A case in point is Seth Seoomal Murchand Khilnani Maternity Home. Opened by the then Mayor M.H. Gazdar in 1942, the maternity home is ranked among the few well-managed public sector health facilities for women. But, surprisingly, despite having a team of competent doctors, a fully equipped operation theatre and labour room, the facility fails to function for 24 hours on a daily basis.
Sources say that the operation theatre has been closed since February when its lights malfunctioned and rainwater seeped into wires. The problem may be rectified but nobody is really interested in making the OT functional which would mean extra work. Even when the OT was functioning, few operations were performed, and that too during daytime, the sources recall.
Partially acknowledging the problem, medical officer Dr Bushra Israr, however, maintains that the OT is still being used for ‘minor operations’ but more staff is required to run the service on a regular basis.
“We need separate staff to deal with emergency and OT requirements. There is no anaesthetist and we have to call one when the need arises,” she said, adding that the 30-bed facility needed an RMO (resident medical officer) to be able to run for 24 hours daily.
Another major handicap in pursuing this goal is also that public sector health facilities, by and large, operate on an ad-hoc basis and there is no constant provision of funds. In case of maternity homes, the only government help that they receive is for repairs or medicines. As for this healthcare facility, proper renovation is badly needed as, according to the staff, most of its ceilings leak and the roof has fallen apart in some places.
At present, 35-member staff, including seven doctors, four nurses, two midwives and two lady health visitors, work here in shifts. While this seems to be enough manpower to properly run the facility, there is no system in place to identify patients needing immediate help. Consequently, such patients suffer as they have to wait for long periods for their turn.
“The doctors come late and the patients have to wait for hours for their turn. I am having constant pains but I have to wait for my turn till all other patients who have come before me are examined,” complained a woman.
However, despite these lapses in service, the facility is a preferred choice and women from all over Karachi come here for antenatal checkups and normal delivery. Around 200 patients daily visit the OPD while over 70 deliveries are performed here every month.
“This is mainly because of the good performance of some staff who have been working here for a long time. People know us and there are families who have been visiting us for generations. We have never had a death at our facility,” proudly asserts Marsi Khurshid, the sister-in-charge who has been working here for 18 years.
According to her, the number of patients frequenting the facility was much higher a decade ago when free food was provided to patients. As more and more private health-care facilities sprang up, their number decreased. Still, some aspects are unique to the facility. Apart from being one of the oldest health-care facilities, it’s the only public sector maternity home in the city which has a midwifery school and is among the few where ultrasound and lab facilities for simple blood and urine tests are available at nominal charges. There are also separate sections for pediatrics and family planning.
Shedding light on social attitudes towards birth control methods, Surriya Asim, who heads the family planning section, says that a major change is men’s willingness to undergo vasectomy if they are told that the use of contraceptives can harm a woman’s health. “It all has come through awareness. We discourage abortion, but motivate women about child-spacing,” she said.
The midwifery school, named after the late Professor Karar Hussain’s wife, Sartaj Bano, opened in 2004. Narrating the story behind its establishment, Dr Shershah Syed, former secretary-general of the Pakistan Medical Association, said that this old building was earlier being used as a clinic for KMC employees. After the second local government elections, some political activists took control of it, but on the immediate intervention of City Nazim Mustafa Kamal the building was vacated.
“This shows that any difficulty can be overcome with a political will. It’s sad that millions of rupees were spent on a fancy fountain while pregnancy-related complications claim lives of thousands of expectant mothers every year only because successive governments have failed to make health facilities operate round the clock,” he regretted.
