The Balochistan Health Department has developed its Health Sector Strategy (2013-2018) to address challenges of service delivery, quality of care, lack of skilled health workforce, governance and regulation, and to ensure adequate health coverage for the poor and vulnerable populations in the province. The key emphasis of the strategy is on integrating health services through a strong monitoring and evaluation system.
The Department is basically responsible for delivery of key health services to the people through hospitals which are working under to components — Basic Health Units (BHU) and Rural Health Centers (RHC). The Department operates more than 550 BHUs, 90 RHCs and 89 Maternal Child Health Care Centers (MCH) to provide health services throughout to the province. The provincial capital Quetta has five hospitals namely — Bolan Medical College (BMC), Civil Hospital, Fatima Jinnah Chest & General Hospital, Helper’s Eyes Hospital and Sheikh Khalifah Bin Zayed Hospital.
For the execution of this new health care strategy the provincial government has committed funds with the development partners, however, to ensure implementation, the strategy needs an overall increase in health budget from 5 to 10 percent over the course of five years (2013-2018).
It is pertinent to note that though the 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 work caused almost no relief to the people in the most backward province. The health indicators in Balochistan are poorer than any other province as malaria, typhoid, hepatitis, gastrointestinal and respiratory disorders are common in the province and particularly in rural Balochistan, the health status is relatively poor.
According to an estimate, a total of 1,432 health units spread over the province and to an average only one doctor is available for 7,300 persons while lack or absence of female doctors and staff in rural Balochistan worsen the situation. Both male and female medical staff tends 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 basic and necessary facilities are the tragedy of the government hospitals in Balochistan. Most of the doctors, serving in the government hospitals, have their private clinics. They are earning 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 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 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.