Tuesday November 28, 2023

Healthcare trauma

By Editorial Board
June 21, 2022

The apathy and incompetence that have become prevalent in our society crossed another ignominious boundary when a 32-year old woman in Tharparkar, Sindh suffered multiple unbearable traumas related to her pregnancy. This tragic case is a reflection of the extremely inadequate healthcare facilities that people in Pakistan have at their disposal. The woman, pregnant with twins, was to go through what should have been a simple surgery. Unfortunately, at a hospital in Chachro, Tharparkar due to sheer incompetence and negligence of medical staff, her baby girl’s head was severed and left in the womb. If that was not trauma enough, in the course of the botched-up delivery, the other twin also passed away. The woman was brought to Mithi and then taken to Hyderabad for another operation to remove the baby’s head from her mother’s body. The sorry end to this tragedy took place at Hyderabad’s Liaquat University Hospital (LHU). Though the director general of Sindh Health Services has ordered inquiries into the two cases, this must serve as a wake-up call for health authorities in Sindh and for the rest of the country.

Pakistan, with a maternal mortality of 186 deaths per 100,000 live births and an infant mortality rate of 58.46 per 1,000 has the worst figures regarding the safety of birth in the region. Indeed, currently Pakistan has double the infant mortality rate of other South Asian countries. This should be something that prompts us to take action – but that has not happened. The country spends barely 1.2 per cent of its GDP on healthcare and the tragedy in Chachro, which will undoubtedly leave the family devastated for life, is an example of our lack of attention to this crucial field of care for our people.

Most rural health centres (RHCs) across the country are devoid of gynecologists, obstetricians, and trained female staffers; the same was the case at Chachro. Such RHCs lack any facility to admit a critical patient. It takes hours before some lifesaving treatment and medication come to the rescue of women in labour. The life of this particular woman has been saved but there are many such cases that go unreported. Even district headquarter hospitals (DHQs) such as at Mithi in Tharparkar do not have technical equipment and staff to tackle such complicated cases. As patients are directed from one hospital to another, the condition of the woman in labour deteriorates. This calls for a thorough audit of all rural and urban medical facilities including the DHQs that lack properly trained staff and equipment. This could easily have been avoided by ensuring adequate neonatal care for pregnant women, possibly through the Lady Health Workers scheme or other initiatives. Had this happened, the situation of the mother and the position of her twin babies would have been known, perhaps making it possible to divert her to a larger hospital if thought necessary. We have often talked of what little value an ‘ordinary’ life in Pakistan holds; this is just one more example of that.