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Medical Incompetence Is At Its Peak In Pakistan. Where Did The System Go Wrong?

Aminah Mohsin argues that greed and illiteracy are at the heart of Pakistan’s medical incompetence, especially reflecting in the tragic death of Nashwa, the refusal of parents to vaccinate their children and the recent outbreak of HIV epidemic in Sindh.

Three pieces of news have been making the rounds lately: 1) people gunning down polio workers and refusing to vaccinate their children, 2) medical negligence and quackery leading to death of Nashwa, and 3) outbreak of HIV in Larkana and Hyderabad. All of these are alarming indicators of improper functioning of our system. These cases are self-sufficient in elucidating the fact that something is wrong with this system and with us, and which is failing our people in every possible manner.

Nashwa’s tragic death, or murder, as many put it, is a clear manifestation of the greed that has contaminated the soil in which roots of morality and ethics grow and define whether a society can stand on its own or not. Unfortunately, the foundations of this country seem to have been rotten by termites like greed and many more.

While this particular case was not the first one of its kind, yet no heed was being paid to previous casualties as businesses of such private hospitals and clinics as Darul Sehat are run by influential families and mafias who prefer selling death over hiring professional staff and buying valid medicines and equipment. One type of greed is where healthcare is eyed as a fruitful business and the misery of people is ruthlessly exploited.

Another form of greed is of the individuals who are too desperate to see the prefix ‘Dr’ with their names that they and their parents are willing to go to any lengths to get them a degree, including leaking papers out and paying millions to private colleges of dubious reputation. Again, admission of such individuals in such colleges benefit these good-for-nothing students as well as the mafias running them since greed of both gets served. In the end, all what is left to be said is “it was out of our hands” and “we are not God”. But Nashwa’s watery eyes were an indication that God is there, and when it would be the time for His will to prevail, somebody else might end up in a similar situation, or even worse.

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Nashwa’s case is all about fighting the giants. What has surfaced in Ratodero and Hyderabad, however, is a classic amalgam of greed and yet another factor – illiteracy. They say ignorance is a bliss, but they would not have said so had they seen ignorance’s by-product, i.e. illiteracy.

With over 225 HIV-positive cases detected in Ratodero and more than 140 in Hyderabad, the disease is definitely transfiguring into an epidemic in Sindh.

While commercial sex-work has always been the most highlighted reason, the fact that 80 percent of the patients reported in Ratodero are children aged between three months and five years with their parents testing negative for the same virus is too dumbfounding to be registered. Hence the two culprits in the given scenario are greed and illiteracy – greed of quacks and illiteracy of people.

Dr Muzaffar Ghagro is just one name. Such large-scale damage cannot be the artwork of one culprit; there are surely many more. Quackery has been a nuisance in our society for ages as people tend to rely on low-cost totkas and phakkis. To remain affordable for the public and earn profits at the same time, these fraudulent practitioners spend below the minimum on purchase of medicines and upgradation of equipment like syringes and lancets.

These contaminated tools are, factually, the biggest source of spreading of this virus, especially in this case. Thus life-long ailment and death are sold by such fake doctors for meagre monetary benefit, while people continue to remain vulnerable and suffer exploitation at their hands due to ignorance.

The case of polio vaccination, however, has always been curious and peculiar in that the parents cross all limits of ignorance and themselves become a hurdle in the way of getting their children vaccinated against this virus. According to a report issued by national polio programme in March 2016, parents of 46,967 children refused to vaccinate their children across the country. The dynamics of this refusal are two-fold.

First, the recently developed staunch hesitance originates from the hunt for Osama bin Laden in 2011. According to Laurie Garrett, a senior fellow for global health at the Council on Foreign Relations in New York: “There already was a tremendous disinformation campaign going on in the Islamist world, claiming that vaccine campaigns were all part of some Judeo-Christian-CIA conspiracy to either sterilise the children of the Islamic world or give them HIV infection. So using a fake vaccine campaign threatened not only the lives of vaccinators – who would be accused of being involved as co-conspirators – but it also threatened to build on an already pre-existing campaign specifically against polio vaccination.”

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Thus, the loss of trust regarding such campaigns among people living in tribal areas or those hailing from less-educated backgrounds is one reason.

The other reason is rather mind-boggling as it involves the well-educated lot. It has been noted at several instances that these parents do not have religious reasons but are generally not in favour of vaccinating their children. A majority claims to have got their children vaccinated privately but often fail to produce vaccination cards or certificates.

This mistrust exists perhaps owing to certain incidents where children were administered the vaccine provided by the government but still encountered the disease due to lack of proper storage of vaccination or its use after expiration. However, there are reports of doctors practising in private hospitals who advise parents not to administer polio drops to children for unknown reasons.

Thence, the aforementioned accounts make one thing crystal clear. Greed and illiteracy are two key factors involved in decay of our morals and ethics. And with identification of these agents, the logical next step should be rectification. But in actuality, we do not bear the burden of changing our society; we need to take up the responsibility of changing ourselves. We need to be the change we wish to see, for failure in doing so will make our system only worse.

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