Call to Action
The healthcare structure in Pakistan remains non-existent and tenuous and is far below most neighbouring and Asian countries.
According to the World Health Organisation (WHO), the average life expectancy in Pakistan is around 70 years. The number of hospitals per 100 thousand population is below 0.5. Mortality rate of infants is estimated to be 56 per 1000 live births. The spectrum of infectious and related diseases is estimated to be 50% acute respiratory infection, 20% diarrhoea, dysentery and typhoid, 20% tuberculosis, malaria, dengue, cholera and 3% others. Malnutrition levels are the highest among infants and children in the country. Water and food-borne diseases including hepatitis, A, B and C are also known to be highest in the country. Diabetes, blood pressure, renal diseases, heart diseases, high cholesterol, coronary artery diseases, etc. are prevalent and every home has some of these health issues. Cancer, particularly oral cancer is an indigenous problem, prevalent in gutka-pan, mawa users. These are primary care issues and can very well be managed and controlled with carefully planned awareness and prevention programme.
While we have a barrage of primary, life threatening, poorly or uncontrolled, indigenous and other diseases prevalent in Pakistan on the one hand, we have a number of immoral, unethical, unwanted and undesirable practices in the healthcare, on the other.
Most of us are aware of strict rules and regulations governing healthcare management in the West where ethical and moral values are equally important. In contrast, our healthcare system, with poor delivery, has little moral and ethical consideration for the large majority of non-affording, general public.
Our graduates with basic medical degrees along with a one-year house job, need further training with senior consultants in order to enhance their knowledge and master their practices. This is not available for all graduates because only a handful of institutions in Pakistan provide specialized training. Subsequently, a good number of medical graduates leave for abroad and rarely return to the country. Some of the remaining, semi-trained physicians opt to general practice where quality of care is compromised.
The role of the pharmaceutical industry is of utmost importance. However, some local pharmaceutical companies appear to produce, knowingly or unknowingly, low quality, low potency generic products. These are promoted with huge discounts through private clinics and pharmacies. Government bodies ignore any action on such corrupt and criminal practices. The financial benefits of the trio result in loss of life and various health complications. In many cases, patients are not fully advised of the correct doses or poorly written on the prescriptions, result in poor compliance. Laboratory tests are usually expensive and often with poor or variable results. There appear to be an abuse of injectable drugs and misuse of antibiotics with a practice of prescribing multiple medications, often one medication with different names and incorrect doses.
The writer is Founding Chairman of the Amana Hasnain Health Foundation (AHHF), Karachi. He can be reached at email@example.com
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