The reality of public hospitals: I lost my nana to medical negligence in Pakistan’s dirtiest hospital

Published: May 10, 2018
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Without asking us about his history of allergies, the hospital put my nana on Moxifloxacin, an antibiotic he was allergic to. PHOTO: FILE

On March 18th at 11pm, my nana (maternal grandfather) developed an acute shortness of breath, and was admitted to the Cardiac Care Unit (CCU) at the People’s Medical College and Hospital in Nawabshah. Arriving at the hospital, the first thing I noticed was that there was no wheelchair available to take a critical patient inside the ward.

Being a fourth year medical student aware of the poor hospital conditions in my city, I took my own blood pressure apparatus and oximeter with me, and immediately checked his vitals; something the doctor, who had not yet arrived, had not done. Even though my nana’s oxygen saturation had dropped to 68%, instead of putting an oxygen mask first, the doctor was keen on conducting an Electrocardiography (ECG).

I tried to be patient, but seeing my nana’s deteriorating condition, I shouted at the staff to put a mask on him. However, none of the staff members responded to the severity of the occasion. I then went to the doctor, urging him to accelerate the process, but to my disgust he arrogantly replied,

“You are not at Aga Khan Hospital, where you can get everything available.”

I was infuriated!

What kind of humanity are they serving, when they don’t even know how to behave with the concerned and worried family of a patient?

This was the moment I realised the class differences that exist in our society. We had always preferred private care in the past and were thus anxious about not being provided quality care at a public hospital, which is where we ended up during this emergency. However, for the underprivileged, this is their only option. They trust the doctors, and this itself is a huge responsibility. Being a medical student myself, I could tell where the doctors were messing up in their treatment, making me think of the hundreds of people who come here every day and trust this incompetent hospital to do its best when it comes to saving the lives of their loved ones.

My cousin and I then took our nana to the hospital bed, where I fixed the oxygen issue by myself. In the meantime, we remained in contact with our uncle, who is a physician, and he kept guiding us about the procedure to follow.

In medical school, when we are on our rounds, our attendings tell us to ask the patient as many pertinent questions as possible, particularly when it comes to drug history. In comparison, we were hardly asked any questions about his history at all.

The next blunder the hospital made was to put my nana on Moxifloxacin without inquiring about his history of allergies, for my nana was allergic to the Fluoroquinolone group of antibiotics. This mistake drained all the hope out of me, as I stared at the innocent face of my grandfather, who was fighting for his life with every breath. I then requested the staff to keep antihistamines ready, in case of an allergic reaction.

Four hours passed by, and the doctor hardly paid my nana a visit. The CCU is a special care unit, which is why the doctor has to monitor the patient’s vitals every now and then. However, in this unit, things were quite the opposite. I was surprised to see this happen, even though I wasn’t new to this. I saw it often. Only when my own loved one was suffering did I realise the real agony of having a deeply flawed healthcare system.

After a while, my nana’s oxygen saturation began to stabilise, and we were finalising arrangements to shift him to a private hospital in Karachi. Like most things in life, this did not go as planned.

Suddenly, my nana’s condition deteriorated again as he went into cardiac arrest, once again putting his life in the hands of these inept ‘professionals’. The doctor proceeded to give CPR, but the bed my nana was lying on, in the CCU, had a defective crank and would not lower. We had to physically carry my nana to the bed next to him while the doctor was performing CPR simultaneously, and that was the moment we lost him.

The doctor kept on doing CPR and defibrillation, but my nana was gone.

With him, I lost my greatest inspiration.

Since his death, I find it hard to sleep, for I keep replaying the events of that day in my head. After all, is fixing a broken bed at a hospital really that hard? In cardiac emergencies, you cannot afford even a single minute of delay.

If the bed was not broken, would my nana still be alive?

Whenever you ask any medical student or doctor their reason for choosing this profession, they will enthusiastically tell you they want to serve humanity. Now, I have begun questioning our objective.

Looking at the current state of our hospitals, I do not think we are serving humanity at all! Not only that, we are growing increasingly apathetic about it all. Recently, the United Nations Children’s Fund (UNICEF) reported that Pakistan possesses the highest infant mortality rate in the world, and no one bats an eye. Not a single statement was released from the Health Department.

Weeks after my nana’s death, the National Institute of Cardiovascular Diseases (NICVD) was inaugurated in Nawabshah, alongside several centres in other parts of Sindh. The Pakistan Peoples Party (PPP) promises the hospital will provide state-of-the-art care without any cost.

Building new hospitals is well and good, and much needed, but what about existing healthcare? Why is no one interested in the state of our public hospitals? An Acute Emergency Care unit with no wheel chairs, very few working monitors, broken beds and smelly oxygen masks, which I am sure have been used by hundreds of patients without being cleaned.

His entire life, my nana took extra care of cleanliness. He used to boil water before drinking, and would take it with him wherever he went. Show him a dirty spot, and he would start cleaning it himself. That same man ended up dying in the dirtiest hospital in the country. Minutes before his death, his last image was of an overflowing dustbin and a stray cat sleeping by the side of his bed. He kept looking at me, as if wanting to complain. How uncomfortable was he in his last moments? Why did he deserve to go like this?

My grandmother keeps asking me,

“Did he get the right treatment?”

I reply in the affirmative, for I do not want her to live with the same regret I will live with for the rest of my life.

Medical negligence is a growing epidemic in Pakistan. Doctors fail to take detailed history from their patients, and make diagnosis without lab tests; prescribing antibiotics unnecessarily, or suggesting treatments without asking for all possible symptoms. To add to this, when you go to the hospital, the instruments are unsterilised, the floors are dirty, and the place is overcrowded and understaffed.

During our five years of medical education, we are not sensitised to our additional healthcare issues, or what we as future doctors can do to change it. Instead, we are expected to mingle in the same environment, and conduct the same ill practices. Not once in my three years as a student have I seen anyone raising their voice about our malfunctioned healthcare system. And even when someone does, it does not get the attention or awareness it deserves.

Seeing what hospitals are like from the perspective of someone bringing in a loved one, I have lost my faith in our medical education system. Doctors are converted into robots; to go on with our day, to work within this existing flawed system without complaining. If you are a future or a practicing doctor, at least try to play your part in improving the quality of Pakistan’s healthcare system. No matter how tired, busy or desensitised you are, please do not neglect a patient. For you, they might just be another unwell human to fix, but to somebody else, they mean everything!

Aneeta Channar

Aneeta Channar

The author is a medical student at Peoples University of Medical and Health Sciences, Nawabshah. She tweets @AneetaChannar (twitter.com/search?q=%40AneetaChannar&;src=typd)

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

  • Sami Thinker

    Sad to know your incident. These hospitals are more worse then a disease. May Allah save us from these courts, hospitals and prisons.Recommend

  • Muhammad Mohiuddin

    I am sorry to hear your ordeal and Khursheed Shah says “come and visit Sindh to see the progress of health and education”, what a joke. We cannot expect anything good for the people of sindh as long as PPP is in rule.Recommend

  • https://varunswordpressorg.wordpress.com Varun Kumar Riat

    sorry to know your lossRecommend

  • Qurban

    very sad – The doctors posted there are incapable and rude with patients and his attendants. Recommend

  • Gualterio Nunez Estrada

    I can’t understand why this happens in Pakistan hospitals, Cuba is a poor country in the Caribbean with better free universal healthcare system than United States. In Cuba you go to emergency room and very quick doctors and nurse save your life. Daily, cubans families are visited by a doctors at home to check them.Now, some turkish tourist are going to Cuba for cuban doctor care every week. Pakistan has good relation with Cuba, I don’t know why the government doesn’t have some help from Cuban MINSAP to rebuild good hospital care.Recommend

  • Javed Ahmed

    bro who did better for sindh can u explain Federal govt has only interst in natural resources sindhi waderas are only looting the money of Sindh We have no water even for drink Our share has been taken by Pakistan1 now whom we blameRecommend

  • F T

    I am very, very sorry to hear about your loss…but no words of sympathy can reconcile your loss. It is bad enough to watch someone close dying in your arms, and the pathetic state of our hospitals makes the ordeal even more traumatic…and it haunts us in time to come….may Allah help Pakistan….Recommend

  • AbdulB1

    Land of pureRecommend

  • Nisar Alvi

    I am not surprised at all. The Zardari in Sindh and Nawaz in Punjab have looted the very resources that could be used for development of Pakistan for everyone. If done we could, as a nation, be ahead of China, Korea and not slave to China, USA or Russia,
    This criminal duo has done everything for their families and few criminals around them like Dar and Saad R. Their business continue to grow while Pakistan as awhole continues to be a failed State.

    Look at who is Chairman of PPP – none other than his son. Look at who is President of PML- N – none other than his brother. Look at who does not trust Pakistan Hospitals and Universities – none other Sharifs and Zardaris.

    These families think nobody other than them and few of their cronies deserve Pakistai resources.

    Get rid of these looters and Pakistan would be ahead of many other nations.Recommend

  • Sher

    Because Pakistanis are corrupt to the core. Please don’t invite them to Cuba, they will corrupt your society as well. I am a Pakistani myself unfortunately.Recommend

  • Gopal Das

    Right now, I am feeling really sorry for your nana and can’t do much for you but just write few words of compassion and sympathy.
    What further I can do that I can share it in on my Facebook timeline and try to shake their attention. But do you really think that it opens the eyes of those who are in a deep slumber and waiting till this bad act will not happen with their relatives as well.Recommend

  • Danish Zuberi

    Cuba was very kind in offering scholarships to doctors from Pakistan. Ironically, the ordeal the writer and many other Pakistanis face is not that resources or doctors are not available, but irresponsibility. people become doctors only to make money and have least concern if anyone “lives or die”. See, what the doctor told the distraught lady, “you are not in Aga Khan Hospital (a high-end private health facility).”Recommend

  • greywolf

    agree. cuba was a big help during the 2005 pakistan earhquake when fidel castro himself rang up the pakistan president and offered help. we should learn from countries like cuba.Recommend

  • Nomad1412

    The reputation of your healthcare has even reached us in India. There are lots of things we Indians can learn from Cuba regarding healthcare.Recommend

  • Veer Singh

    Sorry for your loss! Recommend

  • Waqas

    When incompetent and selfish people will rule this land no change will come, bureaucracy is destroying all institutions apart from politicians any one selected at higher post don’t want to work.
    No doubt Pakistan has potential in all means but this system is like parasites eating slowly and silently and people just blaming each others for not having facilities.
    For God Sake Pakistanis, Wake up! Wake Up, this system is pushing us towards hell.Recommend

  • Fahim

    “Doctors fail to take detailed history from their patients, and make diagnosis without lab tests; prescribing antibiotics unnecessarily, or suggesting treatments without asking for all possible symptoms.”

    When 100s of patients are sitting in line, what you expect. I have met only few doctors who takes detailed history like full 30 minutes of session to make halal what they earn.Recommend

  • Sane

    This is not just healthcare in which Govt. miserably fails. Security – have private guards, Water – have tanker and bottled water, Education – Go to private schools, Electric – Have generators, Healthcare – never ever go to govt. institution opt for private hospitals. But, you have to pay taxes, otherwise you are not a loyal and good citizen and invite penalties and prosecution.Recommend

  • shahidk

    Easy. Cuba 12 million people, Pakistan 220 million.Recommend

  • Sane sid

    The ruling elite and general public is to be blamed for such a state. Had the funds been spent on education rather than Brotherhood and Jamaat, things would have been better……..Its good the youth of Pakistan today realizes importance of education…..Recommend

  • Gualterio Nunez Estrada

    I understand, pakistan population is a very big responsability for any goverment and because health system is expensive everywhere, but by december 2016 the Republic of Slovakia, former Checks Republic, has the cuban medicine Heberprot, the only drug in the world that avoid amputation in diabetic feet. Cuba paid the debt to Slovakia with Heberprot. In the same way it is possible Pakistan trade goods with Cuba for Heberprot and anothers medicine anticancer that they only have in the world. Pakistan don’t need to pay money, you can trade, Cuba has too the lung cancer vaccine, the only one in the world, many smoker now are safe thanks that vaccine. Many canadian are goingo to cuba for cancer doctor care. I’m living in Sarasota, Florida, United States and now I have medication of antibiotic for cellulitis, when I finish I will travel to Cuba to have the inyeccion of Heberprot because I’m diabetic type 2 with neurophaty. I took by phone with a cuban doctor practicing in Islas Canarias, Spain, two days ago and he recomended me to have Heberprot procedure in Cuba, they don’t have yet in Spain the drug but he told me all of them there now the drug by the medical literature.Recommend

  • Gualterio Nunez Estrada

    I don’t know what happens because India signed a deal with Cuba to export to Cuba medicine from India, very famous pharmacist in the world, and later, nothing happens. Cuba is short every time in pharmacist but not in hospitals pharmacist. People in Cuba complaint about in the newspapers. ? What happens with the deal with India ?Recommend

  • Gualterio Nunez Estrada

    Mosttly pakistany I know are nice people, very nice. I know families from Pakistan living here in Sarasota, Florida. I was working with a cousin of the most famous phiilologist of Pakistan,polyglota and ambassador, too, but I don’t remember the name now..Recommend

  • sterry

    Even so called top notch hospitals in Pakistan like Aga Khan in Karachi have problems with bad health care and overcharging for nothing. Even they administer the wrong medicine and have killed patients like reported here:

    https://tribune.com.pk/story/1309244/alleged-negligence-akuh-offers-condolences-bereaved-family/

    I think Cuba has become a success story for the Americas in the way it transformed itself with universal health care. Although people are not wealthy, everyone has a job and shelter and everyone has access to health care and education. The problem in Pakistan like most 3 rd world countries is that the rich people do not want to share with the poor and there is a lot of disparity. Muslim countries talk about equality but they don’t practice what they preach. A top notch Cuban doctor will be paid the same as a worker and both are happy on less than $ 50 dollars a month but in Pakistan, professionals would riot and think they deserve more. Cuban people respect their revolution and the fact that everyone should be paid little because the state gives them so much.Recommend

  • sterry

    You are corrupt but you don’t speak for most Pakistanis and fortunately most Pakistanis are decent, hard working people. Fortunately, I am Pakistani. I love my country and I want to help[ make it better but you should move elsewhere and leave us alone.Recommend

  • Gualterio Nunez Estrada

    Everything you do is observed by who created the universe.Recommend

  • Sane sid

    Yes ….that’s why they are depending on Chinese to help them overcome financial crunch…..Recommend

  • Sane sid

    I support Sindh….. don’t worry mateRecommend

  • Sane

    Stupid and irrelevant response. Pakistanis and Pakistan will keep haunting you all the time.Recommend

  • Sane sid

    No in fact I liked the term Hard Working and Honest…….. trulyRecommend

  • Irfan Lateef

    This is what happens, when people focus more on qualifying for a government job rather than focusing on being responsible human beings. Getting a job is easier as compared to actually doing the job like a responsible human being. The incompetence of PMCH staff is no secret, some may argue that they are under staffed but i say they are poorly staffed.Recommend

  • sterry

    He’s probably another Indian troll – they pepper all the comments so you always wonder why Indians are so obsessed with Pakistan.Recommend