Built in 1880, the Sukkur Civil Hospital (SCH) enjoys the status of being the teaching hospital of Ghulam Mohammad Mahar Medical College (GMMMC), the sixth public sector medical college under the government of Sindh. It is no surprise that people expect the best health facilities here, but the reality is somewhat different.
In the past, the SCH has been in the news for shortage of machinery and equipment as well as doctors, paramedics, and technical staff. There was also a time when it was believed that the hospital fell short of the standards prescribed by the Pakistan Medical and Dental Council (PMDC), for a hospital affiliated to a teaching medical institution.
Presently, despite the presence of doctors who are specialist professors and assistant professors, SCH is struggling to provide adequate diagnostic health facilities to the residents of Sukkur and its surrounding areas
In 2017, equipment for MRI (magnetic resonance imaging) test and CT (computed tomography) scan were installed in the hospital to provide modern age testing and diagnostic facilities to people free of cost. But it wasn’t long before the expectations of the residents of Sukkur and the surrounding areas fell short, because the poor and needy patients had to wait for weeks to get an MRI or CT scan. On the other hand, it is believed that influential people, on the recommendation of certain doctors and members of staff, would get the facility without any delay and even today the situation remains the same.
Mostly, these well-connected people bypass waiting in a queue for their MRI and CT scans and get promptly examined by doctors, while large numbers of patients including women and children who have arrived from different parts of upper Sindh and bordering districts of Balochistan for their doctors’ appointment given four to six weeks ago, are seen lounging around the hospital halls and waiting rooms awaiting their turn.
Those who accompany the patients sit around on the grassy areas outside the hospital or wander through the hospital corridors open to public. One thing common among all of them is helplessness and the desperate need for adequate medical attention and service.
“Before bringing me here, my father took me to a private hospital in Sukkur, where the doctors diagnosed a blockage in my brain that is affecting my eyesight,” says Kainat, a pale young girl. “We cannot afford private doctors and hospitals regularly, so three weeks ago my father brought me here because the treatment is for free.”
After a thorough check up three weeks ago, the doctors ordered an MRI to ascertain the real cause behind Kainat’s loss of sight.
Her father Rasool Bux Tanwari has been requesting the hospital staff to expedite Kainat’s turn for her MRI as she has been waiting since early morning, but they have been telling him to be patient. “Her case is complicated and she needs a specialised MRI, which takes longer than a basic MRI,” says Naseer Abro, MRI technician at the radiology diagnostic department, SCH, as he prepares for the next patient. “Kainat’s turn will come after two more patients.”
Kainat is not the only one waiting for her turn. Naseeba Khatoon who is in her 50s has been waiting for the last three hours. She has arrived from Dera Murad Jamali, Balochistan, with her husband Mohammad Baksh.
Four months ago, she was carrying a bucket of water when she fell down and since then has had a severe backache. “At first we went to the local doctors in Dera Murad Jamali, but there was no improvement in Naseeba’s condition so last month I brought her to SCH,” says Mohammed Baksh. “After her initial checkup the neuro-physician prescribed some medicines and ordered an MRI that we are waiting for today.”
Another patient, Sakina Kalhoro is quite annoyed and frustrated for having to wait so long for her MRI. “I have had severe lower back pain since one and half year,” she says. “I have seen several doctors and hakeems in Jacobabad, but nothing has worked for me so far.”
Sakina’s husband brought her to SCH and the doctor ordered an MRI. After several previous requests to expedite his wife’s turn, this time the MRI technician surprisingly agreed to his random request to expedite and immediately called her in for her test.
While Naveed Ahmed from Shikarpur chooses to pace the room as he anxiously waits for his turn, Ghulam Sarwar from New Pind, Sukker, sits in the less crowded part of the waiting room.
“My neck stays bent on one side, and moving it is painful and impossible for me,” he says, managing a small smile. “We know that for poor people like us, everything is difficult so I’m trying to be as patient as I can about my turn. Let’s see when they will call me for my MRI.”
Abro does MRIs daily from 9am to 5pm. “On the average we test about 50 to 60 patients who need an MRI,” he says. “A basic MRI normally takes 10 to 12 minutes, while an MRI with contrast involves a particular injection for the patient and takes about 45 minutes.”
He disagrees that influential people are facilitated on a priority basis. “Emergency patients are given priority, otherwise MRIs are done on merit,” says Abro.
Generally, MRIs are scheduled two or three weeks after the patient is given appointment for a test because of the large number of patients arriving every day, but emergency situations are dealt with immediately. “More people prefer to get their MRIs done at SHC because there are no charges here,” says Abro. “Whereas in private hospitals, MRI tests cost between Rs5000 to Rs20,000. The injection required for MRI with contrast costs an additional Rs3500. Sometimes, doctors may bring along their friends for MRIs but as technicians we can’t do much about it.”
Mohammad Azhar, the CT scan technician at SCH explains that since the facility is available from 9am to 9pm, more than 100 scans are done in a day. The wait time is much less and patients are staggered through the day. “In case of emergency, we are on call and can do scans during or after midnight as well,” he adds. Does this mean that another MRI machine or increased testing hours could sort out the long waiting time issue at SCH?
Dr Lal Chand (Associate Professor of Neurology at GMMMC) and his colleagues attend to more than 300 patients daily at the SCH. “Majority of the patients have minor problems, for which they need medication,” he says. “For those have severe issues, MRI or CT scan is ordered and in emergency cases, these are immediately done. As these diagnostic facilities are available free of charge, patients often insist on these tests even when they are not required. We advise them to take medicine for a week and then revisit us.”
According to Dr Chand, apart from SCH, four private hospitals are equipped with MRI and CT scan machines, but as the charges for these diagnostic tests are high, 95 percent of patients prefer to come to the civil hospital.
“There is enough space to install more machines, says Dr Abdul Aziz Abbasi, incharge MRI and CT scan department. “An MRI machine costs around Rs120 million to Rs150 million. One reporting doctor, a technician and an attendant are needed per single MRI machine.”
According to Dr Chand the MRI machine at the hospital has also been damaged in the August floods and has remained out of order ever since. The doctors have therefore been referring patients for MRI to Gambat Institute of Medical Sciences. "Even in my Neorology ward two patients currently require MRIs but we are helpless," he says, adding that according to policy the doctors are not actually supposed to be refering patients to private hospitals.
The medical superintendent SCH, Dr Tasleem Khamisani, however, believes that even 10 more machines will not be enough to facilitate the large number of patients arriving here each day. “This reason for the large influx of patients from Larkana and Khairpur districts to SCH is that the MRI machines in Chandka Hospital, Larkana and Gambat Institute of Medical Sciences are not functioning,” he claims. “We are trying to get more machines for SCH, but there is a lack of funds.”
But Dr Rahim Bux Bhatti, director Gambat Institute of Medical Sciences disagrees with Dr Khamisani. “We have two MRI machines and both are functional,” he says. “When a fault occurs in one machine, the standby is used,” he says, adding that when machines malfunction, professional technicians can rectify the fault.
“Our machine had developed a problem, which was duly tackled,” says a source requesting anonymity at Chandka Hospital, Larkana, in regard to their machines being out of order, and hence creating a larger patient turnout at SCH.
Discussing the issues at SCH, the former mayor Sukkur, barrister Arsalan Islam Shaikh shares that as special assistant to the Sindh Chief Minister, he held many meetings with the commissioner, deputy commissioner and the medical superintendant SCH to form a committee to oversee the matters of the hospital, but the committee was never materialised. “Later, I resigned from the post of special assistant due to the local bodies elections, but my commitment to improve the function and facilities of SCH remains,” he says regretting that his plans for development in Sukkur had always either been impeded by the bureaucracy or the lack of funds. Even if that is true, surely the government of Sindh and PMDC at their own level or in a progressive partnership could take some practical measures to ensure better health services for the rapidly increasing population of upper Sindh and their growing need for medical education and health sector services.
Sarfaraz Memon is a freelance writer. All information and facts provided are the sole responsibility of the writer