Nishtar hospital again

The recent incident at Nishtar Hospital in Multan, where a patient underwent surgery without mandatory HIV screening and later tested positive, is another example of the lax safety standards at our hospitals that is driving up the number of avoidable HIV infections every year. In Multan, a junior doctor's objection to the missing HIV report was ignored. This single act of negligence may have exposed an entire surgical team to the deadly virus.

The hospital's response was surprisingly nonchalant - forming an inquiry committee and disinfecting the operation theatre. The former is supposed to happen after every case of potential medical negligence, while the latter should ideally be done after every surgery. To put it another way, the hospital did the bare minimum. But making things worse is the fact that less than two years back, the same hospital was at the centre of an HIV outbreak caused by failure to follow basic safety protocols.

In November 2024, a patient died and 30 others contracted HIV due to gross negligence in the dialysis unit of the Multan hospital. A machine reserved for patients with HIV was being used on patients who did not have the virus. Several patients also tested positive for Hepatitis C, another blood-borne disease which can be spread by sharing equipment that has not been properly disinfected between patients. In that instance, the knee-jerk response of the Pakistan Medical Association was to demand that the head of the hospital, who had been suspended, be reinstated; accuse the inquiry team of incompetence; and say that the government's AIDS prevention protocols were inadequate.

All of these 'defenses' are actually confessions that point to the bigger problem. Firstly, nobody in Pakistan seems to take responsibility for things going wrong. A conspiracy or external bad actor is always to blame. Second, inquiries are only required when disasters happen. A well-run hospital may have to deal with the tragedy of one or two accidental infections that are quickly traced, but not 35. Third, good doctors would aim to outperform the government's minimum standards, rather than struggle to meet them.

The relevant health authorities must improve scrutiny, but doctors must also hold themselves to higher standards. While irresponsible workers in some jobs may only cause financial losses and be allowed to get off with a warning, careless doctors ruin lives, and that is unforgivable.