United under the aegis of the Pakistan Pharmacist Association (PPA), the city’s pharmacists continued their symbolic protest here on the 13th consecutive day by participating in a walk from the Islamabad Press Club to the Parliament House here Tuesday, urging the government to announce for them, a service structure similar to the one approved for doctors. Failure to do so, they said, would be reason enough for them to broaden the scope of their protest to countrywide demonstrations.
The participants of the walk included over 900 pharmacists working in government hospitals, industrial pharmacists employed with pharmaceutical and chemical industries, retail pharmacists working at pharmacies, and those offering services as researchers for development of novel medicines for human use and as regulators and policy makers within the Ministry of Health.
It is pertinent to mention here that the prime minister has approved a summary of a new service structure for health professionals wherein new pay scales from FPS 9 to 13 have been introduced for doctors. Ironically, pharmacists have been relegated to FPS 8, which means that they will be working under doctors — a practice unheard of in any part of the world. It is this alleged “discrimination” on part of the government which has invoked a sense of deprivation among pharmacists — 25,000 of them in Pakistan — inciting them to take to the roads. It is learnt that they will soon be followed by dentists and physiotherapists, who are just as disgruntled.
The PPA’s charter of demands includes the following: a) pharmacists should be treated at par with medics (doctors) in pay scale and non-practicing allowance. They should be given SPS 9 at entry level and should be promoted up to a highest level of SPS 13; b) pharmacists should be provided a paid residence-based training in hospitals like house jobs for medical graduates; c) pharmacists should be included in the any decision-making committee or commission established to decide the futures of health professionals.
Having already rejected the Health Ministry’s proposal of a separate service structure for pharmacists, the Association has sought the same perks and privileges as being given to doctors and has threatened a countrywide protest in case of slackness on part of the government.
The president of PPA Syed Khalid Saeed Bukhari has articulated the demands of pharmacists in a letter written to Cabinet and Health Secretary Nargis Sethi. In it, he has called for a review of the decision and protection of the morale and dignity of the pharmacy profession.
Talking to this scribe a pharmacist speaking on behalf of her fellow protesters expressed her concern in the following words: “We get a degree of Doctor of Pharmacy (PharmD) upon completion of 17 years of education with 210 credit hours. This includes primary and secondary education till 12th grade, followed by five years of professional education. We study all the subjects that are studied by doctors during their five professionals. However, just because we are few in number and hence less visible does not mean that we should be discriminated against.”
The protesters emphasised that pharmacists are not, in any way, less capable and competent than doctors. “We work in emergencies like doctors. However, while doctors are paid emergency, medical and anaesthesia allowances, we get no such incentives,” they pointed out to justify their demand for non-medical allowance.
“In fact, a pharmacist’s role begins from drug formulation to its final delivery to patients, and even after it, in the form of surveillance,” another protester explained. They pointed out that in developed countries, no prescription can be issued until it has been reviewed by a pharmacist. The job of a doctor primarily revolves around diagnosis. “It is we who maintain a check on irrational medication, which takes hundreds of lives every day in developing countries. It is we who ensure correct use of drugs and are involved in a cascade of actions ranging from the manufacturing, formulation and description of drugs to their sale, ready availability and research,” they said.
Moreover, the protesters were of the view that doctors, nurses and pharmacists are equally important when it comes to patient care. “Our strength gets dissolved because pharmacists are working in organizations other than hospitals as well,” they said. The WHO recommends one pharmacist against 20 beds, a utopian scenario in case of Pakistan. The protesters are also urging the government to create additional posts of pharmacists in hospitals.
Pharmacists are indeed an asset. The exorbitant cost of their education explains why many students from Canada, Nepal, Iran, and Somalia come to Pakistan to get degrees from the University College of Pharmacy of the Punjab University and other institutes. Pharmacists get hefty salaries abroad, which is why Pakistan has seen a huge brain drain in this profession. According to the protesters, 70% of the pharmacy graduates leave Pakistan and settle abroad because of poor service and salary structure in their own country. “This is huge discouragement which the country an ill-afford,” they chanted.
The importance of pharmacists can be evaluated by examining the services of two state-of-the-art hospitals namely, Shaukat Khanum Memorial Cancer Hospital, Lahore, and Aga Khan Hospital, Karachi. One of the plus points of these hospitals is the kind of pharmaceutical services being offered by them. Both government as well as military hospitals are deficient in this area. And it is for this very reason that patients suffer on account of non-availability of the right medicine, at right time, in the right dosage form and the right combination.
The World Health Organization (WHO) and the International Pharmaceutical Federation (FIP) summarise the role of a pharmacist through the WHO/FIP seven-star concept in which a pharmacist is described as a caregiver, communicator, decision-maker, teacher, lifelong learner, leader and manager.
Interestingly, there are only a handful of pharmacists (not exceeding two dozen) who need to be accommodated. “There are 2 pharmacists at Policlinic, 10 at PIMS, 1 at NIRM, and 5 at JPMC. As such, even though our voice is too feeble to be heard, we are determined to continue our struggle till the acceptance of our demands,” the protesters resolved.