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Risk of infection

August 08, 2018

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THE country’s health burden, already daunting, can only be reduced by instituting stringent medical protocols. It is therefore disturbing to learn that the oldest hospital, not in some rural backwater but in Pakistan’s capital city, is falling far short of standard operating procedures in this respect. On Monday, the Senate Standing Committee on Capital Administration and Development Division learnt that the Polyclinic Government Hospital does not have an autoclave — which is among the more modern methods for sterilising most surgical instruments — but instead uses the outdated manual method for the purpose. The fact that 23 operations on average are carried out every day at the facility — where the daily patient load varies between 7,000 and 9,000 — is cause for further concern. To gauge from the statements of Polyclinic representatives at the meeting, the hospital is beset with multiple problems. Among these is a shortage of staff: there are only 45 specialists against a sanctioned strength of 147; similarly, only 246 out of 309 sanctioned posts for medical officers are filled; and a paucity of space creates further problems, given the many patients who visit the facility every day.

All invasive procedures entail contact between a medical device or surgical instrument and the patient’s sterile tissue or mucous membranes; they thus carry an inherent risk of pathogenic microbes entering the bloodstream. As pointed out by some committee members at the meeting on Monday, shoddy medical protocols in something as basic as sterilisation of surgical instruments can have extremely serious consequences; among them is the spread of hepatitis B and C. One can quite plausibly conclude that if such an appalling situation prevails in a government hospital in the federal capital, it is certainly not an anomaly and other medical facilities in smaller towns and the hinterland are even worse. Pakistan is faced with an uphill battle against hepatitis C; it has the second highest incidence of the disease in the world after Egypt. According to experts, reused syringes and improperly sterilised medical equipment play a large role in the spread of the infection. So does the practice by barbers of reusing blades, but one expects far better from medical professionals. Sadly however, the shambolic state of affairs at government facilities is symptomatic of the inequalities in our society and the corruption that riddles the public sector. With a new government about to take charge, public healthcare must get the priority it deserves.

Published in Dawn, August 8th, 2018