All over the world it is nurses who take care of patients but in Pakistan owing to its social structure, more than one relative of the ailing person attend to him/her in hospitals.

For patients it is a blessing because the attendants not only give them company but also provide them with medicines and arrange lunch and dinner for them.

But for the doctors it is a nuisance because the presence of attendants can lead to spread of germs and puts the patients at risk of contracting diseases. Besides, they consume most of the oxygen in the hospitals, increasing the suffering of the patients.

Islamabad has 1,400-bed Pakistan Institute of Medical Sciences (Pims) and 550-bed Polyclinic. The CDA Hospital was originally meant for the employees of the Capital Development Authority (CDA) but now it is catering to the general public as well.

A doctor at Pims on the condition of anonymity said that according to rules only one attendant is allowed to stay with the patient. He/she is issued a card at the time of the admission of a patient to ensure that only that particular person stays with the patient.

“Although only one attendant (having attendant card) is allowed to stay with the patient, the number exceeds to three or four and the hospital staff have to request them to leave the ward but they slip into the corridor or canteen for a while and then return,” he said.

“Their presence particularly during the daytime annoys doctors who keep reprimanding them that only one attendant is allowed. The rest then have no option but to leave the wards and make the lawn or corridor their temporary abode,” he said.

“During night-time the attendants, however, have the liberty as doctors do not visit wards too frequently. I have seen two attendants sleeping on the bench lying alongside the patient’s bed and another with the patient,” he said.

“The presence of attendants not only is irksome for the hospital administration but is a matter of inconvenience for themselves too as they cannot get proper sleep.

“Sometimes all family members accompany the patients who are shifted from other cities or provinces like Khyber Pakhtunkhwa (KP) and Azad Kashmir (AJK),” he said.

A doctor at Polyclinic requesting anonymity said that his hospital was comparatively small and could not afford even a single attendant let alone two or three.

“If the hospital staff tries to push the relatives of the patient out of the ward they start arguing with them. The situation gets more irritating when a patient dies as they start protesting and scuffling with the doctors,” he said.

Pims spokesman Dr Waseem Khawaja while talking to Dawn said that at the moment there were around 1,400 beds in the hospital with almost 100 per cent occupancy rate. In the absence of beds the staff had to turn away a number of patients, he said.

“If two attendants stay with each patient, the number of patients and their attendants reaches to almost 4,000. Because of extraordinary number of patients, oxygen level in the building decreases and everyone in the building feel suffocation,” he said.

“Moreover attendants bring germs along with them. A number of attendants bring babies and children too. Because of their weak immune system, children can easily contract a disease. They also enter Intensive Care Units without wearing mask and special shoes, which is not only dangerous for them but the patients as well,” he said.

“It is in the interest of patients that only one attendant should stay with them in the hospital,” he said.

“A radiologist said children usually accompany attendants when they bring their patients for X-Ray and try to enter the X-Ray room along with children, exposing them to radioactive rays” he said.

An attendant, Abdul Khaliq, said that if relatives did not visit the patient or stay with him/her, especially during the night, it becomes a matter of contention between families.

“We ignore marriages but ensure to visit the ailing relative or attend his/her funeral,” he said.

However, an attendant, Nadeem Ahmed, while talking to Dawn, showed another side of the picture.

“My father-in-law, Nazir Ahmed, was admitted to the medical ward of Pims because his liver had ruptured and he was unconscious,” he said.

“In the developed countries staff of hospitals take care of patients but in Pakistan the situation is quite the opposite,” he said.

“My father-in-law stayed for six days in the hospital and died. I can surely say that one attendant is not enough to take care of the patient. Me and my wife’s brothers washed my father-in-law. We provided injections and drips after purchasing them from the market which was not possible for one attendant to do. At times the patient moved his hand due to which blood started flowing towards the drip,” he said.

“When the urine bag was filled it took time to change the bag. Even after the death of my father-in-law it was difficult to get the clearance certificate from the hospital and arrange an ambulance to shift the body,” he said.

“Unless the system in government hospitals is not improved, one attendant restriction is unjustified,” he said, adding that medicines and treatment should be provided to the government hospitals without any hassle.

“I believe that our social system is a blessing for us because it develops a bond between people and they take care of each other,” he said.

Published in Dawn, August 24th, 2014