It is unfortunate that Pakistan has always neglected its health care system, with a meagre 4% of GDP spent on the health sector. The coronavirus pandemic has shown us the worst side of our health system, revealing how the poor remain on the margins of its framework. An example that illustrates this fact is that the first testing kits were provided to the public by a private firm charging a whopping sum of Rs. 7,800 (nearly half of Pakistan’s minimum wage) per test, signaling how the system treats the poor as disposable.
The incompetence of the current federal and Punjab governments have compounded the problem. In the early days of the pandemic, the Punjab government did not report the number of cases and was the last province to close borders and acknowledge the seriousness of the crisis. Another crisis soon appeared when the front-line doctors were initially provided with very low quality masks and gowns, which not only put them at risk of getting the virus, but also of spreading it.
The result was that roughly 200 health workers in the country have tested Covid-19 positive. This alarming sign propelled a few young doctors to start the “Friends of Doctors Campaign”. They began getting donations and having PPE suits stitched to donate to medical professionals across Pakistan. So far they have distributed more than 5,000 PPEs and 1,000 N95 masks, sanitizers and face shields to the doctors in different provinces.
Dr Shahid Ali, the consultant spine surgeon in Jinnah Hospital who led the initiative, believes that ordinary citizens had to step in to fill the vacuum created by the government’s incompetence. “As soon as the pandemic hit Punjab, I was sure that the government won’t take any measures so I tried to take an initiative to help our frontline workers. The pandemic has forced doctors to take on the role of textile merchant.”
While such campaigns have boosted the morale of doctors, the continued government apathy has fueled an atmosphere of insecurity and fear among healthcare workers. Dr. Adnan Qadir stated on Instagram that, “We need protection so that we can help the country. If we aren’t safe, how can we save our patients?” His message echoed the sentiments of other health workers who have felt particularly vulnerable after the passing away of Dr. Usama Riaz, a doctor in Gilgit-Baltistan who contracted COVID-19 while serving on the front-lines screening pilgrims returning from religious sites.
Another case reported from Balochistan is that of Dr. Qaisar Panezai, whose positive coronavirus case led to protests from doctors in Quetta demanding basic rights and protective kits. In a shocking turn of events, the provincial government ordered police to attack and arrest doctors, making Pakistan perhaps the first country where health workers were beaten up by their state during the pandemic.
“Balochistan has always been neglected by the federal government, and the provincial government still does not take this pandemic seriously. They are refusing to provide kits, while they have provided us with sanitizers in tiny 2ml bottles. It appears as if they are mocking us”, complained Dr. Muhabat Khan Tareen from the Young Doctors Association- Balochistan.
A week after the protesting Balochistan doctors were brutalized and arrested, doctors from all over the Punjab went on hunger strike in front of the Medical Health Secretariat in Lahore, demanding PPEs and testing for health workers. These demands have been rejected and the medical workers beaten up by the Punjab police, the same police that was saluting them in front of official cameras less than a week earlier.
“The health minister (Dr. Yasmin Rashid) holds a grudge against the YDA, which is why the secretary of health rejects our demands, leaving us with no option but to go on hunger strike. We will persist and continue the struggle until our demands are fulfilled”, said Dr. Kausar from the Grand Health Alliance. The doctors hunger striking for PPEs in Pakistan enter their 8th day, but the government continues to call their protest a political gimmick.
The COVID- 19 situation not only worsened the health emergency in this country, but also shows the cruel face of capitalism. N95 mask prices have skyrocketed, while those on the front-lines are being forced to work without them. If a few doctors can raise funds to provide their fellows with PPEs, masks and face shields, why can’t the government do the same? In fact, the situation remains precarious for health workers as they hope against hope that government officials will step up and safeguard the well-being of essential workers and the wider public by taking appropriate measures, including providing the much needed PPEs and testing kits.
Dr. Ehsan Ul Hasan, who works in cardiology at Jinnah Hospital said, “The number of the testing kits is too low. We were initially promised 5,000 kits for all the provinces, but are hardly getting 1,500 to 2,000 per day. The deficiency in the kits has decreased the daily testing ratio, which has put us at higher risk of contracting the virus. It is spreading at an unknown ratio.” A nurse working at the same hospital as Dr. Ehsan tested positive for Corona. Tragically, her mother passed away due to the virus, which she most likely transmitted to her.
If Pakistan’s authorities had done some research when their own citizens were stranded in Wuhan, today we would have been more prepared to fight this pandemic. Today, we are losing too many precious souls to the pandemic and the situation will get much worse in just a few weeks if the government remains inattentive to the needs of society and our front-line warriors. The current government’s attempts to impose privatization in the name of the MTI Act has proven an utter joke in the wake of the current pandemic. If anything, this crisis reveals that healthcare should remain the responsibility of the state and must be given the adequate attention and resources it deserves.
One thing the COVID-19 pandemic has made absolutely clear to people is that we need a new social contract that includes a fairer distribution of wealth and an increase in budget for the health system. In the long-run, the current crisis must also force us to initiate measures for redistribution of wealth in society and paying special attention to the health sector.
After the early 20th century turmoil of two world wars and the Great Depression, world leaders understood that it was important to build up the institutional framework for democratic rights, political freedom and social protection. We are experiencing a catastrophic event of unprecedented magnitude today. We can no longer return to the state of affairs that existed prior to COVID- 19 and that have been exposed so dramatically by this virus. We need a new vision in which essential workers who risk their lives to protect us do not have to go on hunger strike to get heard.
We must do better.