Venereal diseases in Bangladesh

Bangladesh is one of the few countries of the world where recent increases in the incidence of venereal disease have been principally determined by poverty and war-time conditions. Other factors have also been at work. The population has doubled since the second world war and is now 75 million, a density of 1,300 per square mile, one of the highest in the world. At present 46 per cent. of the population is under 15 years of age. Population movements have involved large numbers. Between March and December, 1971, civil disturbance resulted in the emigration of some 10 million people to neighbouring India. This was accompanied by the internal migration of a further 16 million. The war lasted two weeks in December, 1971, and this was followed by the return of migrants to their homes between then and the end of February, 1972. Only 15 per cent. ofthe population live in the cities, principally Dacca, Chittagong, and Chalna, which together account for about 3 million. There is a tendency for people, especially unattached males, to move from rural areas to the cities in search of work and education. Although the practice of strict purdah is declining and women are emerging in the pro-fessions and elsewhere, for the most part they lead dependant lives. Family influences prevail in the area of sexual attitudes and behaviour, but as always demands for general freedom are accompanied by similar demands for sexual freedom. It is not sur-prising, therefore, that there is evidence of freer sexual expression amongst some young people in Bangladesh. Size of the V.D. problem Considerable difficulty was experienced in trying to determine the incidence of infection. Data for recent years was available from only five of the ten public clinics in the country. Table I shows the number of recorded cases of infectious syphilis. No data were obtainable regardin