The case of Sindh’s unserviceable trauma centres

Audit report highlights how their deplorable state is a risk to life for those involved in major traumatic injuries

KARACHI:

Despite continuing to guzzle millions in the budget, the latest Performance Audit Report of the Auditor General of Pakistan reveals that most of Sindh’s government-run trauma centres have been out of commission for quite some time.

The audit report for the year 2019-2020 sheds light on the condition of these trauma centres established by the provincial government, highlighting how their deplorable state is a risk to life for those involved in major traumatic injuries like road accidents.

This is reflected in the collective fate of more than two dozen people who succumbed to their injuries in three separate road accidents across the province in the first half of this month. Out of which, over a dozen people were killed in two accidents that took place on May 15. Both of these accident cases were reported to Indus Highway near Sehwan and in Tando Adam. Prior to that, on May 02, seven people belonging to a single family, including two children, were killed in a collision case on National Highway near Qazi Ahmed.

Initially, the number of casualties reported in these road accidents was lesser than the number that eventually made the news. The number however increased over a period of time as people continued to succumb to their injuries one after the another, owing to lack of proper trauma services in the area. Eyewitnesses claim, that many among the injured could have been saved had they received early emergency treatment at nearby centres.

The auditors of the Auditor General of Pakistan conducted an assessment of at least 10 trauma centres in different towns of the province and found none of them fully functional, despite being fully launched in the books. “Two centres were completely out of order, while remaining others were only partially functional and established in Talukas including Golarchi, Ratodero, Dokri, Kipro, Tando Adam, Sinjhoro, K.N Shah, Mehar, Johi and Warah,” the report highlighted.

The trauma centres were established under the Sindh government’s programme that dealt with the up-gradation and strengthening of Taluka Headquarters Hospitals in the province. Under this programme, the government had established emergency-cum-trauma centres across 41 taluka hospitals in the province for the cost of Rs3,334.161 million.

The project was started in March 2012 and was scheduled to be completed within nine months, however, could not come to summation before 2019 and yet a majority of the centres remain unserviceable to this date.

Wasted funds and broken machines

Per the report, the main objective of the Performance Audit was to find whether required facilities were available in the emergency-cum-trauma centers, and whether these centres had successfully achieved the objectives of their establishment. Instead, the auditors become privy to missing facilities, non-availability of required health professionals, absent staff, and other issues plaguing the Sindh government’s big-budget trauma centres.

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Per the auditors’ findings, several such facilities have not become fully operational due to the non-availability of doctors and technical staff. It was also observed that a huge expenditure was made on construction of buildings and procurement of medical equipment and furniture without allocating required budget and staff to run the trauma centres. “The government could have provided orthopaedic surgeons to trauma centres by simply transferring them from major government hospitals but it was also not done,” a personnel privy to the investigation.

The auditors considered the expenditure incurred on the procurement of medical equipment ‘wastage of funds’ as it remained utilised amid to unavailability of technical staff. According to the report the government spent Rs361.507 million on the procurement of medical technology like X-ray machines, ECG machines, Implant screws, Implant plates, generators, and other items but these remained unutilised continuously for six years. The auditors believe this ill-planned decision may have caused damage to the procured medical items worth millions out of the taxpayers’ money.

Speaking on conditions of anonymity, a medical superintendent of a taluka headquarter hospital in district Dadu revealed that not a single trauma centre is functional in the district due to different reasons. “The government had constructed buildings and procured medical equipment without providing required health professionals,” he admitted, adding that medical equipment provided for trauma centres have suffered irreparable damage over the years of gathering dust. Similarly, health officers of districts Thatta and Sujawal also alleged that even the buildings constructed for trauma centres in the two taluka headquarters hospitals have collapsed.

The Express Tribune contacted Sindh Health Department’s spokesperson Atif Vighio for his thoughts on the issue, but he appeared unwilling to comment. However, the spokesperson maintained that the health department has recommended another project to the provincial government to curtail the loss of lives due to road accidents in the province. “The department has proposed establishing trauma centres every 50 kilometres on Indus Highway and National Highway. The government is considering including the proposal in the forthcoming budget,” he told The Express Tribune.

Published in The Express Tribune, May 24^th, 2022.