There is perhaps, no greater paradox than the healthcare system of Pakistan. Very few professions garner the amount of adoration and blind trust as those in Pakistan’s hospitals while also somehow being the most hated and persecuted. Let us be the first to admit, Pakistan’s healthcare system is a mess. Doctors. The beings people trust with their lives after God. The humans who give up on their precious time and energy to serve humanity. However, this will be considered an overstatement by at least a few; those who have been dodged by a doctor who was considered an angel from God, a lifesaver.
Between the strange jigsaw puzzle that is our government and the many diseases that plague our citizens, problems are inevitable. However, at a certain point, difficult questions must be asked.
Earlier this year in Islamabad, an infant was the victim of this malpractice (1). Steps from where our nation’s leaders were sitting making big decisions, a mother lost her baby due to a criminal delay in blood transfusion. This is not the first time such an error was made, and it does not appear to be the last. Our medical system, which was already collapsing under government neglect has been further crippled by the hiring of untrained staff. Public hospitals, particularly in Sindh are known for being short-staffed, with long delays claiming countless lives. Infamously, JPMC hospital is the main tertiary care center for almost a third of Sindh’s population. Is it any wonder then that this system can barely keep up with its patient load.
Even before that, questions of merit and maleficence have arisen time and time again in our medical colleges. It may be a sheer coincidence but it is truly alarming, that certain high profile cases of medical malpractice occurring in Karachi and Sukkur were accompanied by more concerning reporting about the leaking of intermediate papers all over Sindh. If future medical professionals can get intermediate certificates by cheating; they can secure seats in medical colleges by paying high fees to private setups after not coming on merit despite cheating; and they will be hired by clinics and hospitals, again if not on merit then by myriad of clinics and hospitals that are spreading unregulated on every street.
Allow me to be clear. This is not an attack on our dedicated doctors, nurses and the staff that man our hospitals, laboratories and pharmacies. These are some of the finest people in our country, who put themselves through misery to do their sworn duties. We have seen our doctors fight through Karachi’s floods to get to the hospital for the sake of their patients. We have seen residents continuing to work even after being attacked by angry mobs. Our doctors are overworked, and not even paid their basic salaries for months at a time. They have continued to serve even in times of this pandemic, putting themselves at risk. We can never repay their debt. They deserve better.
However, some questions must be asked. Doctors in Lyari passing HIV onto patients, rumors of expired medication, reused syringes and wrong blood types, unnecessary prescriptions, and repeated lab scans. In rural areas, nonqualified people have started clinics, claiming themselves to be efficient doctors and putting up a big question mark on the difficult degree that must be followed by a license granted by The Pakistan Medical and Dental college. There simply must be more accountability.
After the occurrence of Covid19, the lack of medical facilities and the inefficiency of our system became more visible. Pakistan has a limited testing capacity, so most COVID-19 tests are missing their mark even as the virus spreads. The current scenario is also raising several concerns about the capacity of the government to tackle the prevailing healthcare crisis.(2)
Malpractice however, can also stem from helplessness. We must also turn to look at our government and demand accountability from them. Why does the budget allocate less than 10% to healthcare? Who is responsible for our flooded emergency rooms and unattended operating rooms? The chief minister of Sindh announced an allocation of Rs114.4 billion for the health sector in the next fiscal year 2019-20, up 19 percent from last year’s allocation(3), and yet doctors on the ground have not been paid for 6 months.
Healthcare is a tenuous field. A mistake in any other part of society may only result in a loss of money. A mistake here may mean loss of life. There need to be more support from the government to help root out the bad apples, the cheaters trying to put a price on a person’s life. These people have grown far too dangerous and strategies must be put in place to stop them. In a country where more than half of our population lives in poverty, the public health system must be made a priority. We must all do better.