off record
Shaukat Ali Jawaid


Poor patients suffering
from chronic diseases


Dr. KMK is a very conscious, kind hearted, God fearing physician with keen interest in research and academics who not only believes but also practices ethical medicine. He retired as Prof. & Head of the Dept. of Medicine from a medical institution a few years ago. I met him at a conference recently and said, “We have not met since long” to which he responded that “He does not feel like coming to these meetings held at Five Star Hotels any more but do come sometime to meet friends” When I asked him the reason, he narrated a story which I would like to share with you as well.

“Last month a patient came to me for consultation and after making necessary investigations and proper workup, he was diagnosed to be suffering from Hepatitis-C. I asked him, he should be happy and was lucky as now oral medications for this disease are available. There is no need for repeated injections and suffering from various complications. I further told him that treatment will cost about Rs.20, 000/- per month and he will be cured in a couple of months’ time. At this he first kept quiet for a while and then said, Doctor Sahib, I will come back after arranging money needed. He came after few weeks and said, Doctor Sahib, you can start my treatment, I have now made arrangements. I asked him, how to which he responded that he had sold his wife. After hearing this, I was stunned for a while, I felt as if the earth had moved away under my feet. It took me some time to recover and then asked myself a few questions. Was it ethical for me to tell him the diagnosis which forced him to sell his wife? For poor patients diagnosis of any such disease is a life sentence and they will do whatever they can to live. I requested him, begged him to go back and take back his wife and assured him that I will do whatever it may require to get him treated, even if it comes to paying from my own pocket. I think when we hold these conferences at Five Star Hotels and discuss various issues, we are ignorant of the ground realities, he stated”. This shook me as well.

Earlier I remember while sitting with an oncologist at Nishter Hospital Multan a few years ago, I saw a cancer patient from Dera Ghazi Khan who, I was told by the oncologist, has sold one of his children to arrange funds for his cancer treatment. This is despite the fact that the patient was provided some assistance by Cancer Society of Multan as well. More recently while speaking at the PSSLD 11th Annual Conference held at Islamabad, Prof. Muzzafar Latif Gill also shared a story about a Hepatitis-C patient who had relapsed after six months of treatment with Peg Interferon and Ribavirin. Prof. Muzzafar Latif Gill said that I told him that now there is no need for injections and oral medications are available and he should get proper treatment. At this, the patient, Prof. Gill said speaking in his typical Punjabi dialect said “Chaudhry Sahib, Meri Munji Tay Pehlay Hee Thook Gai Aay, I have no money left for treatment”.

Even at these medical conferences at times one hears saner elements within the medical profession voicing concern. At a symposium on multimodal approach to treat depression, Prof. Syed Hamid Shafqat a well-known cardiologist of Pakistan had remarked that “We must sympathize with the patients and give them Hope which most of the doctors are not doing”. Prof. Wasim Jafri an eminent Hepatologist, Gastroenterologist speaking at the PSSLD conference held at Islamabad recently had also remarked that “Prescription is not everything, treating physicians must spend some time with patients to educate them”.

The objective in narrating the above stories is to highlight the fact that there are too many professional organizations, societies, associations’, Foundations and other interest groups in some of the disciplines which deal with chronic diseases. It includes Diabetes, Cardiovascular Diseases, Oncology, Psychiatry, Hepatology etc., and all of them keep on organizing their conferences at Five Star hotels all sponsored by the Pharmaceutical Trade and Industry. Little do they realize that eventually it is all paid for by the poor patients? Pharma and medical device industry all over the world sponsors such academic activities and there is no harm in it but it is also important that one should be aware of the ground realities. A stall at the conference which used to cost few thousand rupees in good old days now costs Millions of rupees. Not only that the organizers also expect the companies to sponsor registration of delegates and Registration Fee is kept very high which is in fact a gimmick to generate funds. Many a times one can see dozens of Registration Badges lying at the Registration Desk as those who were registered by various companies do not bother to come and attend the meeting as they are not interested. Eventually some of the conference organizes end up making a profit which runs into Millions of Rupees which is a Fact. While no one should object to seeking sponsorship from the pharma, medical device industry for such academic activities, what is the justification to extract money running into Millions of rupees and make millions of rupees profit. Unfortunately some members of the medical profession have now become a part of the problem rather than becoming a part of the solution, adding to the miseries of the poor patients. Various professional bodies in the same discipline hold their separate meetings, seek sponsorship and keep on making millions of rupees of profit every year and all this goes on un-checked. Neither the Government functionaries nor the regulatory bodies have woke up from their deep slumber, hence the poor patients will continue to suffer. May be some day the Judiciary takes a note of it and calls for audit reports from all the conference organizers to see what is going on and I assure you it will be an eye opener for everyone.

While there is no dearth of conscious people in the medical profession, Prof. Kh. Saadiq Hussain and Lt. Gen. Mahmud Ahmad Akhtar just to name a few who has on many occasions tried to show mirror to their professional colleagues but unfortunately the leadership of the medical profession is with some (there are a few exceptions) who have made organizing a conference a business. It has given birth to a new class of “Social Dacoits”. Perhaps they have forgotten that when we leave this word, everyone gets wrapped in a six yard white colour cloth which is known as Coffin and it has no Pockets. I wish and pray that God almighty show all of us the Right Path and we all try to help each other and particularly those poor, not so well off in the society.

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