Nothing ‘civil’ about the way these ‘servants’ spent the money for this hospital

One of Karachi’s key hospitals was given Rs112m - but how much of that was spent?.

KARACHI:

Ever had the misfortune of having to go to Civil Hospital, Karachi’s Accident & Emergency centre? It is located to the left of the main gates and its entrance is a grubby cavernous mouth into what can only be described as the bowels of the hospital. The floor and walls merge into each other and centuries of grime and paan juice colour over what the political posters have left uncovered.

If someone told you that the Sindh government gave the hospital Rs112.65 million to renovate the casualty section, you would not be wrong is wondering if that money was spent at all given the state of the department.

The facelift for CHK was approved in the 2010-2011 health budget for the accounting year that is just ending. Despite a year’s delay the scheme is now almost complete, at least on paper. Medical superintendent Professor Saeed Qureshi says except for a few minor issues most of the renovation at the A&E and ear, nose and throat (ENT) wards is complete. (It appears that the money meant for the casualty has also gone to the ENT ward).

What has the Rs112 million managed to do for CHK? Well for starters, Qureshi says, “There are a new X-ray and ultrasound machines, other monitoring facilities, a couple of computers, hearing and endoscopic equipment, microscope, ENT chairs and some reconstruction and renovation work. There is some equipment kept in store as well and will be used when required.”

However, doctors in the A&E ward find it hard to believe any of the money has been spent there. A doctor in the ward who commented on the condition of anonymity says, “Yes, there is some new medical equipment but most of it is donated and not from provincial funds. The machines need proper maintenance which they are not given.”

The sight of a man busy trying to wash the posters off the walls comes as a great relief to some doctors who have been trying to get them off. There wasn’t any money to have the place painted. “There are many avenues where the money could have been spent,” said one clearly frustrated doctor. “It must have been spent but where we can hardly tell.”

Indeed, accountability seems to be the crux here. Health departments compete for resources with the Sindh government and win approval for schemes, both new and ongoing. The projects have to sail through a sea of paperwork before even a rupee is sanctioned. Thus, it should not come as a surprise that more emphasis tends to be laid (in the media and hospital) on the process of assessing the scheme’s feasibility and acquiring the funds than the actual implementation, maintenance and continuation of the project.

Doctors working at the A&E are mystified when asked about Rs112 million. “The refrigeration and cooling of medicines is crucial,” says one doctor. “If anything, the money should have been spent there. Many medicines donated to us are already near their expiration dates and without proper storage and cooling it all goes bad.” The maintenance team of the ward points to an overflowing gutter that also needs to be repaired.

The A&E ward, with its garbage, bloody gauzes and tissues lying around, doesn’t seem to have been the recipient of a new look worth Rs112 million, or even half, or even quarter of that amount.

Published in The Express Tribune, June 13^th, 2011.