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“Plight of a Medical Editor”

Dearest Shaukat sahib,

Thank you very much for sending me the book “Plight of a Medical Editor” an autobiography.  I am reading it with great interest. It is history of professionals and profession more than your autobiography.

Ahmed Badar
Saudi Arabia.
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 My dear Shaukat,

Just finished reading your book “Plight of a Medical Editor” An autobiography  on the train from Birmingham to Peterborough. Once I began reading it I could not stop . Two things clearly emerge out of your book, namely the honesty in  journalism and truth telling . The book may safely be called the 'Who's who in the field of medicine’ in Pakistan.  Please accept my
sincere greetings on yet another mile stone in your eventful life. On a personal note may I thank you for keeping me in your thoughts while recording the events of the days gone.

Prof. Shabih H. Zaidi
UK
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Lessons from Bangladesh,
Sri-Lanka and Cuba

I read with enormous interest your “Off the Record” column “Lessons from Bangladesh” published in Pulse International of July 15, 2015. I worked with the Bangladeshi (Former East Pakistani) doctors serving in the Pak Armed Forces Medical Services from 1955 to 1971. On this subject my articles were published in your esteemed paper ‘PULSE’.

I learnt many things from those East Pakistani doctors. First and foremost they had a democratic mind-set, lead a simple life, had no lust for money and power and provided dedicated services to the patients. There is a background to it. In 1930s, Muslim League formed the Government in the United Bengal headed by Chief Minister Khwaja Nazim-Ud-Din. That Govt. abolished the feudal system completely, while on the other hand the Feudals were very strong in “Northern India (Pre-partition) and they became more powerful after independence. Thus feudal mind-set took deep roots in the West Pakistan.

Your observations of their holding meetings, at institution’s auditorium rather than in the Five Star hotels, their simple ways, not squandering public money is due to their democratic mind-set. Likewise your observations of behaviours of leaders and doctors in Malaysia  and Turkey is also due to their democratic culture. Lust for money and power in our milieu is due to feudal mindset. Medical conferences have become a big source of corruption. Furthermore, you have rightly stated that ultimately the patients suffer. In my view it is one important factor that companies in Pakistan go for manufacturing expensive irrational drugs and avoiding essential/rational cost-effective drugs, recommended by the WHO expert committee. There is an unholy nexus between the politicians, bureaucrats and the industry – the sufferers are the poor patients.

You have mentioned the name of Prof A.R. Khan working at Bangladesh Institute of Diabetes and Endocrinology (BIDE) Dacca. He was Lt Col, senior medical specialist at Military Hospital Rawalpindi (later Major General Bangladesh, Head of the Armed Forces Medical Services). He was my colleague at MH Rawalpindi. He came back from UK after getting medical education/training and did not bring even a car. When asked about it, he replied that he was so much involved in his studies that he had not thought about material things. He worked day and night looking after patients in Pakistan without caring for private medical practice. He is now in his late eighties and serving Bangladesh voluntarily. He has many research publications to his credit.

You have earlier published an article by a Pakistani cardiologist visiting Bangladesh, eulogizing Brig Malik Ali’s voluntarily services at mid-eighties to the Bangladesh cardiac institute. Brig. Malik Ali was my contemporary medical specialist, was one of the pioneers of the MH cardiac department – later developing into AFIC.

I would like to mention the services of Brig. Nawab Ali who served the Pakistan Armed Forces Medial Services. Not to be confused with Dr. Nawab Ali the most senior Physician of East Pak/Bangladesh in whose commemoration 1st stamp 2005 was issued by the Bangladesh Govt. an indication of the respect which Bangladesh Government gives to professionals. Brig Nawab Ali was trained in cardiology at the London institute of Cardiology by the legendary cardiologist Prof Paul Wood – a pioneer of cardiology and author of the famous book on cardiology. Brig Nawab Ali established the cardiology department at MH Rawalpindi which later became the AFIC, However the first Pakistani cardiologist trained by Prof Paulwood was Dr. G.M.K Baloch from KEMC, a brilliant doctor who unfortunately died very young.

Bangladesh at the time of separation was far behind Pakistan in health para-meters like population control, maternal, newborn, neonate, children mortality and lifespan but now is much ahead of Pakistan. Bangladesh is running ‘Essential Drug' program perfectly well, while Pakistan is not providing its people many of the essential life-saving drugs like anti-bacterials, many penicillins, furadantin, trimethoprime, ferrous sulphate etc while Bangladesh is even providing essential drugs free of cost to the poor people. This is a major reason for Pakistan’s high mortality of the poor segment of population. Bangladesh markets are devoid of irrational and harmful drugs while Pakistani markets are flooded with irrational and harmful drugs, robbing the people of their health and scarce finances.

Pakistan should also learn lessons from Sri-Lank which has literacy rate above 98% and universal effective health-care system with much longer life span than Pakistan and far better health-care parameters. This is in spite of Sri Lanka having faced over two decades of civil war.

The other country to learn lessons is Cuba a tiny Island which remained under sanctions from the super-power, yet it has universal education and health care systems. The country has achieved one of the highest life-spans in the world and the lowest mortality rates. Cuban healthcare system was devised by Dr. Che Gavaria a medical doctor turned revolutionary backed by Fiedel Castro. Pakistan experienced the affectivity of the Cuban health-care system during 2005 earthquake. Cubans provided excellent healthcare from primary to tertiary level, donated field hospitals to Pakistan. Cubans have provided services to Japan, Africa and other countries during natural disasters. During Ebola epidemic in Africa, Cubans contained the epidemic while the super power could not do anything. This fact was highlighted by the International New-York Times in an editorial. Pakistan should devise it’s health-care system based on the system of these countries and not follow the example of USA, elitist system where the poor people’s health parameters are as bad as of the poor back-ward counties. The social welfare systems of Nordic countries and other European countries is better but that needs colossal amount of money which Pakistan cannot afford- even a fraction of it.

Lt Gen Prof Emeritus Mahmud Ahmad Akhtar
Former Surgeon General/DGMS (IS), Pakistan Army.

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