Karachi Press Club, which is a couple of yards away from my office, remains a platform for countless people who desperately want their issues to get addressed by the crème de la crème of Pakistan. Last week, en route to work, I saw a man outside Karachi Press Club brandishing x-rays toward a herd of people. Unable to conceal my curiosity, I stepped out only to discover that the poor man was just another unfortunate victim of medical negligence. The x-rays, he carried, showed a grotesque image of a pair of scissors inside his abdomen, which were left in his body by a doctor during a surgical procedure seven months ago.

Shaken to the core after witnessing the worst form of violation of the Hippocratic Oath, I kept wondering why the government and other policymakers of Pakistan heed no attention to the rise in the cases of medical negligence in the country. The well-known case of Imanae Malik, a three-year-old girl, who died in 2009 after her doctor administered a lethal dose of anaesthesia, also made no headway and disappeared after a while.

Dr Rahim*, a doctor who has been in the medical profession for the past 25 years and previously, owned a private hospital narrated his experience by saying, “it is all about money these days. Doctors tend to entertain more and more patients every day because that way they can earn more. They run their private clinics and misguide patients.”

“I remember a case of a 19 year-old-boy who was diagnosed with appendicitis and was operated. The doctor even showed him a specimen of his appendix for authenticity after the surgery; however, recurring pain in the boy’s abdomen led his family to consult another doctor, whose diagnosis confirmed colorectal cancer. Moreover, lab reports also revealed that the boy’s appendix was intact, which proves that the doctor only operated on the boy because he wanted more fees,” he added.

The fact that medicine remains one of the most underpaid professions in Pakistan, so much so that a Resident Medical Officer (RMO) gets Rs 8,000 to Rs 10,000 per month for services, can be possibly attributed to this materialistic mindset of doctors. They, who are considered the epitome of humanity and are known to carry the responsibility for alleviating people’s miseries, should not let money drive them.

We all hear about tampered medical and pathological reports, primarily because perhaps it is more ‘lucrative’ to remove a spleen or appendix than to prescribe medicines.

Medical negligence and incorrect diagnosis, which ideally should be considered equivalent to attempted murder, have become a norm in Pakistan because there is no accountability. We hear about cases of medical negligence and the plight of the victims but what we do not hear is the news regarding the fate of the culprit who has either been involved in malpractice or is found guilty of medical negligence. Termination from employment by the government and medical associations is the highest form of punishment for these culprits, without any mention of suspending their license to practice.

Medical negligence, however, is not always deliberate. In government hospitals evidently the constant flow of patients is one of the most important factors behind medical negligence.

Whilst talking to another doctor who works at the Abbasi Shaheed Hospital in Karachi, I came to know that flocks of patients wait outside the outpatient department (OPD) and surgical wards, which is why doctors are always in a rush to attend and discharge as many patients as possible.

“Leaving cotton packs inside human bodies after surgical procedures is not uncommon in government hospitals and generally these mistakes occur because doctors cater to a huge queue lined up for treatment,” said the doctor on condition of anonymity.

“The government should either deploy more qualified doctors or should construct more state-owned hospitals to resolve this issue,” she added.

Regulations and governance framework, setting a ceiling of maximum patients that a doctor can see in a day, among other measures can resolve issues of unintentional medical negligence.

The most underreported and unknown cases of medical negligence take place in pediatric and neonatal wards.

A speech therapist, who works for children with disabilities, said on condition of anonymity that, “it would not be unwise to say that an extremely high percentage of disabilities that Pakistani children face is either because of an inaccurate diagnosis or medical negligence.”

“Many a times, a child is diagnosed with common jaundice, whereas it is later revealed that the child had Kernicterus or Bronze Baby syndrome. I have personally counselled and treated many children who are completely deaf because they were diagnosed with common jaundice when they actually had Kernicterus,” she added.

Kernicterus is a form of excessive jaundice which can cause irreversible brain damage if the patient is not given photo-therapy or the blood is not exchanged, within the early hours of the birth. All it takes is one wrong diagnosis and screening test to deprive a child of a vigorous and healthy life.

Whether we attribute the failings of our doctors and medical system to a lack of conscience, drive to make more money or inappropriate training, it is essential to understand that policies and punishment for non-compliant doctors are the only way to address the issues pertaining to medical negligence.

It is difficult to say when and how the negligent doctors will be reprimanded, however, unless the culprits are identified and extreme judicial precedents are set, we will continue to read traumatising stories about ‘medical killings’.

*Identity concealed due to security reason.


Faiza Mirza
The writer is a Reporter at Dawn.com


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Comments are closed.

Comments (19)

asad
April 17, 2012 7:18 pm
well said
Zahir
April 17, 2012 12:17 pm
Interesting View... I am a Doctor and I DONOT wants to practice Medicine any more. Because of Misinformation generated by Media and personnel , I do not understand What is " GHALAT INJECTION " till now.. Which is causing deaths in Pakistan only... I have treated a baby with “Wilson Syndrome", When the attendant brought the Child ( 8 Yrs) she was in very bad shape.. I ask why they did not brought the patient earlier.. They informed me that she was being treated by BABA in Lyari.. I told them the baby is very serious they should shift the baby to centre where facilities are more they enforce me to admit the child.. Latter on I was with the child for 3 three days .. I did not went home even.. The Baby died. Next person who enter the room Put a Gun on my head to save the baby or make her alive again. (I asked him to go to Allah and ask him to give life) .. Next day there was a headline in paper that "GHALAT INJECTION" say bacha mar giya..No one investigate in the matter.. ( Neither Media/ Judiciary/ Police ) any one... Baba G ko koe nahe janta... Still now...
Pakistani Muslim (@N
April 17, 2012 10:23 pm
you are right brother... it been trend for last few years to badly criticize the every noble profession by media to become only prestigious and patriotic professionals in the country... they bring things about judiciary, doctors, army... but their lips are sealed against the bad copes of the society...! i don't say the author of this blog post is biased or Doctors, judges, army personnel are free from corruptions, but media attitude towards them is unjustified since the put all people in same line with out realizing that in every society their are both good and bad sectors are present,... bad should be condemned and good must be appreciated..!
Hafsa
April 17, 2012 10:29 pm
very well written article such money makers should be brought to their right places and government must make certain rules to punish such negligent doctors and if these so-called doctors were only willing to make money, then they should have chosen some other field
Hafsa
April 17, 2012 10:31 pm
feel sorry for u but seriously, does your words means that we should not opt for this field
Doc
April 16, 2012 10:35 pm
I am a surgeon in USA (orginally from Lahore) and this is my first comment ever in any form of media. A decent article by Faiza but one with a few oversights. Firstly, medical errors are unfortunately seen even in the western world, where we take numerous precautions to prevent them day in and day out. In USA, we have atleast 3 levels of scrutiny preventing errors such as leaving laps or instruments in patients during surgery but unfortunately it still happens and its a fact of life. Secondly, although prevention is the best cure but I won't waste time on that since we in Pakistan are far from the level of personal commitment and institutional processes required to prevent such incidents. So, how a society choses to react to medical errors is extremely important and will in effect shape the future of our health system. When I left Pak, it was a society where physicians were well respected and never blamed for any wrongdoing which in itself was one extreme of a spectrum (provided most of the physicians back then were competent i.e. before private medical colleges started handing out degrees for money). This caused physicians to be 'all powerful' and did not help their cause much. The other end of the spectrum is here in the US where defensive medicine is practiced by all physicians since everyone is just utterly scared of being sued. This may very well lead to the collapse of the US ecomony in a few decades if they don't fix their health care system (since it eats up a huge chunk of their budget). I am seeing Pakistan heading towards a similar fate. Doctors are blamed everyday for something or the other. Lawsuits and more importantly, the threat of lawsuits is on the rise (most people looking for out of court quick settlements). Don't get me wrong. I am not saying that we should not condemn false medical practices. By all means. If a physician is inflicting 'more harm than good' then he needs to be held accountable but it should be monitored. Europe has a much better model in that respect. We should identify the root cause of such malpractices which were extremely uncommon a decade ago and then treat them. Private medical colleges are NOT helping. Salaries need to be increased to a respectable level and THEN if someone is caught cutting corners, he/she should be punished judiciously. Life, liberty and security should be enforced for all (patients and physicians). Maybe then, trained and intelligent physicians might want to return back home. (P.S: I know nothing will change but I had to vent out)
Khalid Amin
April 16, 2012 10:41 pm
Cases of medical negligence and incompetent doctors must be dealt with by Pakistan Medical and Dental council. They should have the authority to investigate and revoke licence to practice of those doctors found guilty. Unfortunately our rulers priorities lies in filling there offshore accounts with dollars instead of improving the country's health system.
jd shami
April 16, 2012 10:54 pm
Let the Doctors make all the money they can, but they should be held responsible (mandatory jail or monetary fines) for mal-practice and this must be honestly regulated.
Sajid.
April 17, 2012 3:25 am
An eye opening and ''Superb effort''.an other thing i want to share is that with the passage of time some (not all) so called 'great servers of humanity' turn so rude and show so much bitterness in their behaviour that they feel themselves as the only experts survived in this world...
Abdul Rehman Iqbal
April 16, 2012 8:02 pm
Problem is that doctors are living in society where "money" matters. Respect, appreciation may feed the soul but empty stomach aches a lot. I am surprised when doctors are blamed for protesting against wage raise or for negligence during surgeries. Doctors can't survive on low pay, they have to feed their kids and and to perfectly healthy before keeping others healthy. And the negligence! Come on, you don't know the work load on doctors. Doctor to population is drastically low compared to developed countries, even then they are serving to their full potential. We want to serve, but money also matters. Give us all necessary items for living before asking for total devotion. An empty stomach can't give provide you a peaceful healing hand.
M. Shahid Yousuf
April 16, 2012 8:46 pm
The problem is who enters the profession and how they enter it. When all things are sifarish driven, it is obvoious that incompetence will be the order of the day.This will be whether we are dealing with PIA, railways or any institution. Doctors with merit and competence cannot compete against those who have incompetence and sifarish, a deadly combination. Good doctors probably emigrate.
Haider Khan
April 16, 2012 8:30 pm
My family visited Pakistan last summer and my two and half year old son was "diagnosed" with a 'hole in the heart". The Pediatric Cardiologist recommended a surgery at a cost of Rs.250,000. The said cardiologist is a well known doctor in the country. I had my family back to Boston right away and consulted the head of Pediatric Cardiology at Boston Children's Hospital. Making long story short, the dr said that my son had a very minor hole in his heart and dr want to see him after 5 years to make sure that heart was healing properly. All the dr in pakistan wanted to do was to get the money and did not care how it will effect my son. Imagine a 2 years old going through open heart surgery for the sake of few Rs. Shame on the dr. and shame on all of us to put up with all that is going in our country.
Riz
April 17, 2012 1:13 am
How about making a practical suggestion rather than asking doctors to be more humane while earning 10k.... How abt paying them decently and regulating the hours they work and number of patients they see.... How about providing them adequate diagnostic tools... How abt providing them adequately trained support staff and nurses.... Experience from developed countries show that 'blame and shame' doesn't reduce medical errors... There has to be a more systematic approach abt how the error could have been prevented rather than just stretching the over-stretched doctors even further....
Sajid.
April 17, 2012 3:30 am
Great effort. . . An other thing is that some so called great servers of humanity turn so rude and show bitterness in their attitude in dealing patients that they feel themselves as the only experts and specialists survived in this world.
hussein
April 16, 2012 6:06 pm
money, money, money, is all that we hear day in and day out. the irony is that this money is printed mercilessly and has lost its value..............90 rupees or more to a dollar.
zaffar
April 18, 2012 9:02 am
It is shameful to have all this mess. Which is due corruption and injustice in the country. Cut down budget on defense down size army and spend money on the welfare of people. We don't need 1million army,nukes and F16s to run the country.
Cyrus Howell
May 14, 2012 7:45 pm
It has been "a trend" in America since the 1950's. Partly for different reasons, but mostly money reasons. There are good auto mechanics and their are good doctors, Bad auto mechanics - and bad medical doctors. There are also the ethical physicians and unethical physicians and car mechanics. Not the same thing.
Cyrus Howell
May 14, 2012 7:37 pm
I don't buy that.
Shata Hari
May 28, 2012 7:17 am
if all th ese doctors chose a different field u wont have many doctors left in the country . if you want th eend product to be good ,keep the worker happy,atleast give them good conditions at work. You cant expect them to work in a shitty place with no resources and expect them to be as good as the doctors in developed countries.
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