BMJ Case Reports 2017; doi:10.1136/bcr-2016-218293

Basic occupational health services (BOHS) in community primary care: the MSF (Dhaka) model

  1. Mohammad Shariful Alam2
  1. 1Department of General Surgery, Sree Balaji Medical College and Hospital, Chennai, India
  2. 2Artsen zonder Grenzen, Amsterdam, North Holland, The Netherlands
  1. Correspondence to Venkiteswaran Muralidhar, murlidharv{at}
  • Accepted 23 February 2017
  • Published 20 March 2017


The Médecins Sans Frontiérs (MSF) established basic occupational health services to diagnose and treat work-related diseases among tannery, metal, plastics and garment workers and families in one of the more polluted areas of the world populated by 600 000 people. In spite of project limitations, an analysis of the 6-month data showed that of the original cohort of 5000, 3200 (64%) came for at least 1 consultation. Among them, 468 (14.6%) were diagnosed with suspected work-related diseases as per defined protocols. Follow-up consultation was performed for 1447 cases of occupational diseases and work-related injuries. The MSF experience begs the need for replication of such services in densely populated urban areas in developing nations like Bangladesh and India, where no specialty occupational health clinics exist in primary care but are desperately needed and where occupational health clinics on factory premises are exclusive to industry workers and are not accessible to communities.


  • Contributors VM worked with MSF in Dhaka as an MD from June 2015 to June 2016. VM saw all the cases and validated them as occupational disease. VM analysed the data, made tables and wrote the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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