Additional reporting and editing by Ailia Zehra
With a sharp surge in the number of coronavirus cases in Pakistan, all major hospitals of Punjab and Sindh are running out of space. Amid the crisis, healthcare workers battling the deadly virus have been lauded by the government as 'front-line warriors', but they continue to lose their lives due to nonavailability of adequate protective gear.
At Pakistan Institute of Medical Sciences (PIMS), Islamabad's largest public hospital, more than 100 health workers including doctors have tested positive for coronavirus.
Dr Fazal, a registrar at PIMS's COVID ward says that all those infected with the virus were performing duties in Out Patient Departments (OPDs), emergency and other sections of the hospital and they contracted the virus due to nonavailability of Personal Protective Equipment (PPE). Only doctors and paramedics working in the coronavirus-designated isolation wards of PIMS have access to PPE. "Those of us performing duties in other sections of the hospital have been left at the mercy of the virus", Dr Fazal says.
Dr Waseem Khawaja, a spokesman at PIMS thinks that PPE should be given to the entire hospital staff as everyone in the hospital is exposed to the virus.
Coffins for coronavirus victims at PIMS
Shortage of ventilators
PIMS has a limited number of ventilators and may face shortage in the coming days as the number of coronavirus cases in the capital continues to surge. The Islamabad administration recently sealed nine places including Pakistan Sports Board and Saudi-Pak Tower after several residents of these areas tested positive for coronavirus.
Dr Fazal says that the number of critical coronavirus patients at the hospital is on the rise. "PIMS currently has only 26 ventilators and we may soon fall short given the rising demand for ventilators", he told Naya Daur.
Dr Fazal further says that the government's measures to ensure safety of health workers fighting the pandemic are inadequate. "The announcements for special package and safety equipment are limited to the issuance of notifications. No practical measures are being taken to ensure that the vulnerable doctors are protected from the virus", he added.
However, Dr Khawaja thinks that PIMS needs human force more than ventilators. "The trend at PIMS so far suggests that once a patient turns critical, they hardly survive with or without ventilator", he says, adding that more staff is required to look after the coronavirus patients currently admitted at the hospital so they successfully recover.
Healthcare system exhausted
In Sindh, 7 health workers lost their battle to the deadly virus. With major public hospitals in the province filled to capacity, the healthcare system has almost collapsed. Director of Gambat Institute of Medical Science (GIMS), Khairpur on Saturday tweeted that there were no ICU beds left in the hospital.
https://twitter.com/DrRahimBuxBhat2/status/1269324184632639489?s=20
At Karachi's Jinnah Post Graduate Medical Centre (JPMC), all 12 beds of the hospital's High Dependency Unit are occupied.
The hospital's Deputy Executive Director Dr Yahya says that the government's mixed signals led to the surge in coronavirus cases. He said that doctors were facing the brunt of the 'confused narrative' about the crisis by the [federal] government.
He further notes that a significant number of coronavirus patients in Sindh who contracted the virus were asymptomatic, meaning that they did not show any symptoms of the virus. "But since asymptomatic individuals will continue going out in the public spaces, as there is no restrictions on mobility, they would have already infected tens of people by the time their symptoms start showing."
'Premature lifting of lockdown burdened healthcare system'
Sindh Health Ministry's media coordinator Meeran Yousuf says that the haste in lifting of lockdown throughout the country heavily burdened the healthcare system, which has now collapsed. “When people see that the government eases one sector of the economy every other day, they get the impression that the situation is back to normal, and they would naturally stop following coronavirus restrictions", she told Naya Daur.
Meeran says that the confused messaging from the federal government is to be blamed for the general lack of awareness among the public. "The government officials asking the public to wear masks are themselves not wearing any", she said.
KP's terror-hit healthcare system now battling coronavirus
Dr Waqarullah, the head of a government hospital in Ekkagund Tehsil in Mohmand district of Khyber Pakhtukhwa (KP), laments that the region's healthcare infrastructure which was ruined by terrorism now faces the coronavirus challenge. Talking to Naya Daur, he said that the safety of doctors from the deadly virus is totally compromised as they are fighting the virus without adequate resources to protect themselves from contracting the disease.
No corona-designated ward at Mohmand hospital
He said that COVID patients are not categorised separately even in major hospitals of the district.
Suspected coronavirus patients and those suffering from other health conditions are all sent to OPDs due to shortage of staff. "Most doctors do not have protective gear and are relying on face masks while performing their duties", he added.
There are only 4 doctors at the hospital who are on duty for over 15 hours. Dr Waqarullah says that setting up a separate ward for coronavirus patients is not possible because of the low number of doctors.
Patients avoiding hospital visits out of fear
Dr Waqrullah revealed that even patients suffering from other diseases in Mohmand are avoiding visiting the hospital due to the conspiracy theories that doctors are injecting poison in the patients and killing them to get funds from international donors. He claims that several patients suffering from cardiac conditions and diabetes died at homes because they did not want to get treatment at the hospital. He urged the government to act against those spreading misinformation about the crisis.
Balochistan's doctors contract coronavirus while awaiting PPE
180 Doctors, and 70 others medics tested positive for coronavirus in Balochistan. Five health workers in the province lost their lives to the virus. On April 7, Balochistan police arrested at least 50 doctors in Quetta for protesting against the nonavailability of protective gear. Some of them were also manhandled by the police.
The police action was widely condemned on social media, after which Balochistan Chief Minister Jam Kamal alleged that the doctors' protest was politically-motivated. Hinting that the doctors' protest was part of a conspiracy, he suggested that ethnic group Pashtun Tahaffuz Movement (PTM) was behind the protests.
Dr Saboor Kakar, who was among the doctors arrested for protesting for PPE, said that their grievances remain unaddressed. Kakar and his family members recently tested positive for coronavirus. "After spending two nights in jail, we were assured that our concerns will be addressed. But the government is yet to fulfill its promises", he said.
Dr Kakar says the PPE provided by the government is not only inadequate to meet their demands, but its quality is not satisfactory either.
Dr Yasir khan Achakzai, Young Doctors Association (YDA) Balochsitan president who works at the neurosurgery department at Civil Hospital, Quetta, also tested positive for the virus and has since been in isolation. Talking to Naya Daur, he said that in Balochistan there is a shortage of PPE as well as human resources. "Most doctors are currently working inhumanely long hours at the hospital with no incentives", he said, adding that the workload has ended up affecting their immune system.
"When we demanded protective equipment, they arrested and beat us up. But later they gifted PPE kits to the US. Doesn't Balochistan deserve the goodwill they displayed towards America?", he asked.
Another Quetta doctor Muhabat Khan Tareen who is currently living in quarantine after testing positive for COVID-19, told Naya Daur that their requirements are now beyond PPE. "We have reached stage 3 of the pandemic, where in addition to PPE, we need oxygen cylinders, functional corona ICUs, trained staff and other medical installation", he said.
Dr Tareen complains that doctors were not taken into confidence over allocation of wards for coronavirus patients and the influx of patients has been grossly mismanaged.
Moreover, he says that the ease of lockdown followed a rapid surge in coronavirus cases in the province. "Our fragile healthcare system cannot afford this large number of patients. The government should reconsider its policy and impose a 30-day lockdown after devising a strategy to protect the livelihood of daily wage workers", he said.
Violent attacks on doctors and public mistrust
Meanwhile, a dangerous conspiracy theory that doctors are killing coronavirus patients for donations from the World Health Organisation (WHO) has been doing the rounds on a section of social media, especially Whatsapp. This narrative appears to have real-life consequences as health workers fighting the coronavirus amid lack of resources now face an additional threat: public mistrust and hostility.
At Lahore's Mayo Hospital, around 30 men surrounded the security guard deployed outside the building reserved for coronavirus patients on May 20. The crowd manhandled the guard and broke into the building. They hurled threats at the doctors, reportedly angered by a female relative's death from coronavirus. A doctor was shoved into the coronavirus ward without protective gear.
The CEO of Mayo Hospital then wrote a letter to the Capital City Police Office in Lahore two days after the incident, requesting security for the staff. The Mayo Hospital unrest is not a one-off incident as five other attacks on doctors and hospitals have been reported in the last 15 days. Three such attacks took place in Karachi, and one each in Rawalpindi and Peshawar.
Last week, a mob allegedly carrying knives and sticks attacked Karachi's Civil Hospital reportedly after the death of a coronavirus patient they had brought in for treatment. The attackers chanted 'Corona is a conspiracy' and threatened to kill the doctors. In a separate incident in Rawalpindi's Benazir Bhutto Hospital, the attendants of a coronavirus patient who died attacked doctors and female staff of the COVID ward, accusing them of killing the patient for money. In Peshawar, an ENT specialist doctor responsible for taking the swab samples for conducting coronavirus tests at the Hayatabad Medical Complex (HMC) was attacked and beaten by the public because the procedure was taking more than the expected time.
Activist Ammar Rashid believes the 'irresponsible' statements from top government officials including Prime Minister Imran Khan fueled the dangerous conspiracy theories in Pakistan which have now resulted in attacks on healthcare professionals.
"From day one, Prime Minister Imran Khan has been downplaying the pandemic, saying that the virus is fatal only for old people. He even propelled a myth that the COVID-19 will diminish as the temperature rises. The lawmakers of PTI are still sharing misinformation about the virus", he told Naya Daur, adding that the government's lack of clarity and misleading statements served to strengthen the conspiracy theories.
Further, Rashid said that the government's official message for anti-coronavirus campaign “Corona sa darna nahi, larna hai" [We have to fight coronavirus, instead of fearing it] is also problematic. "Coronavirus has claimed hundreds of thousands of lives. Why shouldn't we fear the menace", he asked.
While talking about the federal government’s lockdown policies, Ammar Rashid said that the PTI government ignored multiple recommendations by doctor bodies against lifting the lockdown. "This government has only benefited and listened to the clerics and traders [about lifting the lockdown]."
He also said that PM Imran Khan should help end the conspiracy theories against doctors by making it clear that coronavirus is not a hoax and that the perpetrators of attacks on doctors and hospitals would be dealt with strictly.