Staff shortages plague paediatric facility

With no permanent recruitments made over the past 15 years, NICH fails to accommodate the influx of child patients

Sindh’s largest children’s hospital, the National Institute of Child Health (NICH), has been operating for years under severe staff shortages, with 800 posts lying vacant despite an overwhelming patient load.

Doctors, nurses, and paramedical staff are under extreme pressure, creating serious hurdles in providing timely care. Surgeries are scheduled three to six months later, while MRI and CT scan machines frequently remain out of order. Even the lift used to transport children to upper floors is often nonfunctional. The emergency department has been handed over under a public-private partnership.

The hospital has a 500-bed capacity but accommodates more than 2,000 children at a time, forcing three to four patients onto a single bed. When timely treatment is not possible, poor families are compelled to seek costly private care or wait months at length. Between 500 and 700 children visit the outpatient department daily, while around 300 arrive at emergency.

Parents shared a glimpse of their prolonged suffering. A father from Thatta revealed that his four-year-old son, suffering from a urinary tract problem, was advised of surgery after an MRI. “The machine remained out of order for weeks, requiring repeated visits. After the test was finally conducted, surgery was scheduled three months later, leaving my child in pain for months,” said the father.

Another parent from PIB Colony shared that his two-year-old daughter, born with a cleft lip and palate, was given a surgery date three months later after laboratory tests. “Private hospitals quoted unaffordable costs. When the surgery was eventually performed at NICH, medicines were not provided by the hospital,” said the parent.

At NICH, of 89 approved doctor posts, only 25 are filled, leaving 64 vacant. Out of 200 sanctioned nursing posts, 80 remain empty, while 250 of 410 paramedical positions are unfilled. Due to legal complications, recruitment has not taken place for several years. The annual medicine budget stands at Rs32 million.

At present, 65 house officers, four FCPS trainees, 120 FCPS Part-II trainees, 34 MCPS trainees, and 15 trainee RMOs are working. These trainees are not regular employees, though the Government of Sindh provides stipends. The administration relies heavily on them to run services. Of 1,200 sanctioned posts, only 400 are filled, and no permanent recruitment has been made from 2011 to 2026.

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Previously under Jinnah Postgraduate Medical Centre, NICH was separated in 1990. Senior paediatric surgeon Professor Nizam-ul-Hassan was appointed as its first honorary director. Employees have long awaited promotions, and postgraduate trainees and house officers shoulder much of the operational burden.

Aijaz Kaleri, President of the Young Nursing Association, claimed that of 210 approved nursing posts, only 110 were filled. “Four nurses care for 60 children during the day, while three manage the same number in the evening. The hospital urgently requires 450 nurses along with more doctors and paramedical staff,” noted Kaleri, adding that shortages were a key reason behind surgeries being delayed.

A doctor, speaking anonymously, revealed that only 18 to 20 senior doctors, employees of Jinnah Sindh Medical University were linked with NICH. “Their salaries are paid by the university, though they receive additional benefits from NICH. In this regard, 30 consultant specialist posts, 12 medical technologist specialist posts, 15 pharmacist posts, 106 staff nurse posts, and 53 specialist doctor posts approved in 2024 remain unfilled despite allocated funds. Hence, many children are referred from emergency without admission due to lack of beds,” informed the doctor.

Executive Director at NICH, Professor Dr Nasir Saleem Saddal confirmed that 800 of 1,200 sanctioned posts remained vacant, though around 150 NGO workers were assisting. “NICH provides free treatment to children from birth to 14 years and offers laboratory, radiology and emergency services,” said Dr Saddal, who confirmed the severe shortage of staff, adding that plans for contractual hiring remained stalled due to legal complications.