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Balochistan’s somber health sector

The health indicators in Balochistan are poorer than any other province of Pakistan. Though health sector in Balochistan remained the focus of welfare programs launched by every government in the past, but the leakage, misuse of public funds and irregularities in this sector caused no relief to the people of this most backward province.

Malaria, typhoid, hepatitis, gastrointestinal and respiratory disorders are common in the province. In rural Balochistan, the health status is relatively poor. According to an estimate, a total of 1,432 health units spread over the province. There is only one doctor available for 7,300 persons, in average. Lack or absence of female health staff including female doctors in rural Balochistan worsen the situation.

Both male and female medical staff always tend to live in Quetta, the provincial capital. Their concentration in Quetta and unwillingness to stay in rural areas affected the health status of rural population that have limited or no access to health services in their areas. The Government must announce special and attractive packages for medical staff to serve in rural Balochistan.

The non-availability of medical staff, medicines and necessary facilities is the tragedy of the government hospitals in Balochistan.

Most of the doctors serving in the government hospitals have their private clinics as part time job. They earn a handsome amount as checkup fee at their clinics. Most of these doctors do not pay due attention to the patients who come to them in hospitals for treatment. There have been public complaints about shortage of drugs in government hospitals, lack of public health facilities, questionable doctor’s behavior with poor patients, and duty dereliction and absence of staff.

The business of establishing private hospitals has become highly profitable where the patients are treated as customers like in high profile hotels. There are many doctors who have opened their private hospitals where the patients are treated as scapegoats in accordance with their financial positions. The patients are looted through high room-charges at these hospitals. It has been observed that doctors unnecessarily recommend the patients to be admitted at the hospital for earning a healthy amount in the form of room charges and other services.

The private hospitals, clinics and laboratories have witnessed a mushroom growth in the provincial capital over a short period of last six years. Similarly more than 100 laboratories in Quetta are engaged in flourishing their business. Most of these laboratories lack the professional staff and essential diagnostic instrumentation. There always remains somewhat of a symbiotic alliance between the doctors of the private clinics and laboratory managers. The doctors send patients to their allied clinics for different medical test reports and they only believe and recognize the reports tested from their recommended laboratories. The lab owners give a due share to the doctors for sending the customers for them.

The government hospitals remain as the only option for the poor and downtrodden segments of society, who are compelled to face the arrogant behavior of the hospital staff, as they cannot afford the high expenses of private treatment and costly medication. There have been wide complaints about the shortage of medicines at the government hospitals and the poor patients have to purchase the costly medicines from the market.

‘Health is wealth’ is the old saying but today it comes true with the officers of the Health department, who are concentrating more on ‘public wealth amassing’ than ‘public health improving’. Black sheep in this department are not only becoming healthy but also wealthy.

It has been observed that the consultants and physicians pay more attention to the patients who come for medical check-up at their private clinics. They are found persuading, convincing and sometimes compelling patients in government hospitals to come to their Clinics for a better treatment.

The public complaints about dispensation of substandard medicines to the patients in government hospitals are common. Medicine Store Depot (MSD) provides the medicines of low standard companies. The purchased medicines are dumped in the go-downs and disposed of at a time when the medicines are about to expire. There is no doubt that most of the time medicines expire in these go-downs and are not delivered for the poor patients in the government hospitals in time.

Another important problem is that patients have to wait long for their turn to visit the doctors in government hospitals. The doctors in OPDs are frequently seen busy in discussing their percentages with the medical raps. The medical raps offer attractive packages like foreign visits and other financial benefits to the doctors in lieu of their prescription for their company’s medicines. There is a pitched competition among the pharmaceutical companies in regard to offering packages to the doctors for sale of their product. The multinational, national and local companies are all the hard competitors in this field. Now sale of medicine does not depend upon quality, standard or goodwill of the companies but it is now entirely dependent upon the greater demand of the drugs. The demand is enhanced by the doctors through massive prescription of medicines of their client pharmaceutical companies.

There have been reports that unauthorized people are engaged in sale and purchase of medicines in Quetta and other parts of the province. The matter relates to the public health. It is equivalent to playing havoc with the public health. The Drug Regulation Act bars all the unauthorized dealers from entering into the business. The sale and purchase of medicines mainly the life saving drugs are regulated under this Act.

There have also been reports that some of the dealers are involved in selling sub-standard drugs while many others are selling spurious drugs to the common people. A score of chemists are operating the shops without license. There are many shops and drugstores, which are in operation under a single license. The serious aspect of this lethal business is that some people have hired flats and rooms in the main city centers converting those premises as sale points for customers.

Adulteration in food and medicine is the most significant issue posing serious threat to public health. There have been complaints of adulterated ghee and cooking oil on sale in open market in major townships in the province. All issues related to the public health should be prioritized in the health policy of the present government.

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