Sep 24 - 30, 2007

The dictum "Health (sector) is wealth (sector)" comes true with the officers and staff serving in the public health sector. Black sheep in this sector are becoming simultaneously healthy and wealthy. While they are feeding upon public funds, the poor and ailing masses are bleeding. What is happening in the hospitals and Basic Health Units (BHUs) in public health sector may be summed up as 'criminal negligence' of the administrative and service staff. The state of the country's public health-care system opens the Pandora's box. The public health sector in Balochistan is no exception.

The Bolan Medical. Complex (BMC) Hospital in Quetta, the long delayed project in public health sector was made functional during FY 2002-03. All important departments were shifted from Civil Hospital Quetta to the newly completed building of the BMC hospital. This project consumed billions of rupees from public exchequer and took several years in its completion due to the rampant corruption of contractors and misuse of public funds by the politico-bureaucratic allies. It has been an 'on-road scandal project' of corruption and mismanagement of public funds. Even today the hospital is still a white elephant consuming millions of rupees but serving the poor poorly.

Official sources claim that the health department has completed several mega projects, including the installation of MRI machine at Sandeman Provincial Hospital Quetta and an Angiography machine along with accessories at the BMC hospital in Quetta. Both schemes cost Rs230 million. After the introduction of Angiography machine, the officials had claimed that new open-heart surgery operations would be carried out in Quetta and MRI would also help in deducting all types of disease, as it was the most modern equipment. They claimed that with the introduction of new equipment and the available specialists, Quetta would come at par with other cities of Pakistan.

Even after huge expenditure of public money on infrastructure, equipment and machinery, what health care services are being provided to the common man at the BMC hospital, is the basic contention. It has been personally observed by this scribe that even cotton rolls, bandage and the gloves for the ward-boys are not provided and have to be purchased by the patient's relatives or attendants from the private medical store present in the hospital building. The presence of a private hospital inside the BMC hospital building (from where besides the costly medicines the gloves for the ward-boys and dressing for wounds may be purchased) debunks a racket.

What to speak of the complicated and expensive blood tests, even blood sugar is not tested in the hospital laboratory. The patient and his or her attendants are compelled to conduct these tests from the private laboratories, which are present just outside the main gate of the BMC hospital. There are more than three private laboratories outside the BMC hospital. Understandably, there is a symbiotic connection between the hospital staff and the owners of these private labs, which are making money from the 24-hour running business and receiving customers, thanks to the unnecessary prescriptions made by the hospital staff. The whole racket is actually going through public (staff)-private(labs.) partnership.

An attendant, Noor Ahmad whose three relatives had an accident on Eid day last year and admitted in the BMC hospital, told this scribe that he had provided the disc plates, wire and even cutter to the service staff carrying out a surgical operation of his relative whose lower jaws were damaged and displaced in the accident. He told that he had spent an amount of over Rs.3000/- by privately carrying out CT scan of one of his relative admitted in the hospital. On the other hand, the official sources claim that the CT scan machine at a cost of Rs 45 million at BMC hospital has been installed. What is the use of this CT scan machine at the hospital when the poor are not its beneficiaries?

The hospital staff remains engaged in playing gimmicks of minting money against the common masses, taking full advantage of the illiteracy of the patients or their attendants. An attendant, Abu Bakar Mengal whose 15-year-old son was admitted in the hospital showed this scribe the investigation payment receipt' bearing the name of a 50-year old man instead of his son's name. He told that he had paid Rs. 30/-, but there were Rs.20/- mentioned in the receipt. This was not the mistake, as it is committed repeatedly by the staff.

From hygienic point of view, no regular and proper sweeping or cleanliness is practiced in BMC hospital. The inside environment seems to be infested or infected with germs, smell and odor of different chemicals and medicines. The working staff and visitors are prone to infection or allergy. The bed-cloths in the hospital wards are rarely changed. Water frequently runs out in the bathrooms for patients. The patients are seen as groaning and making shrieks, while their attendants searching or looking for the service staff. An attendant told that recently a seriously injured patient, who was bleeding and moaning in pain, was brought to the hospital one night. He was apathetically left unattended by the hospital staff for more than one hour, as no doctor was available at that time and the patient's relatives had to rush to some private hospital to save his life.

Only on the arrival of some VIPs like provincial Health Minister or Director General Health Department, some cosmetic measures are taken by the hospital management to improve the situation. Ironically these VIPs if ever visited the hospital, they did so to settle their personal business. They are absolutely turning a blind eye to the difficulties and problems, the common masses are facing due to the negligence and apathy of hospital management toward the ailing humanity.

This is ridiculous that a hospital with annual budget of millions of rupees cannot provide the bandage, cutter and cotton rolls. Actually those who show some reference of a VIP from Health department are treated in a VIP manner. They are prescribed and provided patent and expensive medicines and meticulously attended, cared and cured. The poor and common masses are treated as beasts and denied the due medical services and costly medicines. They are taken merely as experimental bodies for medical practices.

In the given status quo in public health sector, how would the common man benefit from the over 89 health schemes being implemented by the Balochistan government at a cost of Rs. 590 million in the sector? Basically, it is the duty of the medical superintendent (MS) and deputy medical superintendent (DMS) to ensure smooth running of hospital but it seems that they are absolutely oblivious of the situation and paying no heed to the initiatives to improve the provision of health care services to the common man. It is worth mentioning that provincial government spent Rs.7.5 million on the construction of residences/accommodation for the MS and DMS of the BMC Hospital, and Rs.1.500 million were allocated for the purpose in the last fiscal year.

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 can not 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.

The common man in Balochistan is still deprived of basic health care services and still anguishing due to the criminal negligence and apathy of the administrative and service staff in public hospitals. The non-availability of medical staff, medicines and necessary facilities is the tragedy of the government hospitals. The negligence on the part of staff at public hospitals may cost human lives and result in human sufferings. The apathetic attitude, which remains extremely patchy, only makes the situation worse, particularly for the poor. If the main public hospital in provincial capital shows such a horrific and gloomy picture of health care system, then what would be the situation prevailing in public health sector of rural Balochistan? Understandably, it would present a worse-case scenario.

No strategy for improving delivery of health services and making it accessible for the common people can work until and unless it is provided with an effective and efficient system of checks and balances. The public health staff must be held accountable for their apathetic attitude toward common masses and criminal negligence of their duties. The Nazim and councilors of the area should also show activity and responsibility to cleanse the Augean stable of corruption in public health sector.