KARACHI: Chronic neglect by successive governments towards fundamental human needs, primary healthcare and preventive healthcare strategies including infection control practices explains why Pakistan has failed miserably to show improvement in the health sector. In fact, matters have gone from bad to worse in areas lacking proper sanitation and refuse disposal mechanisms.

These points were raised at a press conference held at the PMA House on Friday for the launch of a report titled Health of the Nation.

The report highlights the country’s poor health indicators including its high maternal and infant mortality rates, slow progress on stunting and wasting, neglect towards mental health, weak healthcare system and a growing rise in the burden of diseases mainly due to lack of basic facilities, such as supply of clean drinking water, sanitation, primary healthcare services and environmental degradation.

Potable water not available to 90pc people

The Health of the Nation report has suggested govt focus on preventive, primary healthcare

“Clean drinking water is not available to 90 per cent of the population. This is the cause of many gastrointestinal infections, hepatitis A and hepatitis E, typhoid, polio (it can spread through drinking water if it’s contaminated with the stool of an infected person) and other diseases.

“Typhoid is now a big problem in Pakistan particularly in Sindh due to antibiotic resistance. This phenomenon is a looming disaster not just for developing countries but also for developed nations,” the report said.

The report looks into the factors contributing to antibiotic resistance in local settings and said that there were so many elements instrumental to this menace including quackery, irrational use of antibiotics, spurious drugs, availability of drugs over the counter without prescription, self-medication and the role of pharmaceutical industry offering lucrative deals to doctors against (specific) prescription.

The polio infection, according to the report, remains endemic despite over 100 rounds of vaccination being carried out in the past decade. Pakistan is one of the two remaining countries in the world where polio still exists, the other is Afghanistan.

“Our polio programme has deteriorated badly; during the year 2019 as many as 144 cases of polio have been reported as compared to 12 cases in 2018. Till now, seven cases have been reported in 2020,” the report said.

It also speaks about the “alarming increase” in the cases of dog bite and snake bite in the second half of 2019 in Sindh, causing loss of many lives because of non-availability of vaccines or inappropriate medical care.

Over 50,000 dengue cases reported in 2019

The report also focused on dengue and said that more than 50,000 cases of this viral infection had been reported by the end of 2019 with death toll crossing 100.

“And these are only reported cases. We believe that an equal or more number of these cases had remained unreported. Such outbreaks have had been reported from other countries but they managed to overcome the challenge with the help of scientific guidelines. But, we persistently refuse to learn.”

Suggesting solutions, the report points to the fact that developed countries as well as many low-income countries had been able to eradicate many diseases by just putting in place effective vaccination and immunisation programmes.

“But, in Pakistan, our polio programme faces hardships mainly due to lack of political will, misconceptions and lack of awareness. To address this, it is important that (the government involve) each political and religious party along with civil society and the media in campaigns on vaccination and immunisation programme.”

The report recommends that the government invest more in disease prevention. “By just providing clean drinking water, we can prevent 60 per cent of diseases and if we could eliminate breeding grounds of mosquitoes, we can prevent all mosquito-borne diseases that currently constitute 40 per cent of our total disease burden.”

‘Restore PMDC’

Speaking at the presser, PMA representatives including Dr Ikram Ahmed Tunio, Dr Qaiser Sajjad, Dr Qazi Mohammad Wasiq and Dr Abdul Ghafoor Shoro demanded that the government restore Pakistan Medical & Dental Council as an autonomous, democratic, transparent and vibrant body comprising elected and nominated members as per the 1962 ordinance.

“We also demand inclusion of stakeholders like PMA and Pakistan Dental Association and complete overhauling of medical education and training of doctors according to recent trends in the world. We need adequate health budgets with assurance that allocated amount will be spent with honesty,” they said.

Published in Dawn, February 8th, 2020