Un-choking pipes in the healthcare system

Published: May 5, 2010

Sania Nishtar has comprehensively covered health legislation and policy making in Pakistan.

KARACHI: With cases of doctors’ alleged negligence increasingly being reported in the media and healthcare staff boycotts on the rise, Dr Sania Nishtar’s book on Pakistan’s healthcare comes as a much needed eye-opener.

Following its launch in Islamabad, Choked Pipes was launched in Karachi on Tuesday at an event attended by nearly 500 people. The 336-page book, which took Nishtar a year to research, is a detailed journey through the country’s healthcare system and its many problems. Nishtar gives a close-up of policies and practices that mar the system, such as doctors who don’t bother showing up or who hold two jobs without permission, the theft of medical supplies from hospitals and inadequate training of doctors, nurses and staff.

Nishtar described the response to the book as overwhelming. “I had thought that people would be very upset because it is a very hardhitting book but they actually seem to be happy to find out the weaknesses of our system,” she said. However, Choked Pipes does more than just pinpoint the faults and flaws in the system. The book details recommendations for the system’s reform as well.

She discusses policies outside the healthcare system, linking a larger social policy that includes environment, decentralisation and population, with a better healthcare system. The book also highlights the potential outside the medical domain and links health with environment, social factors, pollution and most importantly, governance. Commenting on the book, Dr Tipu Sultan said that it is a concise document. “You name any legislation related to health and it will be there in the book.

It is well researched and written for thinking minds.” The book also had its share of criticism though. Javed Jabbar, former information minister, pointed out what he called an “ill-designed cover” and “irrelevant facts taken from the Economist and other sources”. He also suggested that the book should have been more comprehensive but at the same time lauded Nishtar’s efforts, saying that the book “deserves to be read beyond the health sector”.

According to another doctor at the event, “Choked Pipes reveals the entire health system and can be taken as a piece of research that has been missing for a long time.” The book launch was attended by the dean of Institute of Business Administration, Dr Ishrat Husain, Javed Jabbar, the World Health Organisation representative of Pakistan and director-general health, Dr Rasheed Jooma, who was the chief guest.

Commenting on the launch in Islamabad first, Ameena Saiyid, the managing director of Oxford University Press which published the book said, “We had to bring the book to the attention of the health minister and the related authorities.”

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