KARACHI: The arrival of patients from different parts of Sindh and Balochistan to Karachi’s three major public hospitals has dropped to almost zero due to the lockdown and precautionary measures to contain the spread of coronavirus, triggering concerns for the health of hundreds of thousands of critically ill patients, including children.

The plight of such patients, who mainly belong to the rural parts of the two provinces, has largely been ignored and their issue was seldom discussed on the media.

The number of patients from rural and urban parts of Sindh, excluding Karachi, and remote towns of Balochistan to the city’s Jinnah Postgraduate Medical Centre (JPMC), National Institute of Child Health (NICH) and Dr Ruth Pfau Civil Hospital Karachi (CHK) has drastically dropped and since the last week of March only a few patients from the two areas managed to reach any of the three health facilities for their treatment.

The trend raises pertinent questions about the fate of such patients who visit the metropolis to avail medical facilities their hometowns lack.

Patients from other districts cannot reach JPMC, NICH and CHK because of lack of public transport

With lockdown and a ban on all kind of commercial and passenger transport in the province in place, doctors and officials of the three health facilities say the number of patients from cities and towns other than Karachi had almost come to zero.

“More than 50 per cent of our OPD [outpatient department] patients include the children brought from different towns, cities and rural areas of Sindh,” said NICH director Dr Jamal Raza. “Similarly, they also had a major share in bed occupancy as many of these children are referred from all over Sindh for different kind of surgeries or medicine therapy. They are not coming here due to non-availability of transport after the lockdown.”

The hospital record says hundreds of children are admitted every month mainly with general paediatric problems which includes diarrhoea, malnutrition, pneumonia, tuberculosis, asthma, chronic liver disease, diabetes mellitus and haematological disorders.

The facility also provides paediatric surgical services in almost all surgical conditions and includes general surgery, neonatal surgery, urology, orthopaedics, thoracic surgery, plastic surgery and burns, minimally invasive surgery including laparoscopy, thoracoscopy, selective neurosurgery and endoscopic procedures.

The question remains about the health of those children who used to visit the facility regularly and those who are referred to the city’s major hospital for immediate medical intervention or treatment.

Same is the case with the JPMC and CHK.

The 2,000-bed JPMC caters to a large number of cases from all over Sindh and finding a space for any patient has always been a challenge due to pressure from all over the province. Currently it has just a little more than 350 admitted patients.

“We treat more than 7,000 people in our OPDs every day but that number has gone down by more than 50 per cent,” said Dr Seemin Jamali, the JPMC’s executive director. “Patients from towns, cities and rural areas of Sindh other than Karachi are not coming at all. We are a public-sector hospital and we don’t refuse anyone but the fact is that we are not receiving patients from Sindh other than Karachi. On an average we treat hundreds of people from different parts of Sindh and Balochistan every day even in our emergency.”

The common fear and question among the health experts and doctors is where all these patients are going if they are not coming to Karachi. The most obvious answer is they are not going anywhere but waiting helplessly without any treatment at home in their towns, cities and villages.

The absence of an organised public sector ambulance network is further adding to the woes of the already fragile health system.

“A large number of our patients include those who arrive here from Hub, Lasbela and even Khuzdar and Awaran,” said Dr Khadim Hussain, the CHK medical superintendent. “Similarly, a large number of patients from rural Sindh are also treated at our hospital. Since last week of March, we have not seen any of them visiting our hospital. Similarly, their registration at inpatient department has also declined to almost nil.”

Published in Dawn, May 30th, 2020