Deteriorating healthcare

Published April 7, 2011

Doctors in Punjab went on strike on March 1st, choosing to boycott general wards and OPDs. Children with broken limbs and patients with brain tumors have had to have their surgeries repeatedly postponed. Doctors continued to show up for work but formed barricades outside the hospital for a month and refused to treat any of the patients. According to sources, those doctors who did attempt to provide treatment to some of the patients were harassed and insulted while some were even beaten by their colleagues for not going on strike. Wards were locked down and patients told to leave. A female doctor at the Services Hospital became violent with a woman in labour who refused to leave and insisted on receiving treatment. At least 41 children have died at the Children’s Hospital Lahore so far.

Doctors in Punjab have legitimate demands - a raise in salaries from July 1, pay protection and regularisation, revised job structures and better job security. Many doctors have even been working without pay in government hospitals. In spite of their rising debt, a few years ago, the government dissolved self-financed seats in medical colleges, eliminating another source of funds. On the other hand, Chief Minister Shahbaz Sharif offered 25 acres of land to the Pakistan cricket team if they won the semi-final against India in Mohali. It is no wonder that the doctors are angry at a government which spends lavishly on athletes and celebrities, and not basic healthcare.

It is impossible for a doctor to pay for rent, transportation, food and electricity, let alone live a life with small joys such as eating out or going on holiday, with a salary amounting to a mere Rs 12,000 - 18,000 a month. It is not even enough to save up enough money to resign and look for a job outside the country. Registration alone for the USMLE, a test that allows doctors to apply for jobs in the US, costs a thousand dollars.

One month into the strike, thousands of doctors have submitted their resignation. Walk into any emergency ward in the Punjab and it looks like a relief camp in a war zone. There are patients with gangrene-rotting limbs with flesh that has decayed to reveal the bone. Patients come in from accidents with bloody clothes hanging in tatters. Children come in with burns and skinless limbs.

By refusing to treat patients in emergency, doctors have broken all codes of ethics. To submit a resignation is unfortunate but to stand before a dying patient and refuse treatment is monstrous. There is no justification. It is illegal for doctors to strike under the Emergency Services Ordinance of 2002. In many countries elsewhere, it is also illegal for prison officers, police men, soldiers and air traffic controllers to strike, since failing to show up to work en masse risks lives. In 1981, when air traffic controllers went on strike, Ronald Reagan fired, blacklisted and replaced all of them.

Instead of condemning these actions, there are doctors who deny such accounts of horrific stories at the hospitals, insisting that all negative stories are fabricated by the media at request of the government. The doctors who have submitted their resignations, admit they are now willing to let patients suffer, calling it a last resort. When told that letting a patient die – without being treated - can never be used as a last resort, they say the government is directly to blame for these deaths. Those with dead siblings, children, and parents are not convinced. Medical college professors who haven’t practiced in years are now attempting to run emergency wards along with unqualified final year students.

For the doctors to reach their goals regarding a significant increase in salaries and better working conditions, an overhaul of the entire system is required. It cannot happen in a month, not even if doctors attempt to hold patients hostage.

The federal government is solely to blame for our deteriorating healthcare system by never allocating substantial funds to healthcare, but the way the doctors have reacted to this, has made them as disliked by the general public as corrupt politicians. Instead of striking en masse, the doctors should have reached out to journalists to help voice their demands and educate the public about the government's failure. They should have worn black bands at work, made petitions and tried to contact other professionals for help. To do so would have definitely taken more than a month, but this way they would have been able to garner public support instead of disgust. The kind of support that would have been more effective in the long-run, in bringing about real change.

Doctors wrongly believe the only way they can protest is by blocking traffic for hours, chanting slogans on the streets, or by going on strike. Although no one can stop them from submitting resignations in protest, it is unfortunate and unacceptable to let patients die "as a last resort" in order to get a pay raise.

Sahar Zahir is a concerned citizen.

The views expressed by this blogger and in the following reader comments do not necessarily reflect the views and policies of the Dawn Media Group.

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