KARACHI, March 2: Presenting an uninviting picture of health care in its annual report, the Pakistan Medical Association (PMA) has stressed the need for the provision of primary and emergency services to all the urban and rural population of the country in the shortest possible time.

PMA’s third annual health report “Health of the Nation”, which was released at Karachi and other major cities of Pakistan on Thursday said that despite availability of money from the national exchequer and foreign donor agencies for the last many years the overall health situation did not change.

It remained a perturbing fact that majority of our population had no access to primary health care, emergency obstetrical care or emergency health care throughout Pakistan, the report added, while including a set of demands.

The PMA demands a tenfold increase in the expenditures of the health sector by the government. At present, according to the report, for a population of 160 million, a third of which lived below the poverty line, the government allocates 0.6 per cent of the GDP while the private sector’s expenditures amounts to 3 per cent of the GDP.

There is no national screening programme for breast, cervical and prostate cancer, while clean water and adequate sanction system were not available to majority of the population. About 67 per cent of our one-year old children are immunized against tuberculosis; only 57 are immunized against measles, while hepatitis B and C vaccination is not available to the entire population.

After reading some excerpts from the report at a press conference, PMA Secretary-General Dr Shershah Syed said that the political leaderships, both in the government and the opposition, had been failing to show any commitment or political will to address the real health issues in the country.

“The health of the nation has become a matter of cheap slogans and corruption, more so with increased donor funding. On the other hand the local governments are also not able to provide relief to the patients, whatsoever they could have, because of the tussle between the federal, provincial and district governments”, he added.

Dr Syed, who was accompanied by a senior family medicine practitioner, Dr Aziz Khan Tank, said that copies of the PMA’ report would be sent to the president, prime minister, health ministers, NGOs and other concerned.

He called for strengthening of the basic health units, rural health centres, and taluka hospitals by recruitment of midwife, nurse, paramedics, doctors and specialists on urgent basis.

Dr Syed said that due to the absence of recruitment process, the Sindh and Punjab governments had planned hiring of doctors on contractual basis on their own and not on permanent basis through the public service commission, which would not prove effective or bear any fruit.

He also opposed the changes in the PMDC and establishment of medical varsities as these, according to him, were aimed at paving way for the private sector, who were already exploiting the situation in the name of public-private partnership or BOG in different government health institutions.

The report said that more than 6,000 doctors were unemployed in Punjab, while another 2,500 in Sindh and 2,000 in the NWFP, while due to the non-filling of sanctioned posts of doctors in different speciality posts many health centres and hospitals were facing problems in extending services to patients or were closed.

In Pakistan there is only one nurse against eight doctors, and only one doctor per 1,900 people. More than 340 per 100,000 women die every year during pregnancy because of unavailability of emergency obstetrical care, while on the other hand maternal morbidity (fistula, infertility, loss of uterus, etc) was increasing due to lack of healthcare facilities for under privileged women in cities and rural areas.

The government has failed in producing a drug policy to control the use of magic drugs for the treatment of cancer or sexual dysfunction. Essential drugs are not available and the market is full of spurious and substandard drugs.

In the case of Sindh, it was said in the report that the government had no policy regarding recruitments, transfers and postings. Majority of the postings are not on merit, while honesty and competency were no criteria for appointments, it was added.

Replying to questions, Dr Syed and Dr Tank said that there was no dearth of competent and sincere doctors and if the government required, the PMA would extend all support to make the non-functional health units active and make the doctors to realize their responsibilities even in the remote areas.

They said that only doctors alone could not ensure proper treatment to patients but they also needed health care infrastructure facilitated with essential equipment, medicines and other related facilities.