A country where 58 per cent of the population is food insecure and over 43 per cent of children are malnourished, health should be a primary concern all the time. Add the repeated misery of the floods of 2010 and 2011, and the displacement of hundreds of thousands of people because of military operations in Khyber-Pakhtunkhwa and Fata and it becomes an even more pressing concern. When a matter is that critical, you expect to see it highlighted everywhere. Unfortunately, the Pakistani media is, by and large, silent on this issue.
Let’s start with health issues regarding children. Neonatal mortality is responsible for 57 per cent of all deaths among children younger than five years of age in Pakistan. Furthermore, we also have the dubious distinction of having the highest neonatal mortality rate in the region. According to UN figures, around 432,000 children die before reaching the age of five in Pakistan and the majority of these lives are taken by pneumonia, diarrhoea, measles, malaria, tuberculosis and tetanus. But if you go through any newspaper in Pakistan or watch any news bulletin on any of the TV channels, you would think that the only disease killing children in Pakistan is polio.
Pick any newspaper, almost 90 per cent of the news items about children’s health relate to the government’s polio vaccination drive, its success, failures and the political mileage politicians get out of it. Much of this coverage is based around self-serving publicity-seeking statements by political personalities, especially those who are part of the government and the ruling party such as Aseefa Bhutto Zardari, Farzana Raja and Shehnaz Wazir Ali. Ironically, when it comes to fighting polio, Pakistan is doing badly and is currently experiencing a resurgence of the dreaded disease (it is one of three countries where the disease is endemic — the other two being Nigeria and Afghanistan). Pakistan has not done much to meet the Millennium Development Goal of reducing childhood mortality by 2015 and control of infectious diseases, which should have been the top-most priority but remains neglected.
The higher occurrence of communicable diseases among children and acute malnutrition in the country is primarily due to poverty, high illiteracy rate among mothers and the government’s lack of commitment towards ensuring food security to each and every citizen. Other factors include inherent problems in infant feeding practices and lack of access to the ‘right’ kind of foods, a problem that can be addressed if the media makes it a priority. Unfortunately, even when the health sector is covered, the issues are usually political in nature, such as the recent strike by doctors in Punjab.
As far as health issues of adults are concerned, one sees stories only about cases of criminal negligence, medical malpractice, lack of infrastructure, absentee doctors and protests and strikes by medical and paramedical staff. There is hardly any coverage given to issues relating to nutrition, health policy, legislation and drug pricing policies, etc.
With the devolution of the ministry of health following the Eighteenth Amendment, Pakistan faces the challenge of developing a reliable provincial infrastructure that would integrate the efforts of various stakeholders in promoting better health outcomes. Unfortunately, we are not even at the stage where a workable policy is developed and budgetary priorities are reassessed, so developing a workable provincial infrastructure remains a distant dream.
Published in The Express Tribune, May 26th, 2012.