A quiet crisis is unfolding in the heart of Rawalpindi. It rarely makes headlines, yet it affects the lives of thousands every day. It is not about roads, housing schemes or real estate development. It is about healthcare — and who can afford it.

Step into any of the public hospitals, and you’ll see queues of the patients that begin at dawn and stretch into the evening.

You will find some cradling infants, others leaning on relatives, wait patiently for their turn that may never come as these facilities can’t cater to the growing needs of the expanding city and it’s increasing population.

“Our OPD remains crowded everyday and we fail to keep count of the number of patients we encounter on a daily basis. There simply aren’t enough doctors or beds,” says a junior doctor at Benazir Bhutto Hospital, requesting anonymity.

“Most patients need time, tests, and follow-ups for complete recovery but we don’t have resources to deal with the current number of patients,” he added.

For those who don’t want to bear the wait, there’s always the private sector but it comes at a punishing cost due to lack of regulations.

Its alarming that in city’s private hospitals and clinics, there are no standard consultation fees. A visit to a general physician may cost Rs1,500 at one facility and Rs3,000 at another. A specialist can charge anywhere between Rs4,000 to Rs7,000 sometimes more, and often without a receipt.

“There is no regulation. Everyone charges what they want and it varies in different parts of the city,” says Mohammad Azeem, who works in a private company, and has recently borrowed money to get his mother treated for a kidney infection.

“It’s not just the fee, it’s the tests, the medicines, the follow-ups. Health has become a luxury”, he added.

The people with lower-income, including domestic workers, daily wage earners and small shopkeepers, often avoid seeking medical help unless absolutely necessary. Even the middle class is finding it difficult.

“We first try home remedies because we can’t afford treatments”, says Mehreen, a mother of three living in Committee Chowk.

“For us, it’s choosing between treatment or utility bills,” she added.

On one hand, the city’s ever-growing housing societies, complete with gated clinics and private ambulances, offer world-class health facilities but only to those who can pay. While on other, residents of some other parts of the city still travel miles just to find a doctor who will see them without charging a significant part of month’s salary.

Doctors themselves are frustrated.

“There’s no cap on private fees or a transparent system of complaint,” says a private practitioner in a medical facility in Rawalpindi.

“Some hospitals charge according to the area they’re located in. In some posh area of the city, the same treatment costs double what it does in Saddar”, he said. This lack of uniformity adds another layer of exploitation. Patients often feel helpless.

“You can’t argue with them. If you question the fee, they ask you to leave as it’s a business now,” says Waheeda, whose father was refused treatment at a clinic because they couldn’t deposit the advance.

Rawalpindi’s public health infrastructure is crumbling under population pressure. As a result out of stock medicines, dysfunctional machines, understaffed emergency rooms are a common sight. Specialists are few, and most rotate between private and public jobs to manage their income.

“The growing population of the city has outpaced the capacity of it’s existing hospitals, leaving patients struggling for adequate care”, said a senior health official on condition of anonymity.

He said there was an announcement by former minister Sheikh Rashid about the establishment of a new hospital, but the plan never moved beyond words and was never implemented.

Until health becomes a priority not for billboards, but for budgets and policies, the city will continue to grow in buildings, but shrink in humanity.

— The writer is a freelance journalist

Published in Dawn, June 26th, 2026