KARACHI: Sindh's women doctors on Friday issued a stern warning to people to follow the lockdown imposed to contain the coronavirus pandemic as the government was confused and "not doing its job".
"This writ should be from the government," Dr Nighat said, referring to how doctors were forced to hold press conferences across Pakistan to make people understand how dire the situation was and how practising social distancing was absolutely necessary.
"This is not our job. We have two jobs: to save lives and to work on a vaccine for coroanvirus. Yet, we're here doing the government's job because it's not doing its own job," she added during the press conference here at the Karachi Press Club (KPC).
The six women doctors lambasted the federal government's persistent inaction and the people's indifference over response to the coronavirus pandemic, noting that "if doctors start dying, there would be no one to treat the patients".
They relayed the dire condition of Pakistan's healthcare system, which they explained was on the verge of a collapse as hospitals were overflowing with patients and 80% of the beds were occupied.
"I'm not a God," Dr Safia said, noting that it was unfair to treat one patient and leave another to die.
"This is an extremely painful thing and we're seeing people dying right in front of us," she added. "There have been patients who were infected with the coronavirus and we were unable to do anything for them.
"It is extremely painful to see them [dying]. Whoever dies was someone's mother, a woman," she added.
Dr Safia mentioned that it was said there would be a peak in the number of cases and "we tried to make it a plateau" in the curve.
"The first lockdown was in Sindh, for which we are immensely thankful to the government of Sindh, who implemented an amazing and effective lockdown.
Had there been no lockdown or a partial one, the healthcare system would have collapsed outright, she noted.
"It has flattened slightly and that's why people have got encouragement and thought 'nothing's going to happen so let's go out on the roads'," she added. "That was wrong! If they keep going out on the roads, this rate is going to rise rapidly," she warned.
"We have been witness to [the deaths] because we work in public hospitals. We're getting patients and we are witnesses to the fact that deaths are rising. It's an extremely challenging moment when we see young people dying.
"Some provincial governments had done a commendable job, Dr Safia commented but emphasised that people must follow the lockdown instructions. "It's just for a month or a month and a half. If we follow this properly, then we'll get rid of this pandemic," she said.
Explaining that she removed her face mask only to speak, she urged the media at the press conference to wear theirs all the time. "The virus can spread from mouth and that can happen while talking too and can infect anyone. I request you all to wear your masks wherever you go," she added.
"We're getting pregnant patients every single day [meaning] that the mother is in danger and so is the life of the child," said Dr Nusrat Shah, who also works at the gynaecology ward of Karachi's Civil Hospital. Patients arrive in such critical condition that they pass away before their test results come out positive.
"Regardless of how much we try to save them — we intubate them, call anesthesia teams, get everyone to try and save them — we're unable to save their lives.
"If this kind of situation starts, especially in pregnancy, then the mother and child's lives are in danger because whenever there's an infection during pregnancy, it's extremely serious," she added, noting that even common flu became dangerous and this, on the other hand, was a new strain of the coronavirus.
Everyone's safety was in taking precautions, Dr Shah mentioned, adding that the success of lockdowns in numerous countries, such as China and South Korea, was there for everyone to see. "Until we don't sit at homes safely, don't forget the businesses for a few days, and be patient, then it's extremely difficult" to overcome the virus, she said.
Lamenting that doctors were continuously getting exposed to the virus and were under pressure because they had to see their families when they returned home after treating coronavirus patients, she said: "They ask me, 'Dr Nusrat, how do we go home? Where do we go? We have elderly parents.
"We don't care about our lives but everyone cares for their families,'" she told the press conference, breaking down into tears at this point and distraught at the sheer ignorance of people who were violating lockdown restrictions.
"It's our responsibility to save our doctors! If doctors start dying, then there would be no one to treat patients," she cautioned after a pause. "Then that would become a serious situation — an emergency — when doctors won't be there and coronavirus patients who would turn up [at the hospitals would have] no one to take care of them," she added.
Dr Shah further told the media that none of the doctors were "trying to shirk responsibilities" and planned to continue working but their families were telling them to quit their jobs, fearing losing yet another loved one.
"Their families tell them that their job is not more important than their life and that they could find a job later somehow. My fellow doctors say, 'We don't want to leave our jobs but how do we face our families?'"
Such a pressure could only be reduced if people stood with them, she commented, adding that while the media was standing strong with the health professionals, reporting, and creating awareness, the "people are not able to understand [the seriousness of the situation]".
"And until people don't understand that it's better to bear a little setback right now and especially during Ramadan," it was next to impossible to contain the virus spead, she warned.
"Forget profits for some time! Think about how it is a question of people's lives ... we have to save people's lives. Look at how China fought it. China had such an effective lockdown that they're able to go out now and open markets but we just need to wait for that stage.
"What's the problem in staying at home? This is a time of online businesses," she said, adding that the doctors who also taught were doing so via online classes. If they could do it, why couldn't the businesses do the same, she asked.
"For God's sake, please support us, please listen to us, we, the doctors, are not saying any of this for our own benefit but for that of the entire community," Dr Shah said.
She lauded the government of Sindh for being "the most proactive". Chief Minister Murad Ali Shah, she added, was still advising people not to leave their homes and keep shops and shopping malls closed but no one was playing their part.
The Civil Hospital doctor underlined that "the virus isn't going away soon and this lockdown would extend" but people should not leave their homes unless absolutely necessary. Even then, she added, "take all safety measures".
"We should not be having any gatherings at all where one person may infect everyone else. Everyone saw what happened in the Tableeghi Jamaat.
"So many of them unfortunately contracted the virus from one affected person. People should understand by now that this virus spreads very fast, it's very dangerous, and there's no vaccine for it.
"There's only one way to fight it: we save ourselves, keep our distance, stay at home, and wear masks.
"If we do go out, it should be for crucial matters only — for example, to consult docs — but we have teleclinics these days and we're trying to start teleclinics too for common OPD issues and recommendations."
Dr Nighat expressed worries regarding her colleagues and how infectious the COVID-19 virus was. "There were two people [in the ward] who tested positive. They're our patients, our brothers and sisters, our family members who have started to suffer as we see implications of this" disease, she added.
"I'm not an expert on religion but I was listening to a fatwa from Sheikh Assim Al-Hakeem sahab, who said Islam is a logical religion. It does not say that one should consciously go towards a disease when it's obviously [going to] harm and get infected or be a carrier and infect others.
Dr Nighat added that this was a chance for the Muslim community to show the world that "we're not a mob and we are intelligent and we understand".
It was the federal government's job to implement a proper lockdown. "If the government was not confused and had writ, then we would have been similar to Dubai where we have to obtain online permit to go out. And whoever doesn't follow the permit gets fined $600-700," she explained. "This writ should be from the government. This is not our job.
"We have two jobs: to save lives and work on a vaccine for coroanvirus but we're here doing the government's job because it's not doing its own job. This is unfortunate that the government has forced to sit here [and do this press conference] because this pandemic is going on.
"We should not be sitting here but we're forced to plead to the people. Yesterday, it was Dr Abdul Bari Khan who was begging the people, before that it was Dr Qaiser. This is what we've come down to, we're ready to fall to our knees but it's unbearable to see so many deaths," she said.
"How do we cope up? We can't. Our system has crashed given the conditions we see in the hospitals," Dr Nighat added, noting that some 264 doctors and medical professionals had been infected by the virus while three had passed away.
"None of us is here to engage in politicking, we're not here to run the government," said Prof Dr Razia Korejo, the president of the Society of Obstetricians & Gynecologists of Pakistan (SOGP).
"We're only here to spread awareness among people, to inform them that for God's sake, this coronavirus has affected the entire world and now Pakistan, so critically, so don't assume that there won't be a danger period.
"We don't how long we'll be fighting this but may God give us the strength for fight it," she added. Underscoring that she was speaking on behalf of Pakistan's gynaecologists and obstetricians, she said: "I request you, I plead you all — especially the women — to keep their children, families, and brothers inside homes."
Advising against stepping out unnecessarily, Dr Korejo said the need of the hour was "collective and individual social distancing".
"In context of pregnancy, there are already so many problems during pregnancy. Almost 60% of Pakistan's women birth at homes and there are so many complications [during the process] that they succumb to death during the childbirth.
The virus, she stressed, was extremely dangerous. Doctors did not know for sure how many people were positive, she said, adding that there were deliveries in Jinnah Postgraduate Medical Centre (JPMC), Civil Hospital, and Abbasi Shaheed Hospital, as well as at home.
"Who knows who has the virus or not? We do not have enough testing kits to test everyone. Therefore, it's my humble request to everyone in Pakistan to stay inside homes," she added, giving a nod to the efforts from the governments and the media.
Dr Korejo said there was a lot of relaxation in the religion. "It's not necessary to go to the mosques when the Holy Kaaba [the Great Mosque of Makkah] and Masjid an-Nabawi [the Prophet's Mosque] have been shut down.
"That is our qibla [the direction to pray in]," she underlined, noting that if the Islamic world's holiest sites had been emptied out and people were not allowed there, then Pakistanis, too, should adhere to lockdown measures and offer prayers at home.
"The Prophet (PBUH) himself advised against going to any place where there was a pandemic and not to leave a place where a pandemic had already started. We should follow that example!"
The SOGP president also talked about how people were outright ignoring suggestions and guidelines under awareness campaigns. "We're not butchers, we're on the frontlines, we're here to help our people," she mentioned.
"You've seen how doctors, paramedics, and nurses have been contracting coronavirus. Why is that? Because our healthcare system in itself is not good enough."
Cautioning people to follow lockdown instructions lest it be overwhelmed and break down, Dr Korejo added that experts had already warned that the pandemic could worsen and that there was no treatment for the virus as of yet.
"It's my request that for the next two to three weeks, please limit yourselves to your homes. I'm again telling women not to take their children outside, as I saw one women — with two or three of her children — out on the road unnecessarily.
Everyone, she added, "needs to be saved". If there was an urgent, large-scale need for beds in intensive care units (ICUs), there just weren't enough of them, she lamented. Or ventilators either.
Her organisation had initiated awareness campaigns and webinars, guidance to doctors in village clinics on how to protect themselves, and was giving them protection kits. "We intend to start telemedicine here too," she explained.
"I'm thankful for you all for coming here and actually listening to us women. Save yourself, save your country, stay in isolation, and don't go out unnecessarily.
All of whatever people deemed necessary could "be taken up later if we make out of this healthy and alive", Dr Korejo stated, adding that prayers, fasting, and taraweeh — everything could be done at home.
Dr Farrukha Abuhajir, an assistant professor and pathologist who retired from the Dow University of Health Sciences earlier this year, emphasised on how the coronavirus was "not as easy to diagnose either as opposed to malaria".
"Look at us all; we're mothers, sisters, and daughters, we have our own little children, if one of us gets exposed, she won't be able to meet her kids as she would have to stay in quarantine for 14 days," said Dr Abuhajir, who is also an in-charge at Pakistan Islamic Medical Association (PIMA) relief project in Sindh.
She noted that despite the supply of personal protective equipment (PPEs) from the government, the situation was such that protective gear was not available to many doctors.
"In JPMC, [the PIMA] has provided protective gear to the Young Doctors Association (YDA), Dr Seemin Jamali, and also to those in the gynaecology ward," she mentioned. Some were also handed to two units of the Civil Hospital Karachi.
Referring to how doctors were already underpaid, she said many had to purchase their own protective gear, which was a "huge strain".
"The government needs to try and make this better," Dr Abuhajir added. "To the people, I will say please confine yourselves in your homes and stay inside during this lockdown."
Dr Nusrat Iqbal of the AlKhidmat Hospital's management said medics and health professionals were working on multiple fronts, including the efforts to curb and eradicate the coronavirus and saving those who were attending to the patients.
"It's extremely important in medical terms to practise social distancing, for people to stay apart from each other, abstain from congregating, and stay home.
"The lockdown should continue 100% and it should be made more effective," she added. "At the hospital I work at, I have to save my people, my sweeper, my ward boy, because all of them are exposed to patients who we don't know are positive or negative.
"We have to save all of them, give them protection, and provide protective gear to them so that they can treat patients.
"I appreciate the media for an absolutely effective awareness campaign," she added.
Towards the end of the press conference, Prof Dr Siddiqui, the Civil Hospital gynaecologist, reminded people to ensure that Pakistan avoided a "time where we are unable to treat and save patients in the ICUs".
"It's better to employ prevention now and stop the spread and all doctors are of the same view. This is a health concern so listen to the doctors!
"Practice social distancing and stay at home for two to three months."
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