At government hospitals, life is cheap

Published: April 22, 2013
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These poor children are starved of medical attention but government hospitals have no funds to attend to their needs.

It is almost impossible to change the fate of those little children who depend on government hospitals to save their lives. Recently, I visited several hospitals in Karachi and the condition of those hospitals and the quality of the care provided to the children was disgraceful.

The poor health system prevailing in Jinnah Hospital, especially, made my heart sink.

There was no electricity and to my horror, a large number of insects and cats were roaming about in the wards aimlessly. The terrible stench from the toilets could be smelled till the far ends of the corridor, and to think that this is a hospital where cleanliness and providing healthcare is the primary focus – it was deeply disappointing.

Furthermore, when searching for an on-call doctor to get permission to visit the patients admitted, I came across a locked room. I knocked on it and it was answered by a nurse who told us that the doctor on call was sleeping. He was sleeping on a stretcher inside an air conditioned room; I repeat, the on-call doctor was sleeping in an air conditioned room while his patients suffered in the blistering heat outside!

This served as a catalyst to stimulate my disgust and anger, but I knew the worst was yet to come as this was just the beginning.

A few moments later, I started visiting the patients. Among them was a 12-year-old boy whose mother seemed exhausted and disconsolate because of her child’s deteriorating health.

I had brought some presents with me for the patients as I knew I would be meeting little children; I gave the boy an icebreaker candy and just like that we started talking.

While conversing with him, I found out that not only was he a talented child but had also won numerous trophies in different cricket championships that were held in his locality. During one of the matches, a ball hit his foot which later swelled up. The boy was taken to Indus Hospital where he underwent a surgery, but it did not help him and the condition of his foot worsened.

The doctors put the boy under prolonged observation, but to no avail.

His parents were getting restless as their child was undergoing constant trauma and the only solution that struck them was to take him to a better hospital; so here he was, at Jinnah Hospital. The boy was diagnosed with cancer (in his foot) which required his foot to be amputated in order to prevent the cancer from affecting other parts of his body.

His mother, while mourning the fate of her child, was busy doing other stuff, like, changing the boy’s urine bag because the staff was unavailable to do it for her.

She used a paper fan to help her son beat the heat and was heard constantly uttering words of encouragement and love to keep her child’s faith intact. Yet, her pain was evident in her voice.

Although, the doctors had advised that the child be taken outside regularly to get some fresh air, he was unable to do so. The elevators were out of order and there were no wheelchairs available for the child to go downstairs in the open air.

I have visited many hospitals as I was the CMO (Chief Marketing Officer) of an NGO, Meri Bhi Aik Khuwaish Hai, but the visit to Jinnah Hospital and this particular encounter stuck to me.

It happened almost a year ago, but I am still unable to let it go. Something about that experience haunts me each time I think about it; I can’t help but feel disgusted and disappointed.

When I think about it, the conversation replays in my mind and I can hear the pain of a broken mother trying to keep her son from falling apart.

What worries me is that this is the tragedy of just one of the families present at the hospital and there are many others who have faced a similar fate if not worse and nothing is being done about it.

Private hospitals are beyond reach to a lot of people and this leaves them with no option but to deliberately put their wheel of fortune in the hands of government hospitals; these hospitals are either bound because of lack of funds or they house doctors who are not the least bit concerned about the dignity of their profession. They conveniently forget that this is their job, this is something that they signed up for when they joined the hospital, whether it means sleepless nights or inconvenient mornings.

Alas! The fate of the poor is the only thing at stake and the well to do continue to enjoy the privileges.

We might have forgotten, but destiny has its ways and they say “what goes around comes back around!”

ayesha.yousuf

Ayesha Yousuf

An alumni of Nixor College where she worked with different NGOs. She has a keen interest in community service and is currently a housewife.

The views expressed by the writer and the reader comments do not necessarily reflect the views and policies of The Express Tribune.

  • Hell

    All you need to is vote for the present government once more so we can continue with this successful policy and many others that are a proud achievement of this great and thriving nation. VOTE PPP+MQM+NUUNRecommend

  • http://www.wowelldone.blogspot.com Slaps her foreheadher

    Did you bother to check how long had the ‘sleeping doctor’ been on duty? Recommend

  • http://faraztalat.blogspot.com Faraz Talat

    In government hospitals, everything is cheap. This includes cost of drugs, manual labor, and medical checkups. That’s why people go to government hospitals in the first place.

    I wouldn’t say the cost to human life is a fair trade-off, because it isn’t. But one does need to understand the limitations that we have. This is not because the doctors are slacking off, or the nurses are apathetic about the patients’ suffering.

    It’s because the healthcare system is dangerously out of whack, and it pains me when people pin the blame on doctors serving 36 to 54 hour continuous duties in these hospitals, deriving their strength from odd-hour power-naps and quick lunches.

    And then any industrial-action protest by the doctors to fix this system gets booed to death by the public. Well then, I recommend you get used to the system.Recommend

  • http://lonepkliberal.wordpress.com Loneliberal PK

    It is such an embarrassing cliche to launch a general tirade against doctors, as if they uniquely lack empathy and morality.

    I’m sorry if you find these house officers’ occasional naps such an inconvenience, but guess what: sleepy, hungry doctors don’t operate that well either!

    If you’d rather have a half-asleep doctor hovering over your limp body with a scalpel than a well-rested professional, be my guest. The doctors are already being pushed to the limit. Their “laziness” or “unprofessional attitude” is not the problem.

    The fault lies with the system that is painfully underfunded, poorly regulated, stingy about hiring paramedical and nursing staff, and overly eager to dump the extra work on the already over-worked staff.Recommend

  • Kashif Butt

    Ayesha Sahiba, The hospitals are run on only 600,000 tax payers from country of over 180 mio…..just imagine if tax reforms are done correctly….. what would be the hospitals like…..Recommend

  • Zubair Ali

    Very touching, especially about the little kid and his poor mother.

    Sometimes you have to be part of the solution or at least work for it in any way you can, rather than just write about it (which is also good!). When i say you, I’m referring to everyone, including me.

    Some thoughts –

    Did you contact the hospital management or health board officials about your findings?
    Lets forget about roles and responsibilities for a minute. How about a group of you volunteering (through official channels) and offering to help clean for a few hours a month. Do you realise how motivating that can be for all concerned?

    You are capable of a lot more than you think.Recommend

  • ab

    well said @Faraz Talat. oath or no oath at the end of the day the doctor are themselves human beings not animals. people voting for the present people has no right to demand change in the system.Recommend

  • Dr.X

    So, you spent one day in the public hospital and you felt disgusted and disappointed. Think about the doctors and paramedical staff who work their entire lives in the public hospitals. The hospitals r understaffed and the medical personnels are underpaid!! Whether you like it or not, these doctors and nurses r the only people willing to work in this horrible environment.Recommend

  • Akhter Hussain

    Ayesha Yousuf ! Nice projection and you expressed my heart word which i was thinking to write something about this matters after i have gone through this experince in JPMC.Recommend

  • v

    What is CMO you said? Chief Marketing Officer? I see.Recommend

  • Komal Bukhari

    When you say “the house doctors, who are least concerned about the dignity of their profession”, you remind me of an uneducated common man who might not understand the amount of work load and the pains that doctors have to go through in a government hospital to make sure that their patients live and get better. If it’s a cheap life for the patients, its a very bad life for the doctors too. But since we’re playing the blame game here, how about you think about the hundred year old policies of these hundred year old hospitals and the present condition of our country! For the cats and insects, talk to the hospital administration. I’m sure you would get some insight into the system. Recommend

  • Dr. Abid Shah Mashwani

    Thanks for sharing this story, and wish you were sharing it earlier as who knows some one may have came up to help this particular child – but it is a good reminder to every civilized human being. As you said, this is just the story of one child, one patient out of millions of such patient one can see every day in hundreds of hospital and even thousands of homes (who cant even afford to get to government hospitals). Luckily we have an easy solution for all our problems and short commings – “God Willings” i.e Allah Keh Marzee.

    No doubt, no one can meet all the needs and wishes of every citizen in any country, and no doubt many of our professionals in every field may be doing more than what they should be doing but Pakistan do need a system of justice, where you ask for fair share of responsibilities at a fair cost from professionals and then you held them responsible in a fair way too. Such a just system could only floursih if you have good people at the top. Unfortunately, our leaders act as kabza mafia and are less worried about your problems – As Punjab interim CM put it rightly when someone asked him about loadshedding – “What loadshedding? Power never go off in CM house and in my residence”. So please stand up for your rights and pick people who you think will be answerable to you, not big sharks like Zardaris and Sharifs who you cant even reach to shake hands with.Recommend

  • Ibrahim

    As the saying goes,walk a mile in someone else’s shoes before you judge them.

    Do you have the slightest of ideas what the conditions are like for doctors in public hospitals? And the funny bit; you write that there was no electricity in the hospital, and the next moment you discover the doctor sleeping in an “air-conditioned room”Recommend

  • Parvez

    This state of affairs exists in just about every government organisation. This is the result of inequality in our society that is deliberately kept in place by our leaders. Our policies are tailored to ensure that the 99% remain in a state of despair and only the 1% enjoy.
    The democratic tool available to the 99% is to vote the rotters out, the other option is to physically throw them out.
    Recommend

  • Waheed

    Kindly writer can you do all house drs a favor. You should volunteer with few of your colleagues of your so called NGO for some Govt Hospital. Go spend some time with these poor drs and see after changing how many urine bags ( mind you thats not HOs duty even ) they go and sleep in SOME AC ROOM on a STRETCHER .Recommend

  • Carl

    What can be expected of public institutions when so few Pakistani’s can be bothered to actually pay any tax?Recommend

  • Muhammad Hammad

    well its a true story indeed , the level of health and education in this country is highly disappointing , but one thing that has to be noticed in all govt hospitals that they have got extremely professional and highly qualified doctors but still the infrastructure of such institutions is very low , i usually ask these questions to many people that why such doctors are unable to provide treatment to them, in addition to that all prestigious medical colleges send their student who are in house to government hospital in order to get more learning regarding surgery and medical because a rich patient wont allow a trainer doctor to treat them , and thus all the experiment are made on the poor patients in govt hospitals .Recommend

  • Raza

    For those speaking in defense of the doctors, the author’s main critique is on the hospital conditions, not the doctors. The inefficiency of the doctors is as a result of poor hospital management, not because the doctor’s are inherently bad.Recommend

  • Ali kazmi

    My Fiance is a house office, recently doing her term in Children ward in Jinnah. Would you want to hear how long she stays on duty in a week? 80 hours! including 2, 36 hour night and day calls in a week.

    And she does not get paid for months.
    would you want to write a column on this please? Recommend

  • pani ka horse

    Forget the patients. Lets make another BB’s song?Recommend

  • Mohsin

    Ayesha this is not new to know…….it is going on and on since decades…….Recommend

  • sars

    When you work as a house officer , havuing to make life and death decisions, manage patients check response to management, do procedures and also deal with attendants while being on call for 36 hours, and having to do much of the nursing yourself ………believe me you dont spend much time ” sleeping in the AC” , you catch sleep in small snatches of 20-30 mins to be able to function. Other countries have banned these long hours due to errors in judgement by sleep deprived people.
    Dont blame the doctors, do something to improve the system.Recommend

  • Mohaisin Sharif

    Article is good but it’s not only the fault of doctor on duty, hospital management is also involved which is supervised by admin office controlled by MS. And what is most important is the role of health ministry, according to Pak history minister himself or herself most of the time doesn’t even belong to job, or irrelevant to field so how he or she will run the office? Recommend

  • Saba Fatima ALi

    Lol your anger just got stimulated without you even talked to the doctor. Please do some research before posting such stupid stuff about people. I am sure the doctor wished the entire ward could be air conditioned but he must be so underpaid himself that he cant do that. He is also an employee. A “victim” of the government setup. And after you saw them all in the blistering heat , I think you also shouldnt have the heart to sleep in an air conditioned room ever:) infact we all should never sleep in airconditioned rooms cuz most of this countrys population dont even have fans. Dont blame the poor overworked and underpaid doctor sleeping on the “stretcher”!Recommend

  • J

    @ author….. No need to be disappointed and discouraged, inshaa ALLAH change is coming it is bound to come …” … . We cannot blame doctor`s if the system is only benefitting rich elite class then we need to fight for the system, we can bring change where we are, like you did by writing this story and we can change by charging ourselves…..Recommend

  • H.Pasha

    The Institute of Medicine (IOM) built upon the recommendations of the ACGME(Accreditation Council for Graduate Medical Education) in the report Resident Duty Hours: Enhancing Sleep, Supervision and Safety. While keeping the ACGME’s recommendations of an 80-hour work week averaged over 4 weeks, the IOM report recommends that duty hours should not exceed 16 hours per shift for post graduate year 1 trainees (also known as interns/house officers). The IOM also recommended strategic napping between the hours of 10pm and 8am for shifts lasting up to 30 hours. The ACGME officially recommended strategic napping between the hours of 10pm and 8am on 30 hour shifts for residents who are post graduate year 2 and above but did not make this a requirement for program compliance. The report also suggests residents be given variable off-duty periods between shifts, based on the timing and duration of the shift, to allow residents to catch up on sleep each day and make up for chronic sleep deprivation on days off.
    Link to the report, especially for the author:
    http://www.iom.edu/Reports/2008/Resident-Duty-Hours-Enhancing-Sleep-Supervision-and-Safety.aspx
    Junior doctors in Pakistan are the foot-soldiers of our health system, working up to a 100hrs/week and often, going the extra mile for their patients such as arranging medicines out of their own pockets and donating blood on a regular basis.
    Recommend

  • Mustafa alvi

    Ayesha if i’m not mistaken the NGO that you spoke about is run by nixor students right? Well if you know of any other such cases you should come back to nixor and maybe meet with the hospital team and im sure they will be more than willing to help!Recommend

  • Tariq Sohail

    I dont remember even a single night while ON-CALL and get a chance to sleep for 30 minutes. My residency lasted for 4 long years. I didnt get any stipend as a post-graduate student, only the governments Doctors were paid and we use to work for more than 36 hours without break.
    Recommend

  • Dante

    I take frequent naps when I’m on call during the night here in US. Imagine, even American doctors take naps when they’re on call while their patients have to spend sleepless nights suffering the pain and horror of their conditions.

    Have you ever worked for 28 hours straight in your life without taking a break to sleep? And I’m not talking about working while seated in a comfortable chair?Recommend

  • http://www.bizzlenews.com Pakistani Speaks

    I am totally agreed with your claim. The government hospitals are much worse than local hospitals of small-range doctors. Government has nothing done in the sector of health, instead they pull each and every resource from it to power up their selves. Recommend

  • DR Nadir

    Well written, Amazing. I wrote a similar blog. You’ll see it being published in a few days. Recommend

  • Bubba

    On the bright side – you have nukes and missiles. You can have good health care, education, clean water and flushing toilets in your next life.Recommend

  • BRUTAL

    Still our Docs just want to have the 17th scale perks…
    One can not even walk through the emergency or out door patient departments of the government hospital. Now its not the time to think, its the to just implement.
    I have ma own fellas who are HO’s MO’s in the government hospitals and i have also analyze their punctuality and their sincerity. I will just like to say myself and then rest of the world that try to be sincere with yourself then you can show your sincerity with your profession and with the rest of the world. Recommend

  • Ordinary citizen

    i believe the author lacks knowledge about medicine as a profession. the foremost aim of every doctor is to diagnose and treat their patients. this boy was misdiagnosed in another hospital and came seeking treatment for his aliment not an air conditioned room or comfortable living conditions. he got that at Jinnah. he got treated! yes a clean ward and a comfortable stay would have helped in the well-being of the patient. but we as doctors cannot control the poor administration of the government hospitals. we donate from our pockets. we set up charity organisations. we try to bring change. but we fail. because we r not supported. we work at the bottom of the food chain. the conditions can only change wen the authorities on top change.
    please VOTE. And if that doesnt work; take to the streets to bring change!Recommend

  • Vellayat Ali

    Very a good topic and the problems highlighted in it are a prime concern for us.But sadly the writer has not enough information or the real ground reality which one should be aware of before taking on a topic otherwise it becomes weak in the core.Recommend