KARACHI, March 11: The government hospitals including the Jinnah Postgraduate Medical Centre and the Civil Hospital Karachi badly need an effective infection control strategy through improved cleanliness and sanitary conditions, and a better public image by treating patients with more care, respect and dignity.

The private hospitals of Karachi are not only visited by well-to-do people, but also by the patients of middle income and even low-income groups despite their back-breaking bills as they found the hospitals neat and their staff polite and attentive.

The big government hospitals of Karachi like the JPMC and CHK are almost at par with these costly private hospitals in terms of buildings, medical equipment, facilities and services of senior professors, but due to lack of hygiene and cold attitude of staff they lacked general confidence of patients.

Despite these shortcomings, the JMPC and the CHK are catering healthcare needs of millions of poor and low-income people belonging not only to Karachi, but also other parts of the country, and a little care to improve their cleanliness and attitude of staff could make them popular and acceptable for millions of more citizens.

A visit to both hospitals would tell volumes about the lack of seriousness of administration towards proper hygiene and more importantly to the vital issue of infection control. It is regrettable that two manholes on the main road leading to the JMPC main building, and a gutter each in front of the National Institute of Cardiovascular Diseases and the National Institute of Child Health are without covers.

The corridor between the department of thoracic surgery (Ward-19) and ENT department (Ward-15) at the JMPC is littered with tones of construction debris and refuse.

The primary objective of any hospital is not only to properly diagnose and treat patients, but also control infection to ensure safety of patients, their attendants and visitors, as well as, doctors, nurses, paramedics, other hospital staff and medical students.

The stay of patients in government hospitals is longer as compared to private hospitals, due to the lack of strategies to cope with hospital infection result in delayed recovery of patients. Sometimes a patient is cured from one disease, when he catches another infection due to unhealthy atmosphere at hospitals. It is common practice in our major government hospitals to rely on heavy use of antibiotics, while this costly dependence could be easily reduced if proper infection control strategies are carried out. Even improved general cleanliness and sanitary could bring a substantial difference.

According to experts, patients contract infections at the hospital in many ways, including surgery, bacteria-ridden catheter tubes, unhygienic conditions and most importantly unwashed hands. The excessive use of antibiotics in our hospitals is directly related to higher rate of infection due to improper hygienic conditions. It is said that some 70 per cent of the bacteria that cause hospital-acquired infections are resistant to at least one of the drugs most commonly used to treat them.

People infected with drug-resistant organisms are more likely to have longer hospital stays and require treatment with second or third choice drugs that might be less effective, more toxic and more expensive.

Antibiotics kill the bacteria that cause infections. But today, antibiotics are not working as well as they did in the past because the bacteria have started resisting the antibiotic. This is called antibiotic resistance. When antibiotics are misused, overused or underused, the bacteria causing the infection can become stronger. The infection that is being treated may get worse and require a more powerful antibiotic in the future.

The more powerful antibiotics reserved for treating only the very serious infections in the past are now being needed to treat more common infections.

It is common observation that majority of toilets and washrooms in OPD areas as well as wards are extremely dirty in both hospitals. Generally, they lack proper plumbing work and their water taps and basins not in working condition. There is no provision of soap for washing hands.

Proper sanitation can prevent common infections. It is extremely necessary that hospitals have flawless sanitation. It is a must that patients, their attendants and hospital staff must wash their hands with soap after using toilets, as human excreta always contain large numbers of germs, some of which may cause diarrhoea.

To ensure proper sanitation in hospitals, there should be sufficient toilet facilities for patients, their attendants and hospital staff. There must be a wash basin with clean water and soap facilities. It is strange that these hospitals are spending millions of rupees monthly on drugs, but they are not ready to spend a few hundred rupees to provide soap for washing hands in their toilets.

The corridors and waiting areas of almost all government hospitals in Karachi need cleanliness. In corridors and staircases of the JPMC some empty tins of ghee and some plastic drums are seen to dispose off refuse and litter, but these dirty and uncovered garbage bins create more infections.

Free roaming of peddlers, tea and juice sellers, hawkers and even beggars in corridors of both the hospitals offer a pathetic picture of their administration. These peddlers even roam into wards freely during visiting hours.

The administration of these hospitals needs to focus on effective infection control through improved cleanliness, especially in corridors and toilets. A more polite and caring attitude of hospital staff, especially junior doctors, technicians, paramedics and clerks could further improve efficiency of these hospitals.—PPI