One of the major objections patients have is related to its emergency services. The health facility, visited by over 1,500 people daily, is almost deserted by 1pm as the majority of the staff, which includes doctors, paramedics as well as sweepers, leave for home by then.
The location of the hospital also restricts accessibility as no buses or coaches can approach the facility and patients and their attendants have to reach there by rickshaws and tongas. There is no check on patients’ movements either and it’s a common practice that they leave their beds against medical advice, rest at home and return later in the day or the next morning. Though a casualty section exists that runs 24 hours, patients complain that all major emergency cases, except that of labour, are referred to the Jinnah Postgraduate Medical Centre and Civil Hospital Karachi.
“Over 400 patients report daily to the casualty section. Of them, we admit non-surgical emergencies and attend to patients for referrals or medical advice and prescription. This is because all the staff leaves by 1pm. Besides, the section, too, is not properly equipped to deal with critical emergencies,” said a doctor at the department.
‘Ghost town’
About the hospital’s working in late evening hours, a patient said: “After 1pm, the hospital looks like a ghost town. Only maternity and paediatric cases are attended to and that’s the reason people don’t come here for other emergencies and go to CHK or the JPMC straightaway.”
His assertion was found to be quite true when this reporter visited the hospital the next afternoon. Excluding the gynaecology operation theatres, all OTs, including the emergency OT, surgical ICU, coronary care unit as well as all diagnostic facilities, were shut. It was also found that doctors keep the majority of surgeries booked for the morning. Due to this at times patients have to wait months for their turn.
A few doctors were on duty in different wards but surprisingly, there were almost no paramedics to be found. Only one nurse was spotted in the paediatrics department.
Explaining the situation, a doctor claimed that the union of paramedics was too strong and almost half of them only come in the morning to mark their attendance.
“They do other jobs in the morning and then show up at closing time. The medical superintendent is powerless while they don’t pay any heed to what the doctors say. If someone sticks to a point, the entire staff unites against that doctor and forces him to withdraw the objection,” he said.
He also pointed out that security concerns were one of the major reasons why the hospital had failed to function at its optimum level.
Angry attendants
“An unstable law and order situation in the locality and security concerns about the hospital’s premises are the major reasons that have acutely affected the working of the hospital staff,” he said, while adding that the hospital catered to the needs of Lyariites, most of whom had little understanding of medical complexities. “They can become aggressive about almost anything. There have been instances when doctors were beaten up by attendants,” he said.
Recalling a recent incident, he said that a doctor in the orthopaedics department was beaten up simply because he had asked an attendant not to spit pan on the floor.
He also complained about the shortage of staff and maintained the hospital had expanded its operations over the years, but the number of the staff was the same.
Besides security concerns, water shortages, frequent power outages and a lack of building maintenance and hygiene are some of the major areas that need immediate attention.
A case in point is the paediatrics OPD. The section, visited by over 200 patients daily, was littered with garbage and there was dust all over the place when this reporter visited. It seemed that the section had not been cleaned for ages.
There was no water supply in the section, housed in a separate, dilapidated building. An incomplete structure of a washroom stood there as one of the patients complained that its door had not been fixed in four years. He claimed that the earlier washroom was demolished for no reason and this one was left incomplete.
The internal telephone exchange has not been working for one-and-a-half years. The same is the case with the lifts. Out of the eight dialysis machines, only one works properly. Though there is seepage in almost all departments, the ceilings of all the operation theatres on the third floor leak while sewerage and drainage problems are a permanent feature.
Most of the departments are supplied with saline water and the little tap water that is available is saved for operations. Despite all these problems the hospital, a staffer claimed, maintained a good system of equipment sterilisation.
Patients are charged Rs50 for X-rays, Rs25 for ultrasounds and Rs150 for a complete blood count. However, these services are free for in-house patients. A doctor demanded that these services should be free for all as was being done at the CHK, since both hospitals were under the same board of governors.
When asked to comment on the situation, Medical Superintendent Dr Mukhtar Khwaja maintained that there was no problem at the hospital and all doctors performed their duties as required and there was no shortage of staff either. About any surgical emergency, he said that resident medical officers took care of that and called any doctor required to deal with the emergency.
He also described the paramedics’ union as a helping hand and said a hospital couldn’t run without their support. He commended the gynaecology department’s doctors whose workload, he said, had increased after the closure of the CHK’s unit.
“The only problem the hospital has is in maintenance and repairs, which are under the works and services department,” he pointed out, adding that there was a lack of coordination between the hospital and the said department.
