In their skilled hands was my mother’s ailing heart; a dedicated and experienced team of attendants, doctors, and nurses toiled to restore the rhythm of an offbeat organ. It took several days and nights and ultimately their efforts paid off: the doctors restored the heartbeat and lessened the risk of other complications.
I witnessed firsthand a functioning healthcare system in Pakistan.
My family spent the last two weeks swinging from a cardiac care unit to my parent’s home and from there to advanced diagnostic laboratories. I witnessed the adequately equipped and professionally run Armed Forces Institute of Cardiology and National Institute of Heart Diseases (AFIC-NIHD) dispense specialised treatment to extremely ill patients.
I interacted with several private sector diagnostic labs that readily perform advanced diagnostic tests at short notice.
I met with specialists whose knowledge and skill in cardiology are at par with their counterparts in advanced economies.
I learned that if you could afford it, the quality of healthcare in Pakistan beats even that in advanced economies, where often one has to wait for months, or even longer, to see specialists for specialised procedures.
The past two weeks’ experience has taught me two key lessons:
First: Excellent healthcare is being provided in Pakistan, but at a cost.
Second: An overwhelming majority of Pakistanis cannot afford the specialised healthcare that they desperately need. The challenge, therefore, is to enable access to quality healthcare to those who cannot afford it.
Winning back my faith in doctors
It all started on January 11, when I received the call which all expatriates dread; advising me of my mother’s ill health and her treatment at the AFIC-NIHD’s Cardiac Care Unit. I arrived in Rawalpindi 48 hours later, thanks to colleagues at the Consulate General in Toronto, who arranged the travel documents the same night, and a direct PIA flight leaving Toronto the next day.
I was apprehensive about the quality of healthcare my mother would receive in Pakistan. I had my reasons.
A birth trauma, resulting from doctors’ negligence, hurt my right arm causing a permanent disability. Living with one functional arm has its own challenges and the ensuing hardships were behind the lack of trust I have had for the healthcare system in Pakistan.
With this baggage and history, I landed at the Islamabad Airport from where I headed straight for the hospital.
Take a look: Doctors beyond borders: Reversing the brain drain
What I saw at the AFIC-NIHD has helped rebuild my faith in the medical profession. It is not just the professional expertise and skill of the doctors, but also the commitment of the attendants who maintain patients’ hygiene and dignity.
At the same time, the disciplined staff prevented patients’ well-wishers from crowding the hallways and emergency wards and the integrated patient care supply chain automatically transported patients with caution for tests and diagnostics while providing them with the prescribed medicines.
The quality of healthcare largely depends upon the skill and experience of physicians and the ready availability of advanced equipment needed for diagnostics and procedures. AFIC-NIHD ranks exceptionally well on both metrics.
Professors Dr Sohail Aziz and Dr Azmat Hayat, the two physicians I interacted with the most, had decades of experience in the field, which naturally created a calming effect on the patient and their caregivers. The doctors immediately diagnosed the condition and prescribed an effective intervention that integrated the response from the team of experts who had treated my mother during her stay at the hospital.
I am fortunate to have physicians as colleagues at the university and others in my circle of friends and family who practice in North America. I consulted them daily about the treatment and my mother’s condition. Without exception, they confirmed that they would have prescribed exactly the same treatments as were suggested by the team in Pakistan. This was a great relief and a huge reassurance.
Not only were the AFIC-NIHD’s labs equipped with the most modern equipment, but a large number of privately operated labs also offered the same services. We were able to book an MRI scan at a two-hour notice. In Canada, it took three months to get an MRI for my mother-in-law!
But there is a catch...
The publicly provided health insurance in Canada and many European countries pay for the treatment and services needed. The non-emergency MRI scan may take three months in Canada. However, the patient is not charged for the diagnostics.
In Pakistan, we were able to have all the tests done immediately, but at a cost. The MRI scan alone is prohibitively expensive for the majority of Pakistanis.
What I have described and praised is the pay-as-you-go model of healthcare. What Pakistan needs is a health insurance system that offers the same healthcare to the low-income households at affordable rates.
Writing for the Harvard International Review, Professor Muhammad Hafeez of the University of Punjab warns that poverty is associated with poor health outcomes. He further explains that the cost of living, especially food, has increased rapidly in Pakistan where 75 per cent of the people use private healthcare.
Also see: Health sector mess
The widespread poverty and the absence of public sector healthcare have forced the poor to forego even necessary healthcare services, which they can no longer afford. Professor Hafeez presents comparative data to show that regardless of how one measures it, Pakistan’s public sector healthcare spending is abysmally low.
He recommends that the governments should increase their healthcare spending to at least 5 per cent of the GDP. He further recommends that the focus of healthcare should be broadened from tertiary care to preventive and primary care. In addition, generic drugs should be promoted to reduce the cost of prescription drugs.
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