off record
Shaukat Ali Jawaid


Can we compete with
India in Health Services?


We Pakistanis love to hate India for various reasons particularly due to its atrocities in occupied Kashmir but can we compete with India in health services. We must not forget certain ground realities i.e. India is our neighbor and one cannot change neighbors. Hence it is essential to have peace on borders and good relations with all the neighbors which is extremely important for progress and development.

Over the years India has made tremendous progress in health services may it be interventional radiology, interventional cardiology or Minimal Access Surgery. They have established numerous transplant centers and a large number of patients from Pakistan are going to India for Liver transplant as we have so far failed to provide this facility at any public sector hospital while the facility available at a private hospital is too expensive. India is also earning lot of foreign exchange through medical tourism whereas Pakistan is seen nowhere in this field.

One of the important reasons for all this is the uninterrupted democratic order seen in India while we in Pakistan have never allowed democracy to flourish. After every few years we derail democracy, take two steps forward and one backward. Election Commission in India enjoys credibility for holding fair and transparent elections and it is the voters in India which elect their Government. However, in Pakistan, as regards performance of Election Commission less said the better. Though the people vote in elections whenever they are held but they have no role in electing their government because it is alleged that this is done by those who count the votes and announce the result. Hence, we have miserably failed to strengthen our institutions, we lack stable political governments hence we cannot have the luxury of long term planning.

All India Institute of Medical Sciences and Jinnah Postgraduate Medical Centre in Karachi started their journey together in 1947. While All India Institute of Medical Sciences has made remarkable progress, we are still discussing whether the JPMC should remain with the federal government or handed over to the Sindh Government. The case is at present in the Supreme Court of Pakistan. We have miserably failed to protect, promote, expand services at a healthcare facility named after the Father of the Nation Quaid-e-Azam Mohammad Ali Jinnah. Thanks to Patients’ Aid Foundation, untiring efforts of people like Prof. Tariq Mahmood and Prof. Hasan Aziz that lot of expansion and development at JPMC was possible by funds generated through donations and with the help of various philanthropists. While Prof. Hassan Aziz helped establish National Epilepsy Centre at JPMC and also built a beautiful auditorium, Prof. Tariq Mahmood through Patient’s Aid Foundation has completed a large number of development projects at JPMC. More recently some projects have also been funded by USAID. Despite all this, it is nowhere near to match the AIIMS in any respect. I had an opportunity to interview quite a few faculty members at AIIMS who are proud of the fact that they are on the faculty of AIIMS and they enjoy tremendous respect, which is not the case with our faculty members at JPMC who are all the time struggling for funding as the workload has increased manifold.

High Altitude Medicine is another important discipline even from defense point of view. India realizing its importance established an Institute of High Altitude Medicine almost three decades ago but we in Pakistan have made no worthwhile progress in this regard too. Our approach so far remains casual. An international seminar on High Altitude Medicine was organized by late Dr. Muhammad Ilyas from Peshawar at Gilgit in 80s which was attended by delegates from India, China, and Japan as well. A suggestion was forwarded to the Government of Pakistan to establish proper institute and help undertake some studies but as usual it all fell on deaf ears.

While the number of medical and dental colleges, medical universities has increased in Pakistan, mostly in the private sector but as regards their staffing, developing related teaching and training facilities, other infrastructure, there has been no progress at all. Merit is most often ignored, praise singers among the healthcare professionals are always found close to those who are in the power corridors, hence how can one expect any worthwhile progress and development in the health sector. Yet another important reason for our dismal performance in the health sector is the lack of respect and recognition of those in the medical profession who are keen and serve the ailing humanity with devotion and dedication. Not only that even our media runs a malicious campaign against the healthcare professionals and healthcare facilities without making proper investigations. Many renowned specialists were arrested on cooked up charges, sent to jail, their character assassination campaign was on the media for weeks and months which was extremely painful not only for these doctors but for their families as well. Later nothing was proved against them and they were released but the damage was done. Some renowned doctors have left the country, others who had planned to come back to Pakistan have abandoned their plans keeping in view these very reasons. Hence, it is the country and the people of Pakistan which continue to suffer. We had even handcuffed the eminent educationists, defamed and humiliated them, one of them even died in custody. A country which does not respect its teachers can never progress and prosper.

Members of the medical profession are also responsible to some extent for this sad state of affairs as it has also failed to come up with some mechanism of self-monitoring and accountability. Had it put in place some self-monitoring mechanism, taken action against those who indulge in all sort of unethical practices, it would have enhanced its image which is not so good these days. While the facilities being made available at public sector healthcare facilities have not kept pace with the workload since the number of patients has increased, public’s expectations has also increased. Population explosion has made the situation worse as with meagre resources, Governments cannot afford to provide free healthcare to the entire population.

Stable democratic governments can alone plan for long term and ensure continuity of policies. Let us all respect the vote, give the people of Pakistan chance to elect their government freely, they will kick out the corrupt and inefficient who fail to perform and come up to their expectations. We lost half the country but have not learnt any lesson and keep on making the same experiments again and again expecting for some different outcome which is not possible. Making the popular leadership ineffective is not the answer. Let us give respect to the medical profession which it deserves, stop harassing them. Put an end to the malicious campaign and character assassination of doctors on the media most of which is unwarranted. Differentiate between human errors and criminal negligence while taking any action. It is these very doctors who do wonders when they go overseas because there they get comfortable working environment and merit is recognized and appreciated.

We in Pakistan have the resources and talent to compete with India in health services but this is only possible if we have professionals who are known for their intellectual honesty and credibility. They are consulted, selected for various coveted posts in the health sector to run and manage the medical institutions. Programmes like liver transplants cannot be started in a day or week, it requires long term planning. Even after the basic infrastructure is established, building a team and its training, making arrangements for efficient, post-operative care by training the technicians and nursing staff takes time. If we fail to take these steps, patients from Pakistan will have no other option but to travel to India, China or other countries to seek treatment for liver transplant and many other medical services. At times it is very embarrassing and also brings lot of bad name to the country.

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