‘I feel helpless’: Tensions between India and Bangladesh prevent patients from accessing medicine | Health

Dhaka, Bangladesh – Khadiza Khatun’s life took a devastating turn in September when doctors at Dhaka Medical College Hospital informed her that her 37-year-old husband, Mohammad Nuri Alam, urgently needed a liver transplant – a procedure not available in Bangladesh.

After careful research, they decided to go to the Indian Asian Institute of Gastroenterology in Hyderabad, a trusted destination for many Bangladeshi patients.

But three months later, they still haven’t secured visas for the trip. Amid escalating tensions between India and Bangladesh since the August ouster of New Delhi ally Sheikh Hasina from Dhaka, Indian authorities have significantly scaled back visa operations in Bangladesh.

The result: Khadiza and her husband have already missed two hospital appointments, on November 20 and December 20, and are unsure whether they will be able to reach India in time for January 10, the next date set by the Hyderabad medical facility for them .

“We’ve tried everything since October – we’ve approached travel agencies, we’ve asked friends in the government for help,” she told Al Jazeera. “India remains our only hope.”

Faced with unaffordable treatment options in Thailand and other countries, Khadiza is left to watch her husband’s health deteriorate as she relies on daily symptomatic treatment in hospitals in Dhaka – hoping the new year will bring her the visas she and her husband desperately need. “I feel helpless, rushing between hospitals without a solution,” said the mother of two children.

Khadija’s struggle reflects a larger crisis affecting thousands of Bangladeshi patients, who rely on affordable healthcare in India, because visa restrictions introduced by the Indian authorities. The Indian Visa Centre, on its website, says it only “offers limited slots for Bangladesh nationals on urgent medical and student visas” and is “currently processing only a limited number of emergency and humanitarian visas”.

According to an official at the Indian Visa Center in Bangladesh, daily online visa appointments at India’s five visa centers in Bangladesh, including Dhaka, “have plummeted to around 500” from over 7,000 since the July protests that led to Hasina’s removal from office .

For many Bangladeshis, like Khadiza, the actual likelihood of getting a visa seems even slimmer.

Slide in ties

Relations between India and Bangladesh have soured since Hasina fled the country for New Delhi on August 5 following weeks of student-led protests against her increasingly authoritarian rule.

India has since granted sanctuary to Hasina, straining ties – Bangladesh’s interim government of Nobel laureate Muhammad Yunus last week sent a diplomatic note to New Delhi seeking her extradition.

Meanwhile, the Indian government has told Bangladesh that it is concerned about a a series of attacks on Bangladeshi Hindus. Dhaka, for its part, insists that most of the attacks were political in nature – against those considered supporters of Sheikh Hasina – and not religious in nature. Bangladesh has also accused Indian media channels of exaggerating the scale of violence against Hindus.

These tensions between the two governments also affected the issuance of visas. On 26 August, a protest broke out at India’s visa center in Dhaka over processing delays, after authorities resumed “limited operations” in protest-hit Bangladesh on 13 August. On the other side of the border, the Bangladeshi diplomatic mission in the northeastern Indian city of Agartala was attacked by a mob in early December, which provoked a strong protest from Dhaka.

On January 1, the usually bustling premises of the India Visa Center in Dhaka looked almost deserted. Only a few applicants were waiting for the submission of documents. Most applicants received invitations to submit their visa applications and fees at the visa center after hand-delivering a copy to the Indian High Commission in Dhaka a few days earlier.

However, Khadiza, who followed the same process a month ago, failed. A visa center official told Al Jazeera that the high commission has started accepting more urgent applications, although online submission options remain limited.

Some Bangladeshis, who had postponed their trip to India for treatment while waiting for tensions to subside, are now stuck with expired visas.

“My and my wife’s visas were valid until December 10, but we did not travel then because of the tension over Bangladesh-related issues in India,” said 40-year-old Shariful Islam from Joypurhat in northwestern Bangladesh.

Islam suffers from lung disease. He and five other family members – each with their own health problems, including his wife and father – have been regularly traveling to the eastern Indian city of Kolkata and the southern city of Vellore for treatment for the past four years.

In rural Joypurhat, Ridowan Hossain, who runs a visa support agency, is meanwhile struggling to secure visa appointments for patients, including a cancer patient urgently seeking treatment in India. Over the course of 10 days, he repeatedly tried to complete the online application process but kept facing failures at the payment stage, he said.

When he called the helpline, he said they just told him to try again.

“I process more than 300 Indian visas a year, but I have not been able to process a single one since July,” he said.

Now, many Bangladeshi patients are seeking alternative treatment options in Thailand, Malaysia, Singapore and Turkey.

Mazadul Noyon, manager of Suea Noi Fit & Fly, a Bangkok-based medical and travel agency, told Al Jazeera that inquiries from Bangladesh had doubled compared to before August. “Although about 80 percent of patients consider Thailand after failing to get an Indian visa, most give up the idea when they learn about the 10-15 times higher costs in Thailand,” he said.

For example, the initial cost of treatment for Khadiza’s husband – covering diagnosis, medication, consultation and related costs – along with travel and accommodation, would range from $1,000 to $2,000 in India, compared to at least $10,000 to $15,000 in Thailand.

For a cardiac ring implant, costs in Thailand range from $5,000 to $20,000 – depending on the hospital, excluding travel and accommodation. In India, $2,000 covers high-end rings and medical care. The cost of these procedures is even higher in countries like Malaysia, Singapore and Turkey, making them unaffordable for most Bangladeshis.

A lost situation

But it’s not just Bangladeshi patients who are suffering – India’s “medical tourism” industry, which offers high-quality treatment to patients from developing countries at relatively lower prices than in the West, has also taken a hit.

Industry data shows that 60 percent of the two million international patients in India annually are from Bangladesh. However, since the end of August, the number of patients from Bangladesh has dropped by 80 percent. India’s medical tourism industry is estimated to be worth $9 billion in 2023.

Amitabha Chattopadhyay, a pediatric cardiologist at Narayana Superspeciality Hospital in Kolkata, told Al Jazeera that his hospital had seen a 5 percent drop in Bangladeshi patients.

“But hospitals that treat chronic diseases face even greater challenges,” he said.

Hospitals in Kolkata, the closest and culturally similar city to Bangladesh, have been hit the hardest.

At Peerless Hospital, a 500-bed multi-specialty hospital in Kolkata, daily outpatient visits by Bangladeshi patients have dropped from 150 to less than 30, with almost no admissions, The Print, an Indian digital publication, reported, citing the hospital’s chief executive, Sudip Mitra.

Other key hospitals affected include Narayana Health in Bengaluru, Apollo in Chennai and Christian Medical College in Vellore, according to Alexander Thomas of the Healthcare Providers Association of India.

Meanwhile, two hospitals in Kolkata and Tripura reportedly turned away Bangladeshi patients, citing alleged disrespect for the Indian flag, further straining relations, according to local media reports in early December.

‘Very difficult’

Touhid Hossain, acting head of Bangladesh’s Ministry of Foreign Affairs, acknowledged that patients in the country were struggling because of India’s visa restrictions.

“Not only difficult. It became very difficult,” Hossain told Al Jazeera.

M Humayun Kabir, a former diplomat and president of the Bangladesh Enterprise Institute who previously served in the Bangladesh mission in Kolkata, echoed this sentiment.

“Emergency visas were supposed to be processed, but I have received reports to the contrary… There doesn’t seem to be much chance of getting one [Indian] visas,” he told Al Jazeera.

Bilateral relations appeared to be thawing when Indian Foreign Minister Vikram Misri visited Dhaka on December 9, marking the first high-level meeting between India and Bangladesh since the recent political changes in Bangladesh.

Hossain confirmed that the Bangladeshi authorities had raised visa concerns with their Indian counterparts during the visit. “They assured us that they would increase the issuance of visas and prioritize emergency cases,” he said.

However, so far there are no changes, say patients and visa agents.

India’s foreign ministry and the Indian High Commission in Dhaka did not respond to Al Jazeera’s request for comment on New Delhi’s criticism of the visa restrictions.

But during a meeting with diplomatic correspondents in Dhaka on December 24, Indian High Commissioner Pranay Verma claimed that India still issues visas in Bangladesh more than “probably all the other embassies put together”.

He also said he remains optimistic about the future of relations between Dhaka and New Delhi – a sentiment Hossain, Bangladesh’s de facto foreign minister, expressed in an interview with Al Jazeera.

Analysts, however, remain skeptical.

“Both sides talk about good relations, but the reality says otherwise,” said Snigdhendu Bhattacharya, an independent Indian journalist specializing in South Asian affairs.

Kabir, a retired Bangladeshi diplomat, said he hoped the two governments could insulate the visa issue from their broader diplomatic tensions.

If they don’t, neighbors could face consequences, he warned.

“Such attitudes create a negative mindset in the public and can harm long-term relationships between people,” Kabir said.

But Khadiza does not have the luxury of waiting much longer.

“The visa support agency still hasn’t submitted the application,” she said, her voice heavy with disappointment. She prepares herself mentally for the news that the application cannot be submitted – even as the clock is ticking for Alam, her husband.