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Shortage of medical officers
and Primary Health Care

Dear Sir,

You have touched a very vital but distressing topic in your column “Off the Record” on September 14, 2018 issue of Pulse International. Primary Health Care (PHC) has suffered serious setbacks particularly due to 18th Amendment and due to persistent appointment of general cadre bureaucrats as Secretary Health in all Provinces & Federal Government. Bifurcation of Health Dept. in two separate entities and degrading of Director General Health Office has also contributed towards downfall of PHC. As a Chief Executive in private sector I find difficulty finding general duty Medical Officer for appointment in hospital. Every fresh graduate is ambitious of post-graduation and is running towards PCPS for FCPS Part I. He / She intends to land as a specialist. What to speak of big city hospital, priority of Medical Officer in public sector particularly in primary health care is very pathetic. Perhaps most of them do not know about PHC. In the coming years you will not find GP/FP in rural or urban localities as no fresh doctor is interested in PHC / Family Medicine.

It is indeed a very alarming bell for national health system in Pakistan. In the past when there were few public medical colleges, similar situation was tackled on the advice of donor agencies. Special Courses like health technician (1-Year) Rural Health Inspector (1-Year) Medical Technician (2-Years), Sanitary Inspector (1-Year), Medical Assistant (3-Years) were designed to manage short fall of manpower for public health & primary Health Care. With the passage of time, these cadres either died or were converted or promoted into “clinicians”. Some of them retired in grade 17-18 like medical officers. Most of the vacant posts were filled by less qualified persons, on sale-purchase basis. In short, it is high time that three types of courses should be considered to resolve the prevailing situations:

  1. Train Paramedics to man BHU, Rural /Civil Dispensaries.
  2. Produce Medics like LSMF to head RHC & act as GP/FP in the community with no conversion to full medical officer. 
  3. PHC is a dire national need and cannot be ignored. It requires a proper set up right from DGHS to UC and ward levels to provide / monitors all the components of PHC. 
  4. An organized & well established Provincial Health Directorate must be responsible for planning, training, positioning & monitoring of PHC activities at all levels in the provinces. 

This necessitates creation of PH Technician to play the important role of PH Care provider. Their syllabus and training should be such that these paramedics cannot covert themselves to clinical work & continue to work assigned to them.

Dr. S. Anwaar Ahmad Bugvi
Chief Executive
Mansoorah Hospital Lahore
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Late Prof. Ijaz Haider

I am so sad with this tragic news of Prof. Ijaz Haider’s death. His passing away is a great loss not only to the medical profession and Psychiatry in particular but also to a lot many of us practicing psychiatry. He was a mentor for me and had always helped me in my professional life through different ways (which many people do not know!). May Allah rest him in Peace.

Dr. M. Afzal Javed
Consultant Psychiatrist
UK.
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We were deeply grieved to know the sad demise of Prof. Ijaz Haider. It is so sudden, untimely and tragic. There is so little one can do to mitigate grief in such circumstances. May Almighty Allah bless his soul with eternal peace and grant courage to the family members to bear this irreparable loss. With countless prayers.

Prof. Maj. Gen (Retd) M.Aslam
Pro Vice chancellor,
NUMS, Rawalpindi.

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