Health failure
THE Sindh budget tells us how poorly the provincial government intends to use the people’s money. It is evident that there are clear gaps in planning; thereby making it important to establish whether the stated priorities match what is reflected in the budget. For a party that has been in power for the last decade, the PPP has failed to improve governance and uplift the province — particularly in the health sector.
Chief Minister Syed Murad Ali Shah proposed the allocation of Rs100.32 billion for health in 2017-18, an increase of 26 per cent over 2016-17’s Rs79.88bn. There has also been an increase in the amount spent on staff salaries. However, health services for the common people of the province remain underfunded. Although the increase in salaries, incorporation of 25,000 employees in the Lady Health Worker Programme and the construction of new dispensaries are positive steps, why have we been unable to see the impact of similar measures over the years?
One need not look further than the crisis in Tharparkar, where women and children suffer from iron-deficiency anaemia, malnutrition, measles and diarrhoea, or the several district and tehsil headquarter hospitals that face a severe shortage in technical staff and doctors, including gynaecologists and paediatricians. The fact that private pathology labs now proliferate outside public hospitals indicates that either certain diagnostic services are unavailable or that their results are not trusted, even by the hospitals’ own physicians.
What has the PPP done to fix the health crisis in Sindh?
The conditions in many of Sindh’s public hospitals are so poor that, in accident and emergency cases, patients are now often referred to Hyderabad and Karachi. While the health services in these two cities should be appreciated, what of the rural areas where the majority of the PPP’s voters are deprived of quality health services?
The chief minister purported that the Sindh Immunisation Support Programme, which “will revolutionise the vaccination and inoculation process making our future generations healthier”, has been allocated Rs8.09bn. But the programme has made little progress in disease reduction in the nine years it has been running.
Take the example of the Hepatitis Control Programme. One report states that more than three million people in the province are affected by hepatitis. In Dec 2016, there was an anti-corruption raid on the HCP’s offices over allegations of irregularities in purchases of medicines and vaccines. Such irregularities have also been reported in other disease-control programmes in Kotri and Tharparkar.
Taxpayers would want to know what actions the provincial government has taken against those involved in such malpractices, and what actions it has taken to ensure that patients are provided treatment in a fair manner.
Transparency is essential to achieve the targets Sindh has set out to achieve. Recently, the World Health Organisation listed that Brunei, Cambodia, Japan and Laos had all eradicated measles. This wouldn’t have been possible without a transparent and efficient implementation of their programmes. Pakistan, particularly Sindh, still lags far behind in immunisation, and we will never achieve full immunisation without transparency.
Sindh needs a health system that enables the entire population to access their right to healthcare, but it seems that the current PPP leadership is reluctant to give it this right. It has failed, for example, to control the flow of sewerage and industrial waste into the Indus River — the main source of drinking water for rural and urban Sindh.
On the petition of advocate Shahab Usto, the Sindh High Court established the Sindh Water Commission, which issued a comprehensive report revealing that almost all of Sindh’s drinking water supply was contaminated. Sewerage and contaminated drinking water are major causes of morbidities and mortalities in Sindh.
The PPP is seeking to be re-elected next year. It is time that it abandons its lacklustre attitude towards healthcare and actively scrutinises the performance of government hospitals and health workers who are not providing quality services to the people of Sindh.
The party’s leadership must realise that polluted, unhealthy environmental conditions cannot keep the people healthy, that hard work is needed to improve drainage and sewerage systems to minimise the spread of diseases like hepatitis, malaria and diarrhoea. And while awarding canteen contracts, construction contracts, transfers and postings are all necessary tasks for the health secretary, the health department needs to be integrated and have better coordination with other departments, such as municipal authorities and environmental agencies, for its policies to work.
Only the collective, transparent and integrated actions of these departments can transform this unhealthy province into a healthy Sindh. The incumbent government’s actions should speak louder than its words. Only a healthy entity can create a healthy society and healthy democracy.
The writer is pursuing a PhD degree at the Beijing Normal University.
Published in Dawn, July 13th, 2017