Govt hospitals in Sindh need trauma care facilities


Karachi: Government-run hospitals in Sindh, especially in its rural areas, lack proper trauma care facilities and every day many precious lives are simply wasted in the cumbersome process of shifting the trauma and emergency patients in precarious condition from the far-flung areas to relatively better hospitals of Karachi and Hyderabad.

Though the negligence and wastage of healthcare budget in the district headquarter level hospitals of Sindh is an open secret, but this sorrow state of affairs is exposed after major disasters and tragedies. The pitiable lack of emergency care facilities in the district headquarter hospitals of Shikarpur and Jacobabad was exposed on media after the deadly bomb attacks in both cities, one in last year and other last week.

The root cause of the poor management of the government hospitals cannot be separated from the governance style of our rulers, says Dr Merajul Huda Siddiqui, who is not only head of Sindh chapter of political party Jamaat-e-Islami, but also a senior medical professional himself. He said every year billions are rupees are tagged for healthcare and education in the budget of Sindh province, but sadly the people of Sindh go deprived of both education and healthcare facilities. He said we have many buildings of government schools, sans teachers and education, and many buildings of hospitals and dispensaries sans doctors and medicines.

Dr Siddiqui said during his visit to the neighbouring Iran, he was surprised that in even in the small villages there were functional dispensaries with doctors, paramedics and medicines. He said this is because the State of Iran considers the basic healthcare of its citizens amongst its important responsibilities. He asked why the State of Pakistan does not consider the healthcare of its citizens its responsibility.

He said in Sindh the healthcare system in government sector is a total failure. He said if a man suffers heart attack in the desert area of Thar he could not find any emergency cardiac care till he is rushed to Hyderabad, hundreds of miles away. He said not only the cardiac patients, but other emergency patients, and the survivors of burn, bullet and other trauma injuries have to be rushed to Karachi or Hyderabad to save their lives. He said even proper blood transfusion facilities are not available in a vast area of Sindh province. He said opening burns centres in teaching hospitals of Sindh is still a distant dream, as the only burns centre of the province is situated in Karachi.

Dr Huda said he does not expect any public good from the sitting rulers of Sindh as their priorities are to cater the need of the elite class while ignoring the poor citizens. He said it needs a ‘system change’ to improve provision of the basic facilities of life to people.

However, he stressed the need to upgrade all district headquarter level hospitals of Sindh on emergency basis and to provide advanced trauma, burn injury and emergency care facilities at least at the divisional level in the province.

However, Pakistan Medical Association (PMA) central leader and chairman of health committee of Arts Council of Pakistan Dr Qaiser Sajjad said the main issue is the lack of consultant and specialist doctors in the rural areas of Sindh. He said even in Karachi there is acute shortage of consultants and specialists of trauma and emergency care in the government sector hospitals. He said it is must that the health department of Sindh should offer better salary packages and attractive benefits to specialists and consultants of trauma care and it should also initiate an aggressive program of fast-track training of young and mid-career doctors in emergency and trauma care disciplines. He said without meeting the shortage of expert doctors proper trauma care facilities could not be provided at district headquarter level. He said the medical graduates of rural areas of Sindh should serve their home districts after getting advanced and specialized medical education and training. He said upgrading of hospitals is not possible without supply of specialist and trained doctors.

He regretted that in Sindh the system of healthcare, and medical education and training is in shambles due to corruption and mismanagement. He said even in Karachi the government-run medical colleges and their affiliated hospitals face shortage of faculty members. He said the Pakistan Medical Association (PMA) has been demanding for long to improve the system of medical education and training but in vain.

He suggested that the tertiary care medical facilities should be made available in all district level hospitals of Sindh. He said trauma care facilities should be provided free of cost to people of Sindh. He said the health department should ensure that emergency care patients are not necessarily shifted to Karachi or Hyderabad by rapid capacity building of the government level teaching hospitals of Larkana, Sukkur and Nawabshah. He suggested that more medical colleges should be opened in the province in government sectors and more government hospitals should be upgraded to the teaching hospital level. He, however, said the backbone of the medical care is the sector of primary healthcare and it should be given the priority it really deserves.

He said the PMA has been demanding for long to give a serious focus to the healthcare structure of whole country including Sindh province. He said not only the government hospitals should be improved in the rural areas of Sindh but the government sector hospitals of Karachi being run by the provincial government or KMC also deserve a serious look, as many of them face problems of shortage of staff, facilities, funds and medicines. He said only three major hospitals, Jinnah Postgraduate Medical Centre (JPMC), Civil Hospital Karachi (CHK) and Abbasi Shaheed Hospital (ASH) are no more sufficient for the mega city and more tertiary care hospitals should be opened in other areas of the city like Gadap, Malir, New Karachi, Orangi and Bin Qasim.