The hazardous airport

In March 2013, one of my graduate students, Diego, accompanied me to a conference in Islamabad. He was originally from Colombia and had seen firsthand the impact of war and strife on his country. He had also seen the impact of poverty and corruption on economy and infrastructure in other parts of Latin America. When we landed, he faced the typical chaos of the Islamabad airport. I asked him candidly, about his impression of the airport. He politely responded that it was “comparable” to other places that had seen its infrastructure crumble due to civil war. That was quite concerning — the first impression of Islamabad airport was of a place that had been in the crosshairs of conflict. The only conflict it had seen is between what exists and what ought to be.

We are reminded by the current government, time and again, that life in Pakistan was different pre-May 2013, the previous government was all bad and things have changed dramatically since the landmark mandate of 2013. So let us fast forward to September 17^th 2017. My sister-in-law and mother-in-law were travelling through the same airport, and they had to use a wheelchair. A sharp protruding piece of metal on the wheelchair cut the finger of my sister-in-law and it started to bleed profusely. She asked around for a medical aid, a room to tackle emergencies or a doctor. No one among the staff knew who to call or where to go. Eventually, a porter pointed to a room behind the guy who wrapped the luggage with plastic.

The medical-aid room was littered with empty bags of chips and half-finished juice boxes. Eventually, a doctor was located who came with a nearly empty first-aid box. There were no sutures to stitch the wound or a tetanus shot. The band-aid the doctor had was putting a crumbled paper to shame. It was ultra-thin, crisp and not particularly capable of stopping the blood. But perhaps the most concerning part was the attitude of the doctor. While dressing the wound, she kept throwing the blood soaked dressing on the ground. Soon, there was a pile of bloody mess on the floor. My sister-in-law, who happens to be a doctor herself, couldn’t really believe herself. How could anyone, let alone someone trained as a clinician, casually throw blood stained gauze like that? When she protested, the doctor remarked that the sweeper would collect the dressings later, along with other trash that he is supposed to pick. There was no sweeper in sight, but the doctor remained unmoved and refused to put it away, since that was the sweeper’s task, not hers.

Not quite trusting the system, my sister-in-law picked the dressing herself and put it in the trash. When the complaint was made to CAA, they said the entire blame rested on the airline for providing such bad wheelchairs!

Poverty, policy and pathogens are certainly a challenge for us, but perhaps equally (or more) serious is our attitude. The attitude with which we understand hygiene, refuse to take responsibility or recognise emergency care — all contribute to significant health hazards.

I am not the only one who feels that Islamabad airport is an international embarrassment. Not only is it inefficient and lacks basic hygiene, it also lacks the staff with the attitude to make the change. The argument that another airport is being built is fundamentally weak. A new airport is indeed needed, once built (one wonders when that may be!) it may construct more runways, bring in more airlines or create a better check-in counter, but it cannot fundamentally alter our attitude.

Investment in runways and infrastructure is needed, and perhaps good for elections, but investment in basic training, knowledge and hygiene is an even better investment in the health and safety of our people and their future. It is urgently needed today.

Published in The Express Tribune, September 26^th, 2017.

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