Healthcare neglect amid political circus in Punjab

My last article on these pages probably was on my experience with physiotherapists in Lahore. It seems that from a patient, I have become an expert in a field that I hardly belong to. There is a cure for everything. Even cancer patient has a respite after going through lengthy, complicated, expensive and painful procedures. However, for the patient suffering from a bone ailment – be it arthritis, osteopathy, disc slip or bulge – there is hardly any break from the treatment. It might be my assumption, but after two years of consistent treatment, I have learned that the moment you tell your physio that the therapy sessions should end, you not only return with pain the next day, but the therapist also sees to it that it takes a few days for the patient to settle down. One of my aunts, who has lived all her life in the US, went there when she was a minor. On one of her visits to Pakistan, when she would accompany me on therapy sessions, she told my therapist that even in a worst-case scenario, physiotherapists in the US do not treat patients every day. It is always on an alternative day that patients are asked to return for the next session. Naturally, the argument would anger my therapist. That is the nature of the beast.

It is not only the patient who goes through this agonising experience, the young physiotherapist girls are exploited as well. Private clinics appoint internees with the condition that they would pay for the internship. Girls bear harassment at the hands of male patients – and doctors too. The girls are asked to take things in stride.

Unfortunately, these poor souls have nowhere to return to report their grievances because there is no Council for Physiotherapists. The Punjab Healthcare Commission (PHC), the body mandated to maintain minimum quality standards of healthcare service providers, does not recognise these clinics because they have no council. The irony is that while there is no council to form laws to protect patients and therapists from professional blackmailing, every medical college – from King Edward down to an unpopular private medical institution that blatantly bypasses admission rules of the Higher Education Commission – is allowed to train physiotherapists. Moreover, once these therapists, who insist on being called doctors, are out of college, they are left to bear the heat, the rain, the storm, and the thunder of the inhumane medical practices that this profession has become.

There is no justification for the PHC to inspect, monitor and assess the quality standards of a healthcare establishment when a large section is left unattended because the Commission lacks jurisdiction.

I used to visit a physiotherapy clinic at a hospital in the heart of Lahore. The therapist there told me that during one of their visits to the hospital, the Commission staff came to their department and fined them because they were using an ultrasound machine. That is not only hilarious but outright stupidity. Even a random search on Google informs that “ultrasound – high-frequency sound waves are used to treat deep tissue injuries by stimulating blood circulation and cell activity, to reduce pain and spasms, as well as speeding up healing.” But, according to the PHC staff on inspection, since ultrasound is used to examine body organs only, its use in physiotherapy comes into the definition of ‘quackery’.

I wonder whether or not the therapist had sued the Commission for displaying this level of unprofessional know-how.

The political circus in Punjab had rendered the entire health sector incapacitated. One of my reliable friends only yesterday took his cook to Services Hospital Lahore for treatment. The surgical and emergency departments were filthy and in disorder. He took pictures and shared them with me, whom I shared with one of the directors of the Commission, but as usual, there was no reply.

The highlight is that the Commission has been without a Board for the last seven months. This means no committees. This also means that the Commission cannot decide on any complaint, issuing licences, human resource matters or issues related to inspection and monitoring. In short, this government department, which is now in complete control of the Pakistan Medical Council, is anything but an employment exchange for retired doctors who are getting extension after extension taking advantage of the political circus and their nexus with the big industrial, medical complex.

Yesterday, I was at one of the best hospitals in Lahore’s Defence neighbourhood with acute gastroenteritis. The emergency not only lacked doctors serious in conduct, but the beds were also in miserable condition. The staff was more eager to get the payments done, and for every complaint I made, there was only one reply, “Aik aur injection laga dain?” i.e. Shall we give you one more injection? This treatment by injection has become a norm rather than an exception.

When there is no legal oversight, when the law ceases to respond because those responsible for making and enforcing them are more interested in a power struggle, and when minting money is the only profession lurking at the back of every mind, should we expect the medical profession to remember that their first line of action has been to remove their patients from the harm’s way?

Physiotherapists have turned into a pack of wolves, nibbling into the resources and health of their patients using time-tested techniques, inducing fear – fear of permanent nerve or bone damage.

Published in The Express Tribune, August 18^th, 2022.

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