The medical fraternity in Pakistan is faced with a herculean task: How to keep the nation healthy and fit
PAKISTAN is an underdeveloped country with limited resources. Its population growth is one of the highest in the world (2.1 per cent per year) which has increased five fold in the last 50 years.
Family planning has failed miserably in this part of the world. Thirty-four per cent of her population is living below abject poverty with per capita income less than one dollar a day. At the same time, Pakistan is spending 0.7 per cent of its GDP on health which is lowest this region. It has high infant (8.5 per 1000) and mother mortality rate (350-435 per 100000).
Malnutrition, diarrhoea dysentery, respiratory tract infections are still common in children. Due to EPI (Expanded Programme of Immunization) we have managed to control the infectious diseases to some extent. Still sporadic cases of such diseases like tetanus, poliomyelitis, measles and whooping cough are reported. For example, 32 cases of polio were reported in 2002. Malaria which was once almost controlled in this part of the world, is again becoming a great problem. Drug resistant falciparum API (annual parasite incidence) of malaria was 0.69 per 1000 population in 2001.
Tuberculosis is again on the rise and multiple drug resistant diseases is a real community health hazard. In the year 2002, 175 in 100,000 Pakistanis were suffering from pulmonary tuberculosis.
Water borne diseases like typhoid, worm infestations and gastro enteritis control, is yet a distant dream. Especially since 61 per cent of the population has no proper sanitation facilities and 37 per cent has no access to safe drinking water.
Hepatitis B and C are a real threat to the public health. It is estimated that every one out of ten persons in this country is Hepatitis B positive and 7-20 per cent are C positive. Drug addiction has been on the rise since the Soviet invasion of Afghanistan. This has especially been the case in young people, of ages 15 and 25. There were 3.01 million drug addicts in 1999 in Pakistan which have grown to 4.5 million in 2002.
Aids is not much of a problem right now in Pakistan. Only 235 cases of Aids and 1785 HIV positive cases have been reported till now. However, Who and UNAids suspect that this low figure is perhaps due to under reporting and lack of proper screening of the high risk people like sex workers, migrant workers, drug addicts, active male homosexuals, long route truck drivers, blood recipients, professional blood donors, sexually transmitted infection patients, prison inmates and sea-farers.
It is suspected that there may be 70000 to 80000 HIV positive cases in Pakistan. This low prevalence does not mean that we should sit happily in euphoria. In view of high prevalence of HIV/Aids in the immediate neighbour country India i.e. 4.58 million, a high number of migrant labour (31,77,383 in 2002) and widespread illiteracy and poverty, the danger of epidemic of this disease is hanging on our neck like Domicile’s Sword.
Air pollution too is on the rise and 1800 people die every year in Pakistan due to air pollution related diseases. Diabetes mellitus, cardiovascular disease and cancer are taking a big chunk of health budget and human lives in this country. Eighteen per cent of the adult population is suffering from hypertension and six to thirteen per cent of the population is suffering from diabetes mellitus.
Other diseases of the uncivilized past like, small pox, plague have been completely eradicated, though cholera and sporadic cases of cutaneous leishmaniasis, that were reported in South Punjab, Sind and Baluchistan in the past are again on the rise in Sind and NWFP, partly due to the mass influx of Afghan refugees.
Likewise sporadic cases of leprosy are still reported from Karachi and NWFP.
Who will sort out our health problems? International organizations may come forward and offer us South American, Chinese, Egyptian, even Indian models. They may also offer us some aid or loans. Our health problems and priorities, religion, social customs and economy are different from other countries. So we and only we have to solve our own problems. We have to evolve, our own strategy and ways for prevention and eradication of the prevalent diseases. We have to improve the quality of life of a common man and national well being with whatever meagre resources we have. This can be done with full devotion, conviction and research: We have to harness the power of science and technology to prevent diseases and serve national health interests.
Thank God, we have enough doctors in Pakistan i.e. 1:1466 population ratio, as compared to 1:1800 in 2000 in UK. Credit goes to our College of Physicians and Surgeons of Pakistan which started functioning in 1962 and is producing a high quality of medical specialists in most of the fields, and has passed out 10714 specialists in 80 specialties till 2002. They are not only catering for our country’s needs but are also doing a great service to the ailing people of our friendly countries. However, our dentist and nurses-to-population ratio is much less than desired i.e. 1:29405 and 1:3347 respectively.
What we need is a group of highly motivated, enthusiastic, dedicated and willing young researchers who have the drive in their heart for this noble cause and for doing something for their country.
The medical fraternity in Pakistan is faced with a herculean task: How to keep the nation healthy and fit 
