“In Pakistan it is the Lassi which rules over the Cream-Prof. Iftikhar Ahmad”


Rulers must learn to Listen, Respect Health Professionals
“In Pakistan it is the Lassi which rules
over the Cream-Prof. Iftikhar Ahmad”
It is one of the reasons why Pakistan could not make
any worthwhile progress and become a Social Welfare
State as envisaged by the Founder of the Nation

By Shaukat Ali Jawaid

LAHORE: The above are excerpts from the famous speech delivered by Prof. Iftikhar Ahmad a well-known physician of the country which he delivered at the annual convocation of King Edward Medical College as Principal on December 16th 1987. President General Ziaul Haque was the chief guest on this occasion and the top bureaucrats of the country and everyone who mattered in Government in those days besides a large number of members of the medical profession were present on this occasion. Tracing the professional background of senior healthcare professionals from the day they get admission to medical college being the best students and cream of the society, Prof. Iftikhar had discussed in detail their professional career and then how they are treated by the bureaucracy in Pakistan, It is unfortunate that it is the “Lassi who are the left outs, low level students, then go to other professions and eventually end up ruling over this Cream.” This is one of the reasons, Pakistan could never make any worthwhile progress and it could not be made a Social Welfare State as envisaged by the Founder of Pakistan, Quaid-e-Azam Mohammad Ali Jinnah, Prof. Iftikhar remarked.

Late Prof. Iftikhar Ahmad

His speech was so emotionally charged supplemented with quotations from the famous Sufi Saints Bulleh Shah that he did not spare any one. The strategy which he had adopted was correct and it paid off and he managed to get the desired results. When Gen. Zia-ul-Haque came to the rostrum, he took off his glasses and said, he is not going to read the speech which he was provided but would like to speak from his heart. He went on to say that “He fully agrees with each and every word which Prof. Iftikhar had said but also warned him that Bureaucracy will never forgive him and the medical profession for this sin and they have to be on guard”. However, he did immediately announce that henceforth Principals and other senior medical teaches will also go up to Grade-22 the posts till then only reserved for the bureaucrats. Principals also got some autonomy. Pointing towards Mr. Fazlur Rehman a senior bureaucrat Federal Health Secretary at that time who was present among the audience, Gen. Zia said that “he and by that he also means all bureaucrats should listen and respect Prof. Iftikhar and all other Principals, senior healthcare professionals and make sure that they do not have any complaints in future”.

It was 1986 and now in 2020, if we look at the state of affairs, nothing has changed. The bureaucracy keeps on humiliating and badly treating the doctors. With due respect to God fearing, Kind hearted bureaucrats like Mr. Perwaiz Masood, Mr. Anwar Zahid both of whom later became Chief Secretaries of Punjab and a few others like them, on the whole the bureaucracy continues to treat the medical profession very badly.

Late Prof. Iftikhar Ahmad, it may be mentioned here during his professional career which was full of ups and down, held many coveted posts including Principals of medical collages, Punjab Health Secretary and Chairman of the Chief Minister’s Inspection Team. He was made an OSD, suspended numerous times for speaking for the doctors particularly to improve the working conditions of young doctors but he never compromised. He continued to have a love and hate relationship with the government of the day in general and the bureaucracy in particular but one thing was very clear that everyone was afraid of him because they knew that he can take on any one of them irrespective of the consequences and he did prove it at many times to the great disappointment of the then DG Health Gen. Iqbal, Health Advisor Dr. Basharat Jazbi and the Chief Minister Punjab Mian Nawaz Sharif.

Just look now during this COVID19 Pandemic, doctors were forced to work and treat these COVID19 patients without provision of PPEs, N95 Masks, other protective equipment. When they protested, they have been Lathi Charged, dragged on roads in Quetta, arrested and put behind bars. They were manhandled at Lahore when they protested non-availability of PPEs, the hospitals have been ransacked, and doctors had to lock themselves in the hospital to save their lives from violent mobs coming with patients. Doctors are continuously being harassed, defamed, humiliated, serious allegations are levelled against them. Their character assassination campaigns goes on in the media and no one is prepared to listen to their grievances.

The result of this non-serious attitude by the authorities is that Pakistan continues to pay a heavy price for ignoring the Health Experts advice and now the number of new COVID19 cases in the country has crossed one lac to 123,493 to be exact on June 12th 2020 and the number of deaths has also crossed the figure of two thousand (2,409 to be exact) on the same day. The number of cases continue to increase with the every passing day and the peak has yet to come. An ever increasing number of healthcare professionals treating these patients are getting infected and testing positive. Not only they themselves but their families are also undergoing lot of stress, strain and psychological disorders. The family members of these Healthcare professionals are at a very high risk and every day the news of some HCPs dying due to COVID19 sends an alarm signal among those working in the healthcare facilities all over the country.

As a father of three doctors who got infected while treating these patients and tested positive for COVID19 I know what has been going on in the family. The whole family is going through very difficult times. They had to get their tests done paying a huge sum of Rs. ten thousand each which every one cannot afford. The situation is so bad that none of the children of my doctor children are now willing to take up Medicine as a career. They have decided to opt for some other profession. What happens to those families who have already lost their near and dear ones, doctors, nurses, paramedics is not difficult to imagine. However, with the government, economy comes first and human health has no importance. Even fools know that economy and business can be revived but the human lives lost can never be brought back but the rulers do not understand all this. Sitting in their own ivory towers, they keep on issuing sermons that people have to learn to live with COVID19 pandemic. It is extremely painful to see that even respectable members of the medical profession like Dr. Faisal Sultan, Prof. Yasmin Rashid and Dr. Zafar Mirza who are holding important positions in the present government have failed to impress upon the government to listen to the saner advice of health experts who have been crying for the last couple of weeks to wake up. There have been numerous excellent write-up in Daily DAWN alone contributed by its senior staffers, Editorials and some other contributors advising the Government to learn from its past mistakes and do not keep on repeating the same mistakes again but as usual no one has paid any heed to all this.

Despite tall claims by the authorities, one daily hears complains from the healthcare professionals regarding non-availability and disrupted supply of PPEs, N95 Masks and other protective equipment. After an SOS call by the PIMA which addressed a press conference at Karachi Press Club on June 3, 2020, Dr. Rizwan Kundi President of Young Doctors Association KPK has also expressed concern over growing number of COCID19 patients and asked the government to focus on the infected people and make immediate arrangements for additional beds and ventilators to ensure their effective management at the hospitals. Supreme Court of Paksitan is also not satisfied with the quality of service being made available by NDMA and other government agencies. In a report appearing in Daily DAWN of June 8th 2020 Dr. Kundi has also called upon the authorities to strengthen the District and Tehsil Hospitals and link them with teaching hospitals. He has further stated that more than four hundred doctors have so far been infected with COVCID19 due to shortage of PPEs. As if this is not enough, increasing incidents of violence against doctors and healthcare facilities has made the situation worse and it has become extremely difficult for the doctors to work under such conditions. He has urged the Government to deploy Army and Rangers personnel to provide security to the doctors.

Doctors find themselves helpless reads a headline in Daily DAWN of June 9th and yet another headline on the front page of Daily DAWN of the same day reads “SC tells Govt. to take Covid-19 seriously”. Is it going to make any difference? Looking at the track record of this government, one has serious doubts. “Dr. Rubina Mustafa from Nishter Hospital Multan who lost her sister Dr. Ghazzala Shaheen because of coronavirus has alleged that her sister died because of mismanagement as there were no senior doctors in the coronavirus intensive care unit, no ventilator while even cannula was not available for the patient.” One just has to read all this in the light of the claims being made by the rulers, NDMA and Dr. Zafar Mirza the Advisor to the PM on Health. Dr. Rubina Mustafa is very bitter and has expressed her anger in the following words:

“Her colleagues (Dr. Ghazzala Shaheen Senior demonstrator of Pharmacology Department) with whom she was more than two decades were only giving instructions on the phone while no senior doctor bothered to intubate. Poor trainee doctors are on the front line. Thank you so much corona ICU senior doctors and the anesthetist for mismanagement, carelessness and arrogant behaviour. Bogus Nishtar, bogus healthcare system and minister and worst country to live where patients are buying medicines from black market and injections of Rs. three thousand was being sold for Rs. three lacs. No PPEs, no BIPAP (level Positive Airway Pressure) and no ventilators are available”. My sister contracted coronavirus from the hospital while working where she served for more than two decades. We have more than fifteen doctors in the family from Nishter Medical College and served different specialties with dedication and still serving but unfortunately she was mismanaged, she alleged.

According to Prof. Brig. Waheed uz Zaman Tariq a well-known Virologist, the figures being released by the authorities regarding the number of infected cases and the deaths were not true. Writing in his Blog on June 8th, he describes that “Yesterday he saw four patients on Wheelchair with Oxygen saturation below 50% in extreme agony at my clinic and referred them immediately to emergency DHQ Hospital, they were stabilized with very high flow oxygen, three of them became LAMA (left hospital against medical advice) on a pretext of, in case of death we will have to pay money to police for dead bodies. Those in Punjab government who involved police in COVID pandemic did a huge blunder, he writes. When I discussed with the young frontline doctors working hard in COVID ER at DHQ Hospital Sheikhpura, they told that yesterday in twenty four hours more than fifteen critically sick COVID patients with severe respiratory distress, SpO2 below 60 percent refused admission and attendants took them home for dying at home on similar pretext. It’s indeed very painful. These patients were in severe agony and struggling for each breath. Majority can be saved with different types of oxygen therapies with rebreathe masks etc.” Daily DAWN in its report on April 17th had published an article “Is the number of Covid-19 deaths in Pakistan higher than being reported?” This blog contains lot of other information and details to point out that the figures being released by the authorities were not matching with the ground realities. Prof. Waheed uz Zaman in his Blog has concluded that” Death is a reality but one must not advise to jump in the fire. Let us extinguish the fire, although it is too late by now”.

Time has come when the medical profession must wake up, identify black sheep among its ranks, throw them out or start their social boycott, uphold professional ethics, start their own self accountability. Insist on the patient accountability as well and produce a leader like late Prof. Iftikhar Ahmad who has the guts and courage to speak the language which the rulers understand if they wish to get back their lost respect, dignity and continue to work looking after the ailing humanity. Otherwise, bleak future awaits them, so get ready for the worst times still to come.