HEALTH SECTOR IN BALOCHISTAN
SYED FAZL-E-HAIDER, QUETTA
Sep 24 - 30, 2007
The health indicators in Balochistan like infant and mother mortality, are poorer than any other province. Though health sector 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 in the most backward province. Malaria, Typhoid, Hepatitis, gastrointestinal and respiratory disorders are common in Balochistan. In rural Balochistan, the health status is relatively poor. According to an estimate, a total of 1432 health units spread over the province. There is only one doctor available for 7300 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.
During the FY 2002-2003, funds amounting to Rs. 109.948million including foreign assistance component of Rs.16.250million were allocated in PSDP under non-SAP sector. An amount of Rs. 75.128 million was allocated for implementation of 7 schemes under SAP. The Bolan Medical Complex (BMC) hospital was strengthened by providing necessary machinery equipment/instruments and postings of manpower. During FY 2003-04, the health sector received an amount of Rs.688.183 million for implementation of 23 ongoing and 37 new projects. In the fiscal year 2005-06, 42 schemes had been launched. The total health sector allocation for FY 2005-06 was estimated at Rs.590.298 million that was 5.09% of provincial PSDP 2005-2006. Out of the total health budget for the last fiscal, Rs.523.714 million had been allocated for curative health care. The construction of waiting sheds for attendants in BMC hospital was to be carried out at an estimated cost of Rs.1.800 million out of which an amount of Rs. 0.400 million had been allocated in FY 2005-06.
The health program launched under military government especially focused on improving the District Health systems in the country by addressing inadequacies in primary/managerial efficiencies and removing the professional deficiencies in these systems. A Women Health Project was launched with total outlay of Rs. 3750 million to improve health nutrition and social status of women and girls in the country. The military government of General Pervez Musharraf focused on improving the drug sector and reducing the widespread prevalence of communicable diseases like Tuberculosis. It approved a fund Rs.20 million for establishment of a laboratory at Quetta TB Sanitarium in order to check tuberculosis in Balochistan.
The provincial health department is primarily responsible to provide health services to the people. It deals with all matters related to regulating the health sector in the light of federal and provincial health policies and programs' guidelines. The primary level health services and the District Headquarter hospital are the district governments' domains under Balochistan Local Government Ordinance. The health department is however responsible (through its attached departments) for providing health care services which include the full range of diagnostic & treatment services from its four tertiary care hospitals including the BMC Hospital, Quetta.
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 two 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.
PUBLIC HEALTH ISSUES
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. 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. All issues related to the public health should be prioritized in the health policy of the government.
HEALTH & ENVIRONMENT
The health sector is related to environmental management in the province. This is because of the fact that incidence of waterborne diseases is high and medical facilities are not adequate to tackle these diseases in Balochistan.
Major causes of water-related diseases include lack of water supply and sanitation facilities, no proper sewerage disposal, waste mismanagement and contaminated water. These diseases can be prevented by facilitating the population with proper sewerage and sanitation disposal systems.
The worst polluted air in Quetta and other cities of the province poses serious health hazards to its residents. Today the effects of climate-change and global warming find their manifestation in the form of atmospheric pollution in Balochistan. The recurrence of drought, rise in sea level, salinity of fresh water resources along the Balochistan coast and formation of smog in urban areas are some other forms in which these effects are appearing in the province.
Serious efforts are needed to combat public health problems in the province. Population Welfare Program should be made more effective and more Lady Health Workers be appointed to suffice to the needs of the growing population in Balochistan.
There should be a check on the anti-people practices of corrupt and undesirable elements in public health sector, which are playing with the public health.
Doctors in OPD are appointed for treating patients not for doing their personal business with medical raps in OPD. The medical raps should not be allowed to enter the premises of the government hospitals during the duty hours of the medical staff.
Recently, NWFP government put a ban on private practice of government employee doctors. Government of Balochistan should also do the same in the wider public interest. The doctors may be allowed private practice in the hospital premises in the evening at normal fixed medical check-up fee.
HEALTH SECTOR IN BALOCHISTAN
Source: Social Development In Pakistan 2001