Drastic steps need to be taken to bring Pakistani health care out of the shadows
“CT Scan Facility Suspended at JPMC” read a recent headline. Apparently the radiation tube of the CT Scanner at this premier Karachi hospital, called Jinnah Postgraduate Medical Centre, had brunt out, thereby forcing the closure of the said facility for several weeks, if not months, while the government imported the part from Japan. Why didn’t the hospital administration have a spare one in its stock when they knew the tube was going to burn out (it was way past its scheduled expiry period)? However, in the meanwhile, the patients will have to “avail the facility from the private sector,” the report quoted the concerned department’s head... assuming the indigent patients of JPMC have the money for it!
As we all know, life and sickness go together. We all get sick, be it from common cold or something more serious. In times of ill-health a lot of us seek help and treatment from government-run hospitals, i.e. the hospitals run by tax money for the public. But this is nothing new for government run hospitals as they have almost always failed to meet even the lowest quality standards. Part of the problem is poor allocation of funds by the government, but a lot has to do with just plain, unending plunder and theft of equipment, medicines and funds by their administration, the doctors the para-medical employees. But let’s get back to the the CT Scan facilities at JPMC, Civil and Abbasi Shaheed hospitals in Karachi.
The CT Scanners work for a month and are unavailable for two. Oddly enough, these hospitals have agreements with private CT Scan owners whereby when their CT Scanners breakdown, the scanners are automatically shipped off to this specific private CT Scan centres for repair. Do you smell something fishy here?
Many of us are aware of the importance of the CT Scanners. They are x-ray machines that scan, with the help of an integerated computer, patients bodies and detects microscopic tumours, obstructions, defects etc. in the process saving thousands of human lives by timely detection of diseases in its early stages.
The first CT Scanner in a Pakistani public hospital was installed in the 1980’s at JPMC, Karachi. It was inaugurated by the then President, General Zia-ul-Haq himself.
During a recent trip to the US I met a doctor from Abbasi Shaheed Hospital who recalled how a CT Scan operator/technician working in that hospital’s facility was caught intentionally keeping the equipment out-of-order while all the CT Scans went to a private hospital in North Nazimabad at ASH’s expense. He also revealed that the guilty technician worked for the same private hospital that was benefiting from the closure of ASH’s facility.
However, I submitted to the concerned doctor, that the technician could keep the CT Scanner inoperable, but he could not ensure that the CT Scans from ASH go to that specific private hospital, his second employer, that can only happen if the higher administration of ASH or the City Government was also involved in the scam.
Another example is that of the NICVD. Though it is well known for its facilities, its functionality remains unknown because unlike Europe and the US, there has never been a policy whereby Pakistani hospitals are required to publish their annual performance.
It was confirmed by reliable sources that in the entire year the NICVD purchased merely 400 stents used in angioplasty, a surgical procedure done in patients suffering from chronic heart disease. The stents are very small tubes made of plastic material and are placed inside the heart vessels during surgery to bypass the diseased areas, thereby ensuring a smooth blood flow to and from the heart. Therefore a lot of stents are used and as you can imagine, without these the angioplasty cannot be done. At the same time, numbers from the hospital lead us to believe that it averages only one angioplasty a day. This despite the army of doctors, consultants, cardiac surgeons and cardiologists, not to mention the billions of rupees that it receives through tax/zakat, that it has at its desposal.
There are reports that the low number of surgeries and the resulting long patients’ waiting list, enables some of the junior doctors at this hospital to earn quite a bit of “bonus” by sending the patients away to their “favourite” private clinics/hospitals. Something really needs to be done here. But something only happens when a new government comes to power, be it in the centre or in the provinces.
The concerned health minister sahib makes a “surprise” visit to a few government-run hospitals or clinics, finds a nurse or an orderly sleeping on the job or a junior doctor missing from the duty and suspends them. The health minister sahib gets great press coverage, but no relief for the public, whose sufferings remain unending. We have all seen this song and dance several times in the past as many years, and are sick of it. And what’s more, remember those suspended emplopees? After sometime, they are back as regular workers and back to their usual!
If the government really wants its allocated funds to be properly utilized and the public to get the best medical treatment, then it should:
• Ensure that each and every hospital in the country should publish it Annual Performance Report publicly, thereby allowing full scrutiny by the public and their elected representatives.
• The government should establish an institution like NIPA where all doctors, nurses and paramedics should be required to undergo annual sessions of continuing education.
• And lastly, the funding of each government hospital should be based, not on political expediency, but on their annual performance e.g. number of patients treated, number of operations done, etc.
In short, only by taking concrete steps and ensuring sound accounting of funds and facilities, will the government be ever able to provide us Pakistanis, with the medical care we deserve.
If the government cannot do this then it atleast should stop its health minister sahebans from making tall claims of bringing our healthcare standards up to the international level in a few years, as the Pakistani public is not wiling to be made a fool out of any longer.
Drastic steps need to be taken to bring Pakistani health care out of the shadows 
