KARACHI, Sept 7: While infection control at health facilities is an important concern in the developed world, most medical centres in Pakistan have little or no preventative measures in place. The gravity of the situation can be gauged from the fact that in the US, where the standards of hygiene are generally high, hospital infections affect two million people a year, cost 100,000 lives and add $30.5 billion to the country’s healthcare tab, estimates the Committee to Reduce Infection Deaths.
The situation in many of the city’s hospitals is critical. A case in point is the gynaecology and obstetrics department of the Sindh Government Hospital, Korangi No 5.
The only government-run hospital in the area, this dispensary-turned-tertiary care health facility is visited every day by a large number of patients, particularly women seeking antenatal checkups, treatment for menstrual irregularities or post-pregnancy complications. The gynaecology department is crowded until the afternoon and patients often have to leave without having had a medical examination since the out-patient department closes at 2pm. While this is inconvenient, the patients’ major complaint is the lack of hygiene.
“The labour room is filthy,” complained the mother of a woman admitted into the facility for delivery. “There is no dustbin in the ward and there were no sheets and pillows on the bed when my daughter was admitted. They were only provided when we complained. Similarly, the washrooms are very dirty, there are no utensils and most of the taps have been stolen.”
An inspection of the delivery room proved her contentions. The floor was stained with blood and a bucket serving as a waste-bin was full of used cotton swabs. There is no water supply and a small container is used instead as a temporary arrangement. Furthermore, the room lacks a baby warmer, which is essential to help newborns adjust to the temperature change.
In defence of the pathetic state of the delivery room and the ward, the facility staff said merely that the building was being renovated and an additional block equipped with better facilities has been constructed, to which the gynaecology ward will be shifted within a month.
However, they complained, the functioning of the department is seriously hampered by theft. “Taps, fans, stethoscopes, a blood pressure examination machine and even delivery sets have been stolen. At the moment, we have just one set with which we carry out over a dozen deliveries a day,” said a nurse.
According to another source, the hospital uses the household antiseptic Dettol for sterilisation purposes. “An auto-clave is the best way to sterilise equipment but if that is unaffordable, a boiler or even a chlorine solution can be options,” said the source. “A household antiseptic cannot possibly serve the purpose.”
Frequent power outages are a major impediment in the functioning of the operation theatre, which is opened only for planned surgeries. The rented generator often malfunctions and causes delays during surgeries, with the result that the facility refers complicated cases to the Jinnah Postgraduate Medical Complex or the Civil Hospital Karachi.
The electricity breakdowns also mean that patients are sent elsewhere for ultrasound scans and other tests. “This becomes quite costly but since the doctors give us a patient hearing and we feel comfortable, we tend to ignore such lapses in service,” agreed most of the patients. However, they pointed out, the nursing staff at the Sindh Government Hospital demand money for services that are part of their duty, which is unacceptable.
The healthcare facility employs 34 staff members, including 10 doctors, some of whom are on call for emergency duty. However, such situations rarely occur since only normal, registered cases are attended to at night. One source claimed that most of the doctors run private clinics in the evenings and are unwilling to work night shifts.
The doctors, however, feel that they are doing their best within the limited resources available and express the hope that most of their problems will be solved once they shift to the new block, which awaits an electricity connection.
“The hospital is big enough to be a teaching hospital. Over 150 patients visit the out-patient department every day and about 200 deliveries are performed every month,” said Dr Ayesha Sameen and Dr Tahira. “But such a large number of patients can only be treated well if the staff is increased and a better management system is put in place.”
