I took time out of programme from my neurology training between February and April 2014 to work at Medical College Hospital in Dhaka, the capital of Bangladesh. I wished to improve my clinical experience of tropical neurological diseases and also to contribute, with some of my own knowledge and skills, to clinical cases and through teaching.

Bangladesh, in South Asia, has a population of over 160 million and an area similar to England: it is the world’s eighth most populous country. It is bordered by India to its west, north and east, and Burma to its south-east (figure 1). According to the WHO's most recent statistics (2012), its urban population is 29%, and its gross national per capital income is international dollar 2030 (compared with US$37 030 in the UK). There is a very wide rich–poor divide, and unfortunately, the healthcare system reflects this. The WHO's data give the per capita total health expenditure as US$47 in 2012 (compared with US$3495 in the UK).

The private sector provides most of the healthcare in Bangladesh, with only the poorest patients generally attending government hospitals. There are approximately 150 neurologists in Bangladesh. Dhaka Medical College Hospital is a large government-run general hospital, set up in 1946 while Bangladesh was still a British colony. Dhaka Medical College is the largest medical school in Bangladesh, and also a centre for postgraduate training in neurology. I worked under the supervision of Professor Mansur …