He was bundled in a stark white cloth, his head gaping through the wrapper as he was being ruthlessly carried out of the ward. He was born on the first day of this year, 2011 and died four days later – couldn’t battle long enough for sufficient oxygen. Son of Abdul Sattar died of asphyxia and breathed his last at the National Institute of Child Health (NICH) hospital in Karachi, Pakistan.
The sight was horrific and disconcerting. However, for the medical staff it was a typical incident, which they encounter at least four to five times a day. As we walked through the ward, the parents looked at us with helplessness in their eyes, hoping that we are some senior medical practitioners. Or magical practitioner for that matter – who could wand away their child’s illness and revive them back to health.
We were neither!
Their temporary hope was crushed back to the debilitated facilities of the ward. They were thrown back to the mercy of ill-equipped and unhygienic premises, back to the mercy of irresponsible nurses and undependable doctors.
Pakistan’s public health care sector is under-resourced and over-whelmed. Physicians and nurses display extreme irresponsibility primarily due to lack of financial incentives and resources in terms of medical equipment, facilities, etc.
In the last decade or so, urban cities in the country have seen a drain on resources because of rural migration. Poor sanitation, lack of infrastructure and proper health care are some of the few issues that urban slum dwellers face. Unfortunately people have no access to a continuous, compassionate, family centered and accessible healthcare.
In the low income group, deaths are primarily due to unhygienic home deliveries, premature births and inadequate post-natal care. Low socio-economic conditions, below par income, population explosion and illiteracy are some of the major contributory factors to poor health and high morbidity levels.
The National Institute of Child Health was opened in Karachi in 1962 in the building of the present Basic Medical Science Institute in Jinnah Hospital premises. The emergency ward witnesses an insurgence of patients suffering from diarrhea, respiratory infections, kidney problems and burns. Statistic for December 2010 show there were 120 deaths with half of them being newborns and the other unfortunate half being under 12.
It is interesting to note that until about two years ago the emergency ward was in shambles, with the monthly mortality rate being 250. Until about two years ago the ward was managed by the government.
In April 2009 a young lady, Zantiana Saqib decided to take on the emergency ward of NICH and protect the poor from rising health care costs. Having worked as a full-time volunteer in the Nephrology department of NICH for five years, Saqib realised the need to help the poor children who came to the hospital, suffering from severe illness yet hopeful of survival – many not all, never left the hospital alive. Being a young mother herself, she desperately wanted to alleviate the dismal condition of the ward and offer free medication to the needy children. She had to climb a steep learning curve to understand the workings of the ward as well as dealing with the management staff. Since the last two years she has worked diligently to train her team, manage supplies and control inventory. According to Saqib, “Parents blamed themselves for their child’s death. I wanted to assure them that access to proper health care could do wonders.”
The ward is still in shambles. There is cracked paint on the drab walls, rustic equipment and absence of basic hygiene and sanitation. It is crowded with teary-eyed mothers and suffering children.
However, with her relentless efforts (along with two co-workers, Abdul Ghanchi and Faiza Usman), she has managed to bring down the mortality rate by half. Bulk of the medication is bought from pharmaceutical giants like Roche, Merck and Abbott on a monthly basis, stored in a warehouse and brought to NICH each week. The medicines are then dispensed on the doctor’s prescription to every patient – absolutely free of cost. Saqib has also managed to maintain and update the medical equipment that was present at the time she took over the ER.
Yet, her biggest challenge remains restrained access to capital, the kind of capital that would make a positive social impact on the families living in that area.
The disparity of good health between the privileged and the poor is becoming wider and wider. It is our social responsibility to engage in community services and help reform the lives of young children and their parents who are not so privileged.
To improve the public health care system in Pakistan we have to collaborate and work together. We have to organise and devise solutions, both large and small, to improve the lives of the poor.
We have to give them their basic right to live – which is good health!
Saadia Tariq is an avid photographer based in Singapore.
The views expressed by this blogger and in the following reader comments do not necessarily reflect the views and policies of the Dawn Media Group.