Nebulizer shortage plagues public hospitals

For asthmatic patients living with  breathing difficulties, having quick access  to  special  medications  delivered   through inhalers and nebulizers is a matter of life and death yet nearly all public  hospitals in the port city have failed to  guarantee adequate nebulization facilities for the panting adults and ailing infants, who are suffering endlessly with  their chronic ailments. Even  though  seasonal  allergies  are  a   universal health concern, affecting all  people across the globe to some degree,  in Pakistan’s metropolitan hub, Karachi,  the proliferation of commercial activity  alongside  the  expansion  of  industrial   zones has elevated the levels of chemical pollutants in the troposphere, which  needless to say, has triggered the incidence  of  various  respiratory  ailments   like asthma among the local population,  especially during the inclement weather. However, the repercussions of the sea- sonal epidemic have only been amplified for low-income patients in the city, who in the  absence  of  proper  nebulization   facilities in public hospital’s either have  to take on the risk of sharing contaminated aerosol masks for relief or alternatively turn to costly private  care, which has the potentiality of turning their finances upside down.

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“My  doctor  at  the  Abbassi  Shaheed   Hospital prescribed regular nebulization  for treating my chest infection. However, since no nebulizers were available at the hospital, I had to get the treatment done  from  a  private  facility,  which  cost  me    Rs3000  for  just  three  days,”  lamented   Asma Shiraz, a resident of Nazimabad,  who resents having to bear the additional  financial burden. Likewise, Hira, a mother from  Liaquatabad,  faced  a  similar  predicament  when  she  took  her  daughter,  a   pneumonia patient, to the Liaquatabad  Hospital  for  treatment. “Even  though   nebulizer  machines  were  available  at   the hospital, we had to wait for several  hours due to the long queue. Eventually,  my husband decided to take an urgent  loan of Rs10,000 so that we could take  our daughter to a private clinic for im- mediate medical care,” shared Hira, who  further informed that a large influx of  patients with asthma, pneumonia and  other chest diseases was flowing into the  public hospitals, which severely lacked  the necessary medical paraphernalia.

According to sources from the Health  Department  of  Sindh  and  the  results   of  an  on-ground  survey  by  The  Express   Tribune, no nebulization equipment was  available across many government hospitals in Karachi, which were receiving  a large influx of patients with respiratory complaints, including 20 patients  per day at the Sindh Government Ibrahim  Hyderi Hospital, 15 patients at the Sindh  Government Korangi Hospital, 15 to 20  patients at the Sindh Government New  Karachi Hospital, 8 to 10 patients at the  Sindh  Government  Liaquat  National   Hospital, and an average of 20 to 25 patients  per  day  at  the  Jinnah  and  Civil   Hospital’s each. The data on the rising number of respiratory  patients  was  confirmed  by   Amir, a pharmacist, who reported that  the demand for nebulizer machines had  peaked this winter season, leading to a  surge in its price by Rs2000 to Rs5000. 

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“While some respiratory medicines have  become too expensive, others are entirely  out of stock,” revealed Amir. Dr Faisal Asad, Head of the Respiratory  Diseases Unit, at the Dow University of  Health Sciences, claimed that air pollution, dust, pet fur, household cleaning  agents,  and  kitchen  smoke  all  could   contribute towards the rising number of  asthma cases. “The symptoms of asthma  include shortness of breath, chest tight- ness, wheezing sounds, and persistent  cough,” said Dr Asad, who emphasized  the importance of timely treatment. Speaking  of  treatment,  sources  have   also  disclosed  that  in  the  absence  of   nebulizers,  public  hospitals  including   the  Jinnah  and  Civil  Hospitals  are  directly  administering  oxygen  therapy   from a wall point to all patients who are  presenting with breathing difficulties,  including children.

However, paediatricians, like Dr Khalid  Shafi view the unhygienic, stopgap practice with an eye of caution. “Infants with  breathing difficulties require a strictly  monitored dosage of oxygen, which is  determined according to their age and  body mass. Over exposure to oxygen can  severely damage a baby’s vision,” warned  Dr Shafi. On the other hand, Dr Faiza, Head of  the Chest Unit at the Sindh Government  Hospital, Liaquatabad, highlighted the  fact that no special laboratory was avail- able for diagnosing viral illnesses in our  hospitals. “A 10 to 20 per cent rise has  been observed in cases of respiratory dis- eases due to the flu virus. People must  eat a balanced diet, get vaccinated and  wear  masks  for  their  protection,”  she   added. Putting his two cents on the situation,  Muhammad Tawheed, an urban planner,  whilst  acknowledging  the  need   for  greater  facilities  in  public  hospitals, also highlighted the importance  of investing in long-term strategies to  battle pollution. “We must promote alternative means of transport, ban garbage burning, enforce environmental  laws, limit combustion vehicles, and  encourage walking and cycling,”  he implored