of information for deciding on an airline. Therefore, if airlines want an increased number of passengers to experience their services, they should engage with the community of frequent travelers. As the survey reflects, word of mouth is growing into the decisive factor for a passenger’s choice of flight.

Occupation:

Other 21%

40%

Airline Search Pattern

I research for best deals

• Smarter Flight Schedule:Travelling by air for domestic destinations is yet to be popular among air passengers. The most popular domestic destination for air travel is Chittagong and part of it is because there are more flights to that destination. This is also a key factor in generating traffic in the city. • Encourage passengers to experience flying: To popularize other domestic destinations, airlines may come up with attractive offers to encourage passengers, for example, Syedpur which is a fairly new domestic destinatio is slowly becoming popular among passengers for the an attractive deal of two tickets at the price of one. Thus as more passengers experience the flights, they become accustomed to considering flights as a mode of travel. They also acquire an idea regarding the factors of evaluation criteria of airlines: Travel Cost, Travel Time, Risk & Reliability, Convenience & comfort, Baggage handling, etc. • Win Heart Share: Even though 40% of air passengers are loyal to a brand, the remaining 60% decide the market share of airlines. It is important that airlines work continuously to improve passenger experience so that they tend to choose their airline over other options. • Stay in touch of passengers: With the exception of passengers whose travels are financed by their offices, passengers prefer to conduct research on an airline before booking a flight. Therefore engagement with frequent travelers through activation or online presence will increase the chance of an airline being chosen. www.icebusinesstimes.net

Feature / G&R

The Growing Green & Red Network G&R embarked on its journey in 2009 with a portal called ‘Goromcha,’ which encompassed classified news, events and many other facets.

Initiating their vision with two founders and a team of twenty two, Green and Red Technologies Limited (G&R) is the first and largest ad network in Bangladesh. G&R embarked on its journey in 2009 with a portal called ‘Goromcha,’ which encompassed classified news, events and many other facets. “When we first started out, we knew we wanted to build an internet based company. However, we weren’t entirely sure about what it would be” recalls Muhammad Nazimuddaula, Co-Founder and CEO of G&R. “With Goromcha, we realized that a significant

challenge is how to monetize a website, and to do that, the idea of an ad network first came to our minds” This allowed for the emergence of the ad network in August 2011. Today, G&R is the local Digital Advertising Network in Bangladesh with over 4000+ local websites and apps within its network. Through this robust system, a brand/company can reach up to 20 million Bangladeshis who browse the internet from both their desktops and mobiles every day. G&R also helps them build new online marketing channels that can impact their business in more measurable and innovative ways than the traditional media channels. G&R’s

mission is to make the internet work for Bangladesh. Because of the rapid growth of the relevant sector, recently, G&R has also introduced local mobile ad platforms which enable advertisers, ad agencies and other online media buyers to acquire quality local mobile traffic. G&R consists of two departments - Product and Business. The Product Department has two sub-departments which are Engineering and Design. They work on the core ad network development. Also, the Design Department caters to publishers and advertisers who may require any creative service. The Business Department is made up of a Publisher team

that maintains the publisher’s relationships and Sales Team that is in charge of bringing new markets and maintaining liaisons with advertisers. "Since its inception, G&R has assisted local publishers to monetize better their websites and apps and advertisers to enhance their online reach. Our Publisher team regularly works with local website and app owners to earn revenue from their web and mobile inventory," said Ayub Shahrear, Head of Partnerships at G&R. “The first challenge we faced was to educate the publishers and advertisers about ad networks,” said Rezaur Rahman, Chief Product Officer of G&R, “The

other challenge was to develop our product, and we had to invest a lot on local Engineers who didn’t have sound knowledge on the concept.” It was a challenge that G&R overcame, paving the way for others to enter the market. However, G&R has maintained their top position. Lutfi Chowdhury, Vice President, Sales & Partnership of G&R, informs that they have some unique features that are of international standards, an attribute that distinguishes them from their competitors. He stated, “G&R is currently the number one ad network in Bangladesh, and we are bigger than Google in the local inventory.” It was in February 2015 that G&R was acquired by the UK

based leading ICT Company GenEx Infosys Ltd. When asked about how the acquisition has altered the functionality and management of the company, CEO, Nazimuddaula said that much of the changes that were brought about were positive. The team mostly remained the same while there were certain aspects regarding accountability and management, which has become more streamlined. He further postulated, “There is also a common problem with cash flow that most businesses face in Bangladesh. There was an imbalance between what we’re getting from selling to the advertisers and how much we were paying to the

publishers. We’ve sorted that out and now we even have the costs for house campaigns and promotions covered.” G&R currently has a platform to serve 20 million impressions per day & 600 million impressions per month through a network of 4000+ local websites and mobile apps. Their current advertiser portfolio includes major telecommunications groups, FMCGs, financial service providers, e-commerce firms, international airlines, small and medium enterprises and so on. These numbers are growing with the continuous success of the company. The founders have lofty expectations in the coming years, the first being that by 2016, they are projected to serve over 2 billion impressions. The company will concentrate more on those who want to campaign with a small budget and eventually turn G&R into a household name. G&R have also started a new partnership with Future Startup. The initiative has been dubbed “Promoting Bangladesh 2016”. The partnership was formed to encourage quality local websites and mobile apps grow further and make profits. In turn, more local jobs are created, more money stays in Bangladesh, and local internet users can find quality services that apply to their lives.

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/ Advertorial

GD Assist : A True Health care solution provider beyond borders GD Assist takes care of all of your needs while visiting Malaysia for medical tourism. From consultation and appointments at the best Malaysian Hospitals, VISA, Ticketing, Accommodation and Transportation, we cover all aspects of your tour at affordable rates. Malaysia is reputed as one of the most preferred medical tourism destinations with modern private healthcare facilities and highly efficient medical professionals. In 2015, Malaysia was ranked the world's best destination for medical tourism by the Nomad Capitalist. Malaysia was also included in the top 10 medical tourism destinations list by CNBC. The Malaysia Healthcare Travel Council or better known as MHTC was established under the Ministry of Health Malaysia, bringing together the nation's dual heritage of hospitality and medical innovation, highlighting Malaysia as the preferred healthcare travel destination in the Asian region. As an initiative under the Ministry of Health Malaysia (MOH), its ultimate purpose is to promote and position Malaysia as a unique destination for world-class healthcare services.

Inspired by a steady rise in the number of Bangladeshis seeking healthcare in Malaysia, the Southeast Asian nation is eyeing Bangladesh as a lucrative market for its internationally accredited hospitals. The number of such patients from Bangladesh going to Malaysia has doubled over the last five years to around 20,000 in 2015 “We are expecting 25,000 to 30,000 patients annually [from Bangladesh] in the next two years,” Kavitha Mathuvay, regional director of market development at the Malaysia Healthcare Travel Council (MHTC), told a team of journalists during their visit to Kuala Lumpur from December 7 to December 10. Most of these patients seek treatment for cardiac and orthopedic problems, according to the MHTC, an agency working under the Malaysian health ministry to promote medical tourism. Several lakh Bangladeshis travel overseas for treatment every year, but most of them visit India, Singapore, and Thailand. MHTC officials said they want to get a share of these patients in Malaysia, as treatment cost there is 30 to 40 percent less than that of in Singapore and Thailand as well as healthcare quality is of high standard in at least 68 internationally accredited private hospitals in Malaysia. “Being geographically close, it is feasible for us to treat critical cases like heart surgeries and cancer treatment,” Kavitha Mathuvay said. For that, the hospitals offer packages of health screening

for three days and two nights in the weekends. They also have five-day packages, Kavitha said. For a critical patient, she said, there is always a fear of travelling. “If a doctor says that a surgery is needed, we always want to hear from a second or a third doctor.” She added that they were providing the second or third opinion service to the Bangladeshis in Bangladesh. “We send our doctors to Bangladesh so that patients there can bring the medical records and meet our doctors for the next course of action. It is not an obligation that if they see Malaysian doctors, they have to come to Malaysia. If you have the service at your home country, have it there,” she said. However, if a patient is willing to travel, the MHTC will support his or her treatment in Malaysia. MHTC also works through its

representative in Bangladesh -- GD Assist, a subsidiary of Green Delta Insurance Company (GDIC). Zalifah Yasmin Ibrahim, corporate executive at the KPJ Healthcare Berhard in Kuala Lumpur, said Bangladesh and Malaysia have many similarities, including weather and halal food. “So, Bangladeshi people travelling to Malaysia would not find it difficult to stay and get treatment,” she said. Dr Kumara Gurupparan Ganesan, cardiologist at the National Heart Institute in Kuala Lumpur, said the hospital has state-of-the-art technologies to treat cardiac patients. Drawn by the facilities, many Bangladeshis are now coming to this hospital for cardiac treatments, he said, adding that some Bangladeshi doctors are also working there.

Awards and Recognitions: International Medical travel Journal (Medical Travel Awards 2015) - Medical Travel Destination of the Year 2015- Malaysia - Excellence in Customer Service – Gleneagles Kuala Lumpur - Best Quality Initiative of the year- Imperial Dental Specialist Centre - Best Travel website of the year- Ramsay Sime Darby Healthcare - International Cosmetic Surgery Clinic of the year – Beverly Wilshire Medical Centre - International Dental Clinic of the year – Imperial Dental Specialist Centre Reader’s Digest Asia Gold Trusted Brand Award 2015 in the “Private Healthcare” category - KPJ Healthcare - Ramsay Sime Darby Health Care - Pantai Hospital Kuala Lumpur Frost & Sullivan’s Malaysia Excellence Awards 2015 – Hospital of the year: KPJ HealthcareMHTC- member hospitals with accreditation.

/ Artificial Intelligence / Technology

Innovation Next

BIG COMPANIES ARE BETTING LARGELY ON ARTIFICIAL INTELLIGENCE. HERE IS A BRIEF ACCOUNT.

By Sheahan Nasir Bhuiyan

T All three innovations are extremely exciting and can lead to massive advancements across many sectors.

he concept of Artificial Intelligence (AI) has been around for years now. Back in the 90s, the Terminator franchise portrayed a possible future dominated by AI. A similar storyline was used in the Matrix trilogy. We havenâ&#x20AC;&#x2122;t quite reached that level as of yet, but astounding progress has been made in the field in recent years. In 2014, a computer program called Eugene Goostman, which simulates a 13 year old Ukrainian boy, became the first computer to have passed the Turing Test. The Turing Test was developed by Alan Turing in 1950 to test the ability of a machine to exhibit intelligent behavior similar to, or indistinguishable from that of a human being. Although the results were disputed by some, it is nonetheless an amazing feat. We will further look at a few more innovations which can drastically alter everything we do in the very near future:

Nadine

eet Nadine, who works as a receptionist at Singapore’s Nanyang Technological University (NTU). She is just like every other receptionist, very friendly and outgoing, and even remembers you from previous visits. The big difference is that Nadine is a robot. Named after NTU professor Nadia Magnenat Thalmann, Nadine is a lifelike humanoid who can shake hands, and exhibits her own personality and emotional range. Professor Thalmann, the director of NTU’s Institute for Media Innovation, led Nadine’s development and claimed that robots like her (it?) will be ready to be deployed into real life scenarios very soon. Nadine is powered by a software similar to that of Apple’s Siri and she has the capability to act as a personal assistant or a companion. Her applications can range from receptionist to companionship for the elderly and the young. Thalmann claims that such innovations could provide part of a solution in developed countries where the ageing population will reduce the size of the workforce in the near future. This leads Star Wars fans to look forward to the prospects of having their very own C3PO or R2D2 droids!

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IBM Watson

AlphaGo ack in 1997, headlines were created when IBM’s Deep Blue defeated chess Grandmaster Garry Kasparov to become the first artificially intelligent machine to beat a reigning world champion under regular time controls. IBM achieved this feat by calculating all possible end games and then choosing the best move. In March 2016, Google’s AlphaGo defeated world champion Lee Sedol 4-1 in the ancient Chinese game of Go, a feat far more impressive than Deep Blue’s achievement. While it is possible for a computer to calculate all the end games in a chess game, it is impossible in the game of Go. The possible outcomes in a standard 19-by-19 grid is 10,761, which is more than the number of atoms in the observable universe. Thus to defeat the world champion, AlphaGo needed to exhibit human-like intuitive behavior which it skillyfully mastered. There were instances when AlphaGo made unpredicted moves and completely stumped Lee. AlphaGo is an algorithm developed by Google which is capable of self-learning and tackling different problems. Prior to playing Go, AlphaGo was used to play other video games such as Space Invaders, Breakout, Pong and others. No specific programming was required and AlphaGo mastered each game by a process of trial and error to showcase its abilities to learn from previous experiences. This was done by creating a network of hardware and software much like the web of neurons in our brain. Just as we seek rewards, the algorithm can be programmed to seek rewards in the form of better scores in games. Such an ability, to analyze millions of gigabytes of data and then making high-reward choices all in a short time span can lead to thousands of applications in the future, way beyond gaming.

BM’s Watson may be the most exciting artificial intelligent being out there, or at least the one with the most promising real life application to date. Initially created to appear on the TV show Jeopardy, Watson is a question and answer machine which is capable of understanding natural language alongside machine learning to provide answers from a huge swathe of unstructured data stored in its system. Similarly to AlphaGo, it started out playing games but since then has progressed to more useful applications, especially in the health sector. Watson has three critical components which make it what it is: 1. the ability to understand natural language, 2. having access to an enormous corpus of data and information, and 3. the machine learning aspect. Machine learning is described as the ability of the machine to improve the accuracy of its answers by being told what is right and wrong over time. Watson remembers the answers and over time improves its abilities to answer patient questions. Watson has access to millions of pages of medical journals and patient data and is able to provide recommendations to physicians. A doctor needs to describe the symptoms to an iPad app in regular spoken English for the app to give a recommendation. A key human attribute is our ability to recognize patterns. Till now, this ability has given us an edge over machines. Often a doctor is able to provide a diagnosis just by hearing your symptoms. Watson has nullified that advantage and for as little cost as an Ipad app!

All three innovations are extremely exciting and can lead to massive advancements across many sectors. However, several prominent tech gurus have warned against the uncontrolled advancement of AI. Elon Musk compared AI to be potentially more dangerous than nuclear weapons while Steve Wozniak has said, “Will we be the gods? Will we be the family pets? Or will we be ants that get stepped on?” in response to AI. Quite some dark thoughts, but AI will create job losses once advanced enough. Much like how automation decimated blue collar workers, programs like AlphaGo and Watson will threaten white collar jobs. But the loss of one type of job will lead to other new jobs. Just like we went from being weavers and spinners to aircraft engineers, we can go from being white collar workers to who knows what in the future.

/ Tech / Smartphone Prices

Flagship Smartphones: Overrated? Are you getting enough of a bang for your buck?

et’s face it – we are all attached to our gadgets, in varying degrees. Our smartphones, in particular. Most of us are so reliant on them nowadays that it’s hard to even imagine a life without them anymore, and with good reason. When smartphones first came into being, they were luxury products that were well above the

affordability ranges of most people. Even when the form factors of smartphones started to change after the advent of the iPhone (which, mind you, was not the first of its type – there were other touchscreen-only phones available before it, but the iPhone was the first one to go so big), the price paradigm,

unsurprisingly, remained unchanged. If anything, Apple seemed to have cemented the destiny of smartphones to be the overpriced sci-fi-like tools of the elite, not affordable by paupers without being saddled with a multi-year contract with a mobile operator. Want it off-contract (as we do with phones in www.icebusinesstimes.net

Bangladesh)? Prepare to pay upward of $600 at the very least. Things got even crazier when other manufacturers entered the game with smartphones of their own. However, Apple had already set a bar with its premium pricing, and the other manufacturers, perhaps in fear of appearing ‘cheap’, chose to stick to the premium pricing plans for their flagship hardware. These manufacturers also made mediocre lower-end smartphones to cater to markets which were not willing to pay nearly as much. By this time, China had decided that it had manufactured enough smartphones for other nations, and they started making and exporting their own original and knockoff smartphones based on their learnings, ranging from sub-par to downright amazing handsets that anyone would be proud to own, with something catering to every budget. It didn’t take very long for the ever-industrious Chinese to realize what features customers with shallow pockets would actually want to have on their sets, and they put that knowledge to good use. Before long, the Chinese started to add little touches of convenience that the bigger brands would be very late to catch up to, if at all – starting with the ability to stick multiple SIM cards in a phone and have them all on standby simultaneously, eliminating the customers’ need to buy and carry two separate phones. The Chinese knew better than anyone that not everyone buys phones as fashion accessories, and

It didn’t take very long for the ever-industrious Chinese to realize what features customers with shallow pockets would actually want to have on their sets, and they put that knowledge to good use. instead of making every phone a svelte slab you can slice bread with, they boldly stuffed giant batteries into many of their phones, letting them survive for days even over heavy use, putting utility before beauty. Some phones even eliminated the very basic annoyance of having to plug in earphones to access the FM radio, allowing people to blast their favorite radio hits from the absurdly loud speakers (yet another great feature which many high-end manufacturers neglect to include to this day) of their phones. Needless to say, the unique feature sets of these phones, combined with their ridiculously low prices, made them immensely popular among customers looking to economize. However, the most interesting twist to this story is one of twofold development. Google (sorry, Alphabet’s) Android is the primary choice of operating system for almost all of these sets. The developers of Android had spent years optimizing their code, trimming fat and squashing bugs while adding amazing new features (which were being aped by Apple’s iOS in a most ironic reversal of past events). Translation:

Android now runs far smoother and further on low-specced devices, while consuming even less battery. And secondly, mobile hardware started to grow more advanced at quite a fast rate, and what was state-of-the-art and super-expensive even last year came to be classed as low-spec for this year’s run of sets. While this doesn’t sound like much, consider this – after pushing a certain threshold, some upgrades become rather superfluous. A 720p display may not be the choice of phone elitists anymore, but it is more than adequate for most users, because it is miles ahead of the grainy 360p/480p displays of yesteryear, beating the ‘threshold of comfortable usability’ by a mile. By next year, the chances of 1080p displays being listed as low-spec are not low at all. What does this mean? People can get way more for much less now, and the gap between the elite flagship smartphones and their cheaper counterparts is steadily shrinking. I switched to a Chinese-made Symphony Xplorer H175 after my Samsung Galaxy S6’s screen died. The H175 cost me Tk 10,500. Do I miss the vibrant 1440p display and

the incredible camera of the Tk 65,000 (at the time of its purchase) Galaxy S6? Yes, I do. But anything else? Not really. Rather, the snappy performance of the H175, combined with its microSD card slot and gigantic 4,000 mAh battery (which offers me more than 6-7 hours of 720p screen time on a single charge, as opposed to the S6, which conks out after a couple of hours of use), has left me pleasantly surprised, and I can safely say that it’s good to finally have a phone that can keep up with my kind of brutal usage. And the best part? It’s so cheap that even if it dies on me after its one-year warranty period is over, I can easily get a new set for a similar price (I keep all my stuff auto-backed up on the external SD card), perhaps something with a 1080p display and an even larger battery, instead of being stuck with something that costs many times as much. I can upgrade to my heart’s content. Moral of the story? Unless you are terribly image-conscious, love to bleed money after seeing fancy marketing gimmicks, and show off your super-expensive tech, don’t get the flagship handsets. When buying a laptop, it’s usually very easy to tell the difference in performance between a cheap one and a more expensive one, but that isn’t the case with phones. If you are a practical person, before you buy your next phone, do some research. You can get any feature you want on your phone for less than half the price of a flagship – be it a waterproofed chassis, a great camera or a fast CPU.

/ Corporate Fitness / Sleep Deprivation

Hello Corporate Bangladesh, Are you getting Enough Sleep?

You better be asking yourself this question before itâ&#x20AC;&#x2122;s too late So, where will you be sleeping today? As you move high up the corporate ladder, besides responsibilities, you are burdened increased stress. You burn the midnight oil unproductively and then, during day time, you just snooze like a nomad. Special IBT Report

ife of a bottlenose dolphin is marvelous. Be it a sleepy blue ocean or a stormy sea, they glide through the mighty currents with an unparallel ease. What makes them more mysterious and amazing is their ability to cross

thousand miles of an ocean asleep. Yes, you read it right. They can sleep and swim simultaneously. I bet you also wish to enjoy something similar in your fast moving corporate life. Unfortunately, that is not possible. You are not

allowed to sleep and attend corporate meetings at the same time. Your yawning face will surely irk your client; your diverted attention will hamper the meeting; your productivity will plummet and all these may land you in the

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jeopardy of missing the next big promotion or even losing the job. Sleep is still a mysterious land where scientists would love to have many adventurous trips. Ever wonder what sleep does to your body? You must be thinking there is nothing to ponder. Because you think you already know what sleep does to you: it refreshes your body. Well, contrary to the common belief, sleep really does not have any affect on your muscles. Any prime biological function that sleeps can restore is yet to be discovered. So, what does it do? Why we all crave for it after certain time? The fact is sleep means a lot for your mind. A good night rest benefits your brain largely. While you doze, your brain review and consolidate all the information it gathered while you were awake, suggests one study. There are also speculations about brain getting rid of wastes and gather fuel for the next day. Which is why, we need at least six hours sleep to have a properly functioning brain with adequate judgment quality, happy mood, sped up reaction time and proper capability and accuracy to solve problem. This essay, a pile-up of information from the journal Sleep, will try to show what valuable blessing you have been missing these days. A decade ago, a survey was undertaken to look into how much people work for every hour of sleep is lost. What they found is not applicable in today’s context, as now people work 30 minutes more at the cost of one-hour sleep, which was almost four times lesser than what it was ten years ago. This means sleep deprivation due to work-related stress is on the rise. However, the ‘why’ behind the sleep deprivation vary from country to country. While stress is the menace that‘s stealing away z’s from the eyes of a major portion of Americans, Indians and Singaporeans; people from Brazil, Taiwan and Germany are just way too busy to hit the sack early and wake up early. As many of you might argue that there has hardly been a day when you missed work for sleep deprivation induced ailments or insomnia. Right you are. Nevertheless, what you did not know is though you come to your work all gussied up, inside your brain, you are tired and that is not good news for your productivity levels. An article published in TIME magazines informs that insomnia costs the average American worker 11.3 days, or US$2,280

Insomnia costs the average American worker 11.3 days, or US$2,280 in lost productivity each year. That adds up to US$63.2 billion (and 252.7 workdays) for the whole country.

in lost productivity each year. That adds up to US$63.2 billion (and 252.7 workdays) for the whole country. Maybe you are a surgeon who is trying to make a balance between your govt. job and private practices; may be you are a corporate banker who has loads of accounts to take care of. Many a time you just ignore a good night rest and try to stay awake for hours at a stretch. Did you know that your brain ‘checks out for night’ whether you go to bed or not? But before it takes a rest, it give you some sign: you yawn. A study published in Sleep magazine reveals that if you are awake for 18 hours continuously, your reaction time begins to slow from a quarter of a second to half a second and then longer. In a condition like this, at least for the time interim, you try to stay awake by gulping mugs of coffees down your throat, burning sticks one after another or just by chatting up with colleagues. Nevertheless, be sure that this is not going to work. Many a time you doze off in an office meeting or while driving for a short period, which according to scientists are phases of micro sleep. During this moment, you snooze out for anywhere from 2 to 20 seconds and find yourself driving in a different lane or reading the same lines. As serious sleep deprivation rampages the brain activity severely, your eyelids start to sink more rigorously and by the 20-hour mark, you begin to nod off. Your reaction time, studies show, is roughly the same as someone who has a blood-alcohol level of 0.08--high enough to get you arrested for driving under the influence in 49 states of the USA. You forget to do things like double-check the spelling of a name or set the brake when you stop on a speed breaker. So, next time, you fall asleep in a deal signing ceremony or in the midst of a negotiation, think twice before blaming it on the weather or the boring session: be sure it’s your sleep deprivation eating into your efficiency. The cost of sleep deprivation is more than what one can anticipate. Feel free to embrace obesity, diabetes, cardiovascular disease and psychosis if you are one of those millions of short sleepers of this digital era. In addition, contemplating how about becoming someone like Debraj Sahai, the epic character of a patient of Alzheimer’s disease portrayed by Amitabh Bachchan in the movie Black? Yes, long-term sleep deprivation is sure to take

a toll on your memory. Studies have found that for each hour of sleep you lose, ‘level of psychological distress rises by 5 per cent’. Those who fail to sleep adequately are 14 per cent more like to come to the psychiatry department of a hospital with symptoms of psychological stress. The youth are usually the victims of such sleeplessness and in the course of time can suffer further from mental health troubles like ‘full blown depression and even bipolar disorder’, revealed a research compiled by Professor Nick Glozier. However, you are yet to hear the worse. Short sleepers are unlucky people as another study indicates that insomnia can cause premature death due to heart attack and stroke. Once your sleep cycle becomes irregular, many of you take a resort to sleeping pills. How many of you know that those pills can cause you diseases like lymphoma, lung, colon or prostate cancer associated more than cigarettes? This was found in a research co-directed by Dr. Daniel Kripke, of Scripps Clinic, USA. The research documented a 35 percent increased risk of cancer among people taking sleeping pills, compared with the non-prescription group. Dear dedicated corporate Bangladesh, hope the discussion above has made it clear as to what sleep means for your physical fitness and productivity. It is of no doubt that every day you get at least 6 hours of seamless sleep. To ensure that the first thing you should do to identify whether you are sleep deprived at all. ‘Accept it if you really are; there is nothing to hide or embarrassing. In fact to be physically fit, you need to come out to your boss and try to sort out things like: taking some less work loads for sometime, until your sleep pattern is back on track,’ advises Doctor Lutful L. Chowdhury, coordinator and senior consultant-gastroenterology, Apollo Hospitals Dhaka. He also suggests to learn how to draw a line between your office and bedroom. Try to be done with your work mostly in the office. Home is sweet until you keep it safe from the bitterness of the office work. Talk with your colleagues and make sure the workload is shared properly so it does not becomes too much for one person. If you have a boss who does not send you mail and expect replies at the wee hours of night, consider yourself lucky. CEOs and managers should also shun the habit of bugging subordinates after the office hours as that stresses them out and

The youth are usually the victims of such sleeplessness and in the course of time can suffer further from mental health troubles like ‘full blown depression and even bipolar disorder’.

is sure to take toll on productivity if it becomes chronic. Your lifestyle and food habit also have something to do with your sleep. During office hours we usually love to indulge ourselves with shots of caffeine or energy drinks. Yes, some of them those can keep you awake for hours but ultimately tells upon your health in the long run. Try to avoid them when you really feel like taking a nap in the afternoon. To beat your mid-afternoon slump, try some refreshing snacks like nuts or yogurt, which is good for your stomach and brain. Having a routine life is necessary. Before you go to sleep, try to enjoy a brief period when you can relax forgetting everything on this earth. Read a good book, take a warm or cool bath according to the demand of the season, drink a cup of chamomile tea, which increases your body temperature and helps you sleep fast or just do some meditation. Do not pursue into any kind of exercise at last three hours before snoozing. Turn off your cell phone or keep it in vibration mode. Try to sleep on a comfortable bed placed in a dark, cool, and noise free ambience. Try not to take sleepovers during weekend mornings as that disrupts your circadian rhythm and makes you more prone to insomnia and sleep deprivation over the weekdays. In addition, the word power nap is not just an ornamental word. It does invigorate your mind and help you get back to your usual level of productivity. NASA conducted a study to check whether small naps can be beneficial for its pilot and what it finds is stunning: a 26-minute nap increased pilots' performance 34 percent. Name just one management strategy that will help improve your performance to a stunning level, can you? So, next time you are yawning continuously-which usually happens when your brain is deprived of ample amount of oxygen- go get a walk in the fresh air or take a nap. Understanding the importance of offering small napping facilities, there are cool offices around the world one of which even offered special ‘relaxation room with US$4500 massage chairs, headphones and a four way dimmer for the lights’. Companies in Bangladesh may not be that much rewarding but what they can do here is inspire people to take naps when long work our is concerned, which is sure to increase their productivity with a renewed vigor.

www.icebusinesstimes.net

/ Different Perspective / Career

Entrepreneurial Moonlighting

Start Your Venture While You Are Still Employed By Sabrina Afroz Erina

SET UP YOUR MIND

SAVE MONEY

PUT YOUR JOB FIRST

Starting up your business besides your 9 to 5 job will require you to be ruthlessly efficient.

One of the most important reasons of starting business while you are still employed is to ensure financial security.

Dedication is a key to earn success in your venture. But you cannot compromise your job at the outset of your business.

Be mentally prepared for all the worst case scenarios. Take a look at the things that will be absent from your life for the time being: holidays, long sleeping hours, going out with family, procrastination, useless chatting, care-free net browsing etc. Even after sacrificing your sleep, fun and comfort you may or may not like the business after staring it. Bear in mind, you can lose money but you cannot- lose your confidence.

Spend your salary very wisely and save maximum portion of it. Think twice before spending on any luxury item. You can always save that money and buy something classier in the future.

Your commitment towards your current job leaves a trademark of ‘sincerity’ on you, which will facilitate you to earn peoples’ trust and this trust factor will aid you in the future. Moreover, you never know whether your business is going to sustain or not; to be on the safe side you should, therefore, carry out your job sincerely. However, do not take such responsibilities which you cannot accomplish.

BUILD A STRONG NETWORK

You have to work on your networking skill. The colleagues and boss from your business can be your potential customers. Try to build good relationship with the people you meet in the course of work. You never know whom you will need to contact for your business.

aving a steady job with a regular paycheck surely is a secured way to lead your life whereas an entrepreneurial venture is mostly viewed as a dicey effort. Even though, many people want to get rid of the corporate fetter to unleash the ‘entrepreneur’ inside. They come to a point in their career where they have to choose a path between two; one being smooth and another being bumpy. You can always choose the smooth one but at the end of the path you will be working under the same owner; may be with a higher salary than the one you started with. On the contrary if you choose the bumpy one, at the end of the path either you will own a company & give job to others or at the worst case, you may become bankrupt. A lot of people dream to be an entrepreneur but they are often perplexed at this junction of their career. Are you also facing the same quandary about which path to choose? This month, Ice business Times is going to present you the safest way to take risk, the guidelines on how to start your business while you are still working.

SET UP GOALS

You have to carry out all sorts of financial calculation before starting your business. Firstly, calculate the projected demand and expected revenue. Figures like required rate of return, projected Net Present Value (NPV) will tell you whether to take the project or not. You must set your priorities correctly as you will need to let some of the things go. Determine the initial investment amount and figure out the time required to save that amount of money. You have to set goals in your brain and visualize the whole scenario; otherwise you will be lost in the middle.

MAINTAIN WORK ETHICS

Don’t use your job hour for your business purpose. And be very careful so that your business does not conflict with your company’s interest. Do not deal with your employer’s client as part of your business. You cannot use any confidential information that you came along during the course of your job. Examples of confidential information include: customers information, company’s trade secret etc. The safest way to avoid all these is to run a business different from your current job. Otherwise, any conflict of interest with your employer would create legal complications.

MANAGE TIME

It’s really difficult to manage time to do a job and a business together. But you have to utilize every second of yours properly.

DON’T ADVERTISE IN YOUR OFFICE

Do not brag about your venture too much in front of your colleagues although that might sound very tempting to you.

You have to stop chit-chatting with colleagues during free time. Rather you can utilize that time to develop your business model or to contact a potential client. However, do these if you are not engaged in the company work. Instead of going out for a lunch alone, set up a meeting with your investor or buyer during the lunch or you can check the mails while eating. Thus you have to be a crackerjack of multi-tasking.

Bragging too much may make your boss think that you are utilizing the company time for your business or it may hinder your future promotion as people will start seeing you as a temporary employee who may leave anytime. This will harm you terribly in case your business does not grow in a good shape as re-building your deteriorated image would be extremely difficult.

Entrepreneurship does not necessarily mean that you have to throw everything at once and take impulsive decision. By taking calculated decisions, you too can be a great entrepreneur. Have faith on yourself, your idea, and your dreams. Composure is the most required thing in this journey which you can’t afford to lose. It you have a fixed target, no matter whether you take small or giant steps, you will definitely reach there one day. www.icebusinesstimes.net

/ On the Book Shelf

Democratizing Global Media: One World Many Struggles, Edited by Robert A Hackett and Yuezhi Zhao. Lanham, MD: Rowman & Littlefield, 2005 By Sohana Nasrin

T 92

he concept of media participation is astoundingly complex on multiple levels. Carpentier, Dahlgren and Pasquali (2013) argue that the levels of complexity arise because of media participation is a conflation of two similar forms of participation, which can be termed participation in the media and through the media. The consistent forms of participation are similar to the way by which many scholars distinguish between democratization in and through the media (Carpentier, Dahlgren & Pasquali, 2013). Historically, the debate about the definition of participation matters for contextualizing the early phases of participation in media production. The prolonged argument as to whether the shift from traditional print methods to the internet will lead to

media democratization has shifted towards the more modern medium. With conventional methods increase the participation of institutionalized politics, the internet allows more non-media professional to produce their own content, creating a more eclectic base of a source through which information is relayed. Being interested in the democratization and participation process, I chose this book in discussion in an attempt to find the history and strategies of democratization of media worldwide. Democratizing Global Media explores the multifaceted relationship between globalizing media and the spread of democracy around the world. An international interdisciplinary group of journalists and scholars discuss some contentious issues such as the power of media, the benefits of media globalization and the political role of media. It can be argued that in the title of Hackett and Zhaoâ&#x20AC;&#x2122;s book, the word democratizing has a dual meaning. If used as an adjective, it expresses the democratic potential of the global media, whereas if taken as a verb, it implies a necessity to make the global media more democratic. The motivation behind the book appears to be the necessity of a global media reform as the editors and writers in the book firstly draw the issues and challenges of the rapid development of the market driven communication system on a global scale (Hackett & Zhao in chapter 1, Hafez in chapter 7, O Siochru in chapter 10, Hackett & McChesney in

Democratizing Global Media explores the multifaceted relationship between globalizing media and the spread of democracy around the world.

chapter 11), secondly offer different kinds of theoretical and practical framework for building of the global media democratization movement (Hackett & Zhao in chapter 1, Hackett & McChesney in chapter 11, O Siochru in chapter 14). In addition, strong impacts of the media globalizations are inspected on the national level. The contributions in the book are grouped under three headings: Media Globalization and Democratization Deficits; Media and Democracy in Global Sites and Conflicts; and Modalities of Democratization. The first section contains essays on the democratization of

media scenario in Eastern Europe, China, India, Latin America and Africa. The second section is more of a conceptual essay section that highlights the important regions within the globalization debates. The third section leans towards practical implications and focuses on issues like the critical role of gender discrimination and of feminist activities in media reform, peace journalism, and the whole media reform scenario in the United States. Downing (2007) singles out three different kinds of essays that he thinks really moves forward the dialogues challenging the traditional and existing knowledge base- they are: the essays by Thomas on current media scenario in India, Zhao on China and Aginam on the African Continent and Sreberny and O Sciochuru on transnational communication. Downing (2007) observes that Thomas inclusively shreds away some of the existing myths about the robustness of democracy and democratic media in India. Zhao accentuates the ever-intensifying class divide in China and the ways that divide enables the country to access and exclude from global communication map. According to the same source, Aginam confronted with an impossible task of analyzing media in all 53 nations in Africa and discusses the democratization of media and all other prominent aspects of the phenomenon (Downing, 2007). In addition, the essays on peace journalism by Oberg and Lynch and McGoldrick certainly add a dimension

of media in the current period. Peace journalism, being a topic of importance for the last century, needs much attention and understanding, as the essays suggest. Hackett and Zhao (2007), apart from their valuable contribution in assembling all the empirical information from all over the world, also suggest potential targets and a strategy of the global media democratization. They elaborate upon social agents such as global and national civil society organizations and transitional NGOs dedicated to the genuine democratic developments. These social agents can be placed in the center of the struggle for global media reform, which the editors suggest should be generated by four major fields of action: â&#x20AC;&#x153;building independent media, finding openings for progressive messages in corporate media, media education and building coalitions for media reformâ&#x20AC;? (Hackett, P. 242). With these strategies in mind, the book portrays a clear message that the time to reconsider global media development has materialized. The big corporations and the capitalism to sustain them can only allow for the media to relay the story from a limited perspective. It is time media reformers and activists raised their voices against such capitalistic stratagem and bring forth a method that ensures participation in the form of democratization so that the stories from distant villages are given an equal voice.

www.icebusinesstimes.net

/ Capital Market Update

Top Ten Companies by Turnover Value for this fortnight February 16-29, 2016) Sl. No. 1 2 3 4 5 6 7 8 9 10

Name of the Securities Bangladesh Steel Re-Rolling Mills Limited Lankabangla Finance Com United Power Generation & Distribution Company Limited IFAD Autos Limited Lafarge Surma Cement Beximco Pharma Square Pharma Aman Feed Limited Quasem Drycells Singer Bangladesh

Category

Value in Tk. mn

Volume in Nos.

% of total Value

A A A

2,354.56 1,928.41 1,596.48

13,165,031 54,308,818 9,636,586

5.55 4.54 3.76

A A A A A A A

1,304.59 1,291.33 1,046.53 957.77 889.25 885.43 755.44

13,362,061 16,239,382 11,401,373 3,574,486 16,321,621 7,557,025 4,120,526

3.07 3.04 2.47 2.26 2.09 2.09 1.78

Top Ten Companies by Turnover Volume for this fortnight February 16-29, 2016) Sl. No. 1 2 3 4 5 6 7 8 9

Name of the Securities Lankabangla Finance Com United Airways (BD) Ltd CMC Kamal Fu-Wang Ceramic One Bank Limited United Commercial Bank Ltd. Tallu Spinning Zaheen Spinning Limited C & A Textiles Limited

Al-Arafah Islami Bank

Category

Value in Tk. mn 1,928.41 306.01 708.72 568.22 493.65 512.27 552.50 501.05 207.27

% of total Value

A A A A A A A A A

Volume in Nos. 54,308,818 45,294,821 37,231,093 32,848,856 31,967,825 24,667,258 22,452,243 21,222,684 20,351,385

19,450,697

284.12

1.72

4.80 4.00 3.29 2.90 2.82 2.18 1.98 1.87 1.80

Top Ten Gainer Companies by Closing Price for this fortnight February 16-29, 2016) Sl. No.

1 2 3 4 5 6 7 8 9 10

Name of the Securities

Lankabangla Finance Com Sinobangla Industries CMC Kamal Bangladesh Steel Re-Rolling Mills Limited Prime Islami Life Phoenix Finance Zaheen Spinning Limited Dafodil Computers Premier Cement Mills. Fu-Wang Ceramic

Category

Current Fortnight Closing Price in Tk.

A A A A

40.80 37.60 21.30 204.30

A A A A A A

72.00 24.50 25.20 23.40 97.80 17.60

Last Fortnig ht Closing Price in Tk. 29.40 28.90 16.40 168.70 60.50 20.90 21.70 20.50 86.00 15.50

% of Change

38.78 30.10 29.88 21.10 19.01 17.22 16.13 14.15 13.72 13.55

Value in Tk. mn

1,928.41 548.90 708.72 2,354.56 197.69 249.27 501.05 200.29 457.40 568.22

Average Daily Value Traded Tk. mn 214.27 60.99 78.75 261.62 21.97 27.70 55.67 22.25 50.82 63.14

Top Ten Loser Companies by Closing Price for this fortnight February 16-29, 2016) Sl. No.

Name of the Securities

Category

1 2 3 4 5 6 7 8 9 10

Libra Infusions Limited Prime finance Delta-Brac Housing Kay & Que Summit Alliance Port Limited Quasem Drycells Gemini Sea Food Linde Bangladesh Limited Kohinoor Chemicals Shurwid Industries Limited

A Z A Z A A A A A Z

Current Fortnight Closing Price in Tk. 411.50 8.20 105.10 17.50 38.90 106.70 557.60 1,123.30 343.20 10.70

Last Fortnig ht Closing Price in Tk. 531.90 10.50 130.20 21.50 46.30 126.30 652.70 1,287.50 388.10 11.90

% of Change

(22.64) (21.90) (19.28) (18.60) (15.98) (15.52) (14.57) (12.75) (11.57) (10.08)

Value in Tk. mn

30.07 48.50 129.12 0.86 264.11 885.43 80.72 191.06 10.04 14.05

Average Daily Value Traded Tk. mn 3.34 5.39 14.35 0.10 29.35 98.38 8.97 21.23 1.12 1.56

Disclaimer: Dhaka Stock Exchange does not hold any responsibility for these date.

Top Ten Companies by Turnover Value for this fortnight March 1-15, 2016) Sl. No. 1 2 3 4 5 6 7 8 9 10

Name of the Securities

Category

Lankabangla Finance Com Orion Pharma Ltd. Aman Feed Limited Bangladesh Steel Re-Rolling Mills Limited CMC Kamal Summit Power United Power Generation & Distribution Company Limited Beximco Pharma Quasem Drycells IFAD Autos Limited

Volume in Nos.

A A A A A A A

Value in Tk. mn 2,087.89 1,567.08 1,286.65 1,194.45 1,092.88 1,069.68 1,062.85

52,620,889 37,940,707 20,886,058 6,752,609 50,886,913 25,324,151 6,559,284

% of total Value 5.08 3.81 3.13 2.91 2.66 2.60 2.59

A A A

1,053.49 1,024.42 927.99

12,153,441 10,216,106 9,885,745

2.56 2.49 2.26

Top Ten Companies by Turnover Volume for this fortnight March 1-15, 2016) Sl. No.

Name of the Securities

Category

1 2 3

Lankabangla Finance Com CMC Kamal United Airways (BD) Ltd

A A A

Volume in Nos. 52,620,889 50,886,913 41,826,587

Value in Tk. mn 2,087.89 1,092.88 255.72

% of total Value 4.56 4.41 3.62

Orion Pharma Ltd.

37,940,707

1,567.08

3.29

One Bank Limited

34,164,715

534.77

2.96

Keya Cosmetics

25,693,282

321.15

2.23

Summit Power

25,324,151

1,069.68

2.19

Zaheen Spinning Limited

21,694,414

555.77

1.88

Aman Feed Limited

20,886,058

1,286.65

1.81

BEXIMCO

18,699,217

550.70

1.62

Top Ten Gainer Companies by Closing Price for this fortnight March 1-15, 2016) Sl. No.

Aman Feed Limited

Current Fortnight Closing Price in Tk. 68.50

Eastern Lubricants

704.50

564.40

24.82

81.74

7.43

Orion Infusion Ltd.

64.10

56.40

13.65

354.46

32.22

AFC Agro Biotech Ltd.

73.30

64.60

13.47

413.33

37.58

Rupali Life Insurance Company Limited Bd.Thai Aluminium

40.90

36.20

12.98

222.68

20.24

42.20

38.10

10.76

456.53

41.50

LR Global Bangladesh Mutual Fund One Delta Life Insurance

5.20

4.70

10.64

8.94

0.81

114.90

103.90

10.59

298.45

27.13

57.00

51.60

10.47

434.42

39.49

Emerald Oil Industries Limited Summit Alliance Port Limited

42.70

38.90

9.77

158.17

14.38

Sl. No.

Name of the Securities

6 7 8 9

Name of the Securities

Category

Last Fortnight Closing Price in Tk. 54.40

% of Change 25.92

Value in Tk. mn 1,286.65

Average Daily Value Traded Tk. mn 116.97

Top Ten Loser Companies by Closing Price for this fortnight March 1-15, 2016) Category

GPH Ispat Limited

Current Fortnight Closing Price in Tk. 32.20

Last Fortnight Closing Price in Tk. 46.50

% of Change

Bangladesh Lamps

186.10

235.50

(20.98)

58.71

5.34

162.50

204.30

(20.46)

1,194.45

108.59

Bangladesh Steel Re-Rolling Mills Limited Singer Bangladesh

146.10

181.10

(19.33)

698.08

63.46

Sonargaon Textiles

10.10

12.30

(17.89)

4.93

0.45

IPDC

22.80

27.60

(17.39)

111.82

10.17

Reliance Insurance

42.00

49.40

(14.98)

3.81

0.35

Lankabangla Finance Com

34.90

40.80

(14.46)

2,087.89

189.81

Wata Chemicals Ltd.

149.90

174.30

(14.00)

93.19

8.47

Phoenix Finance

21.10

24.50

(13.88)

236.23

21.48

(30.75)

Value in Tk. mn 228.22

Average Daily Value Traded Tk. mn 20.75

Source: Dhaka Stock Exchange