Dismal state of healthcare

Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity. In this context, the number of unhealthy people in Pakistan is alarming. With the rapidly growing population, at a rate of 2.4, the quality and quantity of health services provision has become a challenge. In addition, the poor governance in almost every sector is the multiplying factor for the poor health of the masses. For example, the lack of basic municipal services has contributed to several of communicable as well as non-communicable diseases. The recent study of drinking water contamination is testimony to this fact.

The recommended arsenic concentration in drinkable water is less than 0.01 mg/l by the WHO. However, in Pakistan the arsenic concentration was found high in surface and ground water mainly in two provinces, Punjab and Sindh. These figures are horrifying as arsenic is a toxic element and exposure to it causes a markedly elevated risk for developing a number of cancers and several other disorders.

The poor governance can also be witnessed in the food regulatory authority. There have been reports that many restaurants and food-related business owners use uneatable raw materials, and not only substandard raw materials. Moreover, the chicken that is being sold has been found to be unhealthy for human consumption. The feed on which they are farmed contain extraordinary amounts of steroids for rapid growth. When humans consume this commercially available chicken, the deleterious effects of weight gain, growth, obesity and hormonal irregularities, many leading to polycystic ovarian syndrome and infertility, are witnessed.

Similarly, the dismal state of drug regulatory authority has also cost severe health hazards. The fake and substandard drugs circulated in the market without proper monitoring is not only costing the people of their valuable money but also putting them at risk of not getting the disease cured, or may sometimes lead to other dangerous effects.

As health is a multifaceted issue and is affected by several factors, climate change is one of those — one that is least given attention in Pakistan except that of the Billion Tree Tsunami project in K-P. The heat stroke-related deaths in Sindh, particularly Karachi, during the summer of 2015 is testimony to the above fact. During that time, the need for special rescue services was felt as such services in any area plays a vital role in augmenting health services. While rescue 1122 in Punjab and K-P was established to play that augmenting role, Balochistan and Sindh have yet to establish such service.

On the other hand, health budget allocation in Pakistan is minimal. According to the World Bank, Pakistan’s current per capita health spending is $36.2, which is below than the WHO’s low income countries benchmark of $86. This is reflected in quantitative and qualitative aspects of health facilities. For example, there is one doctor for 997 people, one dentist for 10,658 people and one bed for 1,584 people. These figures will further worsen with the rapid rise in population.

Though the private sector health facilities have somewhat eased the pressure of an increasing demand of rapidly growing population, it is mostly unregulated. The doctors, laboratories, pharmaceutical companies and others involved in the sector exploit patients to extract money for profit as they are minimally regulated or are unregulated. In contrast to this, the staff in governmental hospitals is underpaid and overburdened, both in space and time. The working hours sometimes extend to 36 hours continuously. On top of that, the vast numbers of patients in this time period cause doctors to get exhausted and compromise on efficiency.

Health can never be improved without improving governance. Corruption has to be curbed to overcome the issues that directly and indirectly affect health. There is dire need of an integrated and comprehensive policy with inter-sectoral approach with modern modes of administration.

Published in The Express Tribune, December 11^th, 2017.

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