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November 21, 2019

Issues of health

Opinion

November 21, 2019

In the run up to Mian Nawaz Sharif’s impending exit from the country on LHC orders, there has been a great deal of virulent criticism on social media over the failure of the PML-N government able to offer treatment at home. The point here is twofold. In the first place, it seems harsh and in extremely bad taste to jeer at a man who is quite evidently struggling for his life.

The other problem is that the ability of hospitals to treat his condition is not the problem. It is the diagnosis they are not able to arrive at. Doctors trained in the US are part of the panel, but diagnosis and the specific tests he may need to acquire one are not commonly available anywhere in the world.

Yes, we should ask about why our healthcare is in such poor shape. Why do people struggle to obtain even basic care. We should also ask about why there are over 85 polio cases reported in 2019 compared to 12 in 2018. Somewhere, Pakistan is losing its way and the PML-N government cannot be held responsible for what has happened after it was ousted from power in an election.

There are other aspects to the criticism surrounding Mian Nawaz Sharif’s departure and hospitalization. People ask why he is being singled out for special treatment while other convicted prisoners must go without such care even in life-threatening situations. We all know prisoners have died in hospital after the failure to offer them the treatment they needed. But the answer to this is not very complicated. Perhaps the government should be attempting to offer similar treatment to all prisoners so that no one is singled out. After all, every citizen of the country has a right to life and a right to dignity. It should not be a question of treating VIPs differently, but of ensuring the same facilities exist for every person regardless of wealth, status or position. It will be a long time before we reach this point. But the attempt can begin now.

It is also sad over the past weeks to see PTI supporters and even members insinuate or openly state that Nawaz Sharif was faking his illness. A panel of doctors set up by the government itself has confirmed he is in critical condition. Remarks in poor taste about health have cropped up before: most recently perhaps in the case of Kulsoom Nawaz Sharif, who pro-PTI political enthusiasts suggested was not suffering cancer at all but simply pretending to be ill in a London hospital. Her death due to blood cancer clearly proved these uncouth comments to be both incorrect and highly insensitive.

This insensitivity is disturbing at many levels. It is sometimes shocking to see the way in which medical practitioners treat the less privileged who appear before them even in top private hospitals. The failure to spend time on assessing their situation, explaining their condition and seeking their views on treatment options is a violation of medical ethics. Even if the patients are uneducated, this does not mean they are stupid or to any degree unable to understand their own condition if it is put out before them clearly.

Patients have a right to know what they are suffering and how they are being treated. Rights over the body after all belong primarily to the person who lives in it. Fooling people or simply attempting to spend as little time as possible with them and their families is a scourge linked perhaps to the money-making industry that the medical business has become in our country. It is also true that families urge doctors not to tell patients suffering serious diseases the truth, in order to avoid demoralizing or alarming them. This is a culture the medical profession can help change.

Health and improvements in its set up had been one of the major claims of the PTI as it campaigned for office. Yes, there has been change. But we must ask if it follows the right decision. The Pakistan Medical Commission Ordinance of 2019 was enforced by presidential order after parliament turned it down. This is not a good way of going about legislative business. There have been protests by a grand alliance made up of young doctors, paramedics, nurses and other medical workers for weeks over this change. Essentially, the new law, which can stay in effect only for 180 days under the constitution, empowers private medical colleges to charge any fee they decide to, abolishes the Pakistan Medical and Dental Commission which has been the main statutory body regulating medical practice since the 1960s and empowers the private medical sector in other ways.

Some commentators suggest the powerful lobby of those who own private medical universities may have been behind this move. We do not know if this is correct. But it seems unwise to make major changes in laws governing the health sector without taking on board all stakeholders including doctors, interns, nurses and indeed even patients.

We need dramatic changes in our health sector. There are surprising examples of minor success. For all its other failings, the Sindh government has been able to improve facilities at rural health centres and basic health units, making this a priority. It is unlikely these will be maintained, but when there is some will to do good, it can be achieved. The chaos in Khyber Pakhtunkhwa over hospital administration and other aspects of medicine raise further doubts about the government’s planning and ability.

It goes without saying that healthcare is the fundamental right of every citizen. It must be catered to. Without it, we cannot gain any control over the death of millions of children the moment they are born, the death of their mothers as they give birth or the highest under five mortality rate in South Asia. We can also not get rid of the stunting which afflicts some 50 percent of Pakistani children and the wasting which others suffer.

Essentially, we are ending up as a nation with some of the poorest health statistics in the world. The rate for diabetes, heart disease and other behaviorally influenced illnesses tends to keep up even among lower income groups because we are unable to promote a healthy diet or raise awareness about the basic needs for good health. This is a travesty. Almost every citizen suffers, and it does not appear that there is any hope in the near future of things taking a dramatic turn around the corner, where a new scene opens up out of the darkness.

The writer is a freelancecolumnist and formernewspaper editor.

Email: [email protected]

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