Developing emergency medicine in Pakistan – need of the hour

Islamabad : It is need of the time to introduce specialty of Emergency Medicine in all public sector hospitals of the country and in leading private hospitals as trained personnel can save lives of thousands of patients coming to accident & emergency departments of hospitals in critical condition.

There are not more than nine qualified specialists in the field of emergency medicine in Pakistan, a country having a population of over 220 million with extra ordinary burden of both the communicable and non-communicable diseases and trauma cases.

College of Physicians and Surgeons Pakistan recognized Emergency Medicine as a primary specialty in 2011 but till 2014, only two teaching hospitals both in private sector namely Shifa International Hospital in Islamabad and Aga Khan University Hospital in Karachi were offering the training in EM to medical professionals. Even today, there are only seven hospitals across Pakistan that have about 70 EM trainees in various years of training.

Elected Councillor and Regional Director at CPSP Islamabad/Rawalpindi Chapter Professor Muhammad Shoaib Shafi expressed this while talking to ‘The News’ on Sunday on importance of specialty of emergency medicine in healthcare.

He added that ideally, it is the specialists in emergency medicine who decide what course of action to be followed for a patient reaching hospital in critical condition and if we want to strengthen emergency healthcare, we must produce specialists in EM.

The dynamic field of EM was recently focused upon in Pakistan though unfortunately, in a country where major medical and traumatic incidents are a common happening, there is critical shortage of competent emergency staff, pre hospital services and established emergency departments. Primary health care is still not widely accessible so the first presentation of most of the patients is a serious health condition in an understaffed and ill-equipped emergency where their clinical outcome is greatly compromised, said Consultant and Program Director Emergency Medicine at Shifa International Hospitals Dr Khawaja Junaid Mustafa.

Disproportion in the current health care budget versus high patient turnover in public sector is also compromising acute care and it can be said that the task is mammoth at hand but with timely measures and political willingness, these challenges can be met, he said.

Professor Shafi believes that it may not be possible to improve quality of emergency medical care without introducing EM in public sector. “At present, only one public sector hospital, Lady Reading Hospital Peshawar is training medical professionals in the field of EM.”

Policy makers and relevant government health departments are still lagging behind in realizing the importance of this front door acute specialty which can impact significantly in acute care of patients, said Dr. Khawaja.

Giving Pakistani perspective of EM, I feel that there is a strong need of working towards developing this specialty because any further time delay will cost us exponentially in terms of patient care, he added.

This can be achieved by a strong political will and the benefits of this effort would surely be seen as improved care for the patients, decrease in the mortality rates especially for infants and other vulnerable populations, and overall decreased economic burden as the care would also be economically efficient, said the expert.