One of my doctor uncles once joked that “ aapki zindagi likhi hu tu aap hospital mein bach hee jayengein” ( if you have a long enough life, you will survive the hospital). This pretty much sums up Pakistani healthcare system.
The first time I came out of my happiness bubble, was when I interned for a rural health clinic in Hafizabad. It was a microcosm of Pakistan, with extreme and diverse limitations that had ugly outcomes.
The patients were often poor and therefore couldn’t afford medicines and consultants. They were unaware of the urgency of treatment, often reluctant to approach hospitals and therefore, mismanaging, mistiming and often dying in the process. Like everywhere else, the law was negligible, the patients and care-givers had no rights and the major brunt was faced by women in hospitals.
Strange complications resulted. Newborns died over-night by pneumonia, leaving their parents sullen and would-be mothers arrived at near-death stages after many days of labor at home. It was such a torturous affair, visiting the clinic and the wards, that literature was my cup of tea not medicine.
In 2007, I was in USA for a summer when I decided to rent a bike and go for a ride. But this resulted in an unforgettable incident. The bike slipped on a slope and I landed myself in a hospital, thus experiencing arguably one of the best healthcare systems in the world. The first thing they did was, they put me in a wheelchair. When I protested that I can walk, they said I have to write them a disclaimer that if I trip it’s not their fault.
A nurse came to take my bio-data, and after that some three different types of nurses appeared before the doctor arrived, some five hour later. The CT scan was already done by then, to check my brain for damage (which my mother thinks happened nevertheless). The doctor gave me five minutes, explained that the facial tendons are pulled and left after giving me high-powered painkillers (like valium) which I didn’t buy because they were worth several dollars per tablet. Though the doctor was very late, I felt two things there. I could go to the court if they mistreated and my life was worth it.
In the last few weeks, I have frequented Punjab Institute of Cardiology to see my grandpa in the midst of the “fake medicine” scandal. Four years back PIC was at par with any American hospital. This time it was in shambles. Perhaps this is the end of ladder for every Government institution in Pakistan. And I hope that this medicine scandal will serve as evidence against public-private enterprise.
When I was in college, I went to this private clinic for my skin treatment from the best dermatologist available. But one visit cost a whooping Rs 1000, and the ointments and medicines were worth several thousands. After a few months I realized, that he doesn’t face any consequence for suggesting anything. There was virtually no responsibility or accountability and then the Imanae Malik case came to light. In healthcare at least, the private sector is more expensive but equally flawed because health laws, qualified personnel, upgraded equipments, latest medical treatments and technologies are absent everywhere. It like getting arrested in Pakistan- once you are behind the bars, you are in trouble even if you are the former Prime Minister.
I have been going to Jinnah hospital for many years now. It has grown so much, since the time it started. And since five of my siblings were born there, it is a source of pleasant memories for me. Just two years ago, I was in their labor room with my aunt and it was stunning. A line of ladies in labor, some of them forced to stand because of lack of beds. Some shared a bed with other would-be mothers, while the sweepers mopped the floor and asked for bukshish. Dozens of women thronged the labor room, most of them attendants like me.
Yet this is the best they can get, no one is refused and most people go back alive. This is the most enchanting aspect of our healthcare that most people survive against the odds. All Government hospitals have this to their credit that they are operational despite all the challenges.
Pakistani healthcare, like our Judiciary and Police, needs less badmashi and more modern trainings, come under the legal grip and get more fiscal allocation in the budget. If hospital staff earns as much as rickshaw drivers, patients will feel the road bumps, hear the searing noise and inhale in the contaminated air. If we deserve a better service, they deserve a better pay.
This piece was first published in the News on Sunday.