‘I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.’ These are lines from a modern version of the Hippocratic Oath taken by doctors.
Although purely ceremonial today and no in way legally binding, the ancient oath dating back to 275 AD, was once solemnly taken by physicians to ensure the ethical practice of medicine in society. That was a time when doctors were driven first and foremost by a duty to help mankind. Every life mattered. Today every rupee per second takes priority.
The death of 9 month old Nishwa is proof of how little doctors, nurses and hospitals in general value human life. The beautiful baby girl suffered irreparable brain damage and became paralyzed after she was administered the wrong drug by nursing staff at Darul Sehat Hospital in Karachi. After sixteen days of suffering, Nishwa passed away on Monday the 22nd of March.
After public outrage the government managed to seal Darul Sehat. The hospital admitted its error and offered to bear all the expenses incurred for the child’s treatment. But no amount of money can return the child to its parents. Medical malpractice and negligence in hospitals is a grave issue. It cannot and should not be brushed away under a pile of cash. The hospital’s method of making amends reflects the poor norms of our new “modern” world: money is all that matters.
Capitalism has crushed humanity. Treating patient after patient, the medical faculty has become numb to concepts of compassion and duty of care. As the population grows, so do the number of patients. According to the Bureau of Statistics, Pakistan’s population in 1998 was a little over 130.8 million. By 2017 the population has risen to more than 207.7 million. But how much was the health sector developed during this period?
As per data gathered by the World Bank in 2014 there is almost 1 doctor per 1000 people in Pakistan and not even 1 hospital bed per 1000 people. Even at high-end hospitals where consultation fees range from 2000 to 6000 rupees, the doctors fail to spend the time needed for taking a patient’s history properly. According to a study published last year in the British medical journal BMJ Open, on an average doctors in Pakistan spend less than 1.79 minutes with one patient. Even Maggi noodles take more time.
Prescriptions are scribbled quickly, very little is explained, and the patient is told to come back if the issue persists. The goal is to squeeze in as many patients per day as possible and squeeze out the maximum amount of money per minute, with little consideration as to how this affects the quality of health care being provided. Nishwa is not the first case of negligence by hospitals in Pakistan.
Many cases concerning medical malpractice go by unreported as families are told by medical staff to be ‘patient’ if they want to see their loved ones get better- in other words, a subtle warning to remain silent. And the families are compelled to say thank you politely because the lives of their loved ones are hanging by the hospital’s fingers.
As per research conducted by the Agha Khan University, the private sector attends to more than 70% of the population. However, the practices of these private hospitals cannot be scrutinized as effectively as those of public hospitals falling under the direct jurisdiction of their respective provincial governments.
Shutting down Darul Sehat Hospital will serve as a warning to other private hospitals, but it cannot be deemed a solution. Hundreds of private hospitals, big and small, are sprawled across Karachi alone. How many will be raided and shut down? How long will the exercise take? And where will the patients of these hospitals go?
Government hospitals simply will not be able to manage the additional load. They are just barely able to treat the patients they currently receive. Jinnah Hospital’s beds are overcrowded. Often there is not enough space to even bring the stretchers in. Patients lie in pain between corridors or outside under the burning sun. But a lack of facilities is not the only issue at hand.
Pakistan has a severe shortage of competent doctors and nurses. The government can erect a small hospital in six months or even a year but doctors take a minimum 5 years to graduate. This gap between the demand and supply of doctors and nurses needs to be bridged over time but the increase in fees of medical colleges continues to restrict the medical community’s growth.
In 2018, after the court’s intervention, the Pakistan Medical and Dental Council (PMDC) and Pakistan Association of Private Medical and Dental Institutions (PAMI) reached an agreement to raise the annual fee of medical colleges from Rs.800,000 to Rs.950,000 with an additional Rs.50,000 to be paid as admission fee.
To safeguard other patients like Nishwa will require a long term comprehensive strategy reforming the entire medical faculty. The government must develop the health and education sector to decrease the public’s reliance on private hospitals and private medical colleges. But first and foremost any doctors, nurses or medical staff reading this must let their moral conscience stand in front of money. You do not just do any ordinary job. You serve humanity.