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Do we want doctors to leave Pakistan? – by Dr Anis Rehman

First it was Dr Aftab Qurieshy from Hyderabad, who was kidnapped and then brutally murdered. Yet again we see another doctor, Dr Rahim Bux who was murdered cold bloodedly while he was working at his clinic in Karachi. Such incidents make to the headlines almost every now and then. A few years ago, Amnesty International published detailed report on how doctors in Pakistan, particularly those of persecuted communities, are being attacked and murdered.

Medical profession is considered to be the most sacred profession because doctors save lives. They are given much respect around the world for the same reason. However, these life-savers do not enjoy the same respect in Pakistan now. For example, security issues of doctors’ community have been deteriorating recently.

Media and general public has been misrepresenting doctors in the current healthcare crisis rather than coming onto table and finding a solution.

Pakistan is a country where doctors work 60-70/hours/week or even more. Other countries have limit of 48 h/w or maximum 60 h/w. Even then, they are expected to work more due to lack of doctors in most of the hospitals. Still they are the bad people.

As far as the salary structure is concerned, young doctors were not paid enough in the recent past. However, with the introduction of new salary structure, some of their concerns have been subsided. But still, if we compare the salary of the young doctors, we find its low as compare to other professionals in Pakistan. Middle East and West, along with most of the countries, including our neighbor pays approximately 5 to 10 more to their doctors, because doctors are the life savers.

Moreover, the hygienic conditions of the hospitals also affect doctors’ health badly. In the government hospitals, there are neither clean toilets nor reasonable places to have meals. Doctors on night duty, face problems if they want to take a nap or rest for a while.

Lack of resources and research facilities in most of the teaching hospitals is another setback to the doctors. Availably of internet and access to the paid medical journals, is limited to a handful of tertiary care hospitals only. Hence, most of the doctors can’t access the up to date information nor can benefit from telemedicine.

With fake medicines and fake laboratory reports, there is nothing much a doctor can do to help his patient. In the end, doctors get the blame if the patient suffers.

It’s a sad fact that Cuba has 67 physicians per 10000 population and Pakistan has only 8/10000, while the global average is 14/10000. This reflects the reason behind the excessive workload on doctors in the tertiary care hospitals particularly those run by the government. Yet doctors are blamed for any negligence that happens as a result of long working hours and over burden.

According to a report (2008) from Higher Education Commission (HEC), Pakistan, approximately 1500 doctors migrate from Pakistan and only 10% return later on. Brain drain is a big issue in Pakistan. Recent Gallop survey estimated that 33% of the Pakistanis are willing to leave the country, which is the highest in the history. Same goes for doctors. Each day, more and more doctors are leaving the country for a better, more respectful and most importantly, safe and secure lives. Middle east, West and Far East offer great opportunities to them as compare to the home country and above listed issues, are persuading them to migrate from Pakistan.

Doctors can’t be blamed solely for the leaving their country or not serving their patients properly. It’s a collective responsibility for all the stakeholders of the society. Major efforts should be taken in order to encourage doctors to stay home and serve the local people. If the same situation continues, Pakistan might face extreme shortage of doctors as seen in my African countries.

Moral obligations? That is a funny word to hear. When the doctors themselves are dying of hunger and target killings, rather then getting sympathies from the people, they are abused badly in media and social forms and then given lectures of morals. Doesnt it a responsibility of the government to provide positive circumstances to the doctors?
Strike! I personally will never do that and leave any patient. I don’t work for money but for people. If that’s the situation, I have to face, I will certainly resign from that job, find another or switch to some other business. This is what my morals are. As stated, however, I don’t blame the doctors for going on strike. Its their right of self determination. They are human beings and not machines.

Who is responsible? Doctors worked day and night for FREE during the floods of Sindh in 2010 and 2011. I worked for three months without getting paid. Many worked for dengue crisis and earthquakes during 2011 and 2005 respectively. I don’t understand why this nation always proves to be such an unthankful nation?

Before talking ill about doctors, just think for one second that you could have been dead if there were no doctors. If you look at the history of humans, its not the wars or atomic bombs or crimes that have killed the most of the people. It’s the Malaria. Even today in Africa, malaria is the number one killer. It’s the doctors who have been treating people despite such bad circumstances.

If this nation cant given them money or sense of security, then at least they should give them respect. This current crisis of healthcare will have its grave effects in the long run. One fourth of the doctors in Pakistan are on strike and do you think they will work in future? Most will start looking for jobs elsewhere and believe me, even with grave economic situations, there are still lots of jobs because, the world considers Pakistani doctors to be the best one. They have proved that many times!

There is a grave concerns that in next five years, Pakistan might have acute shortage of doctors. Pakistan Medical Association Sindh (PMA), has been voicing over this as well.

To sum up, should we blame the doctors for leaving Pakistan and remind them that they were educated in Pakistan? Or should we blame the healthcare system and the current working situation instead? When the ex PM himself says, why don’t they leave? Doctors are just doing what a democratically chosen PM said!

About the Author: The author graduated from Dow Medical College, Karachi (Class of 2011).
Email: anisramay@gmail.com

About the author

Abdul Nishapuri

9 Comments

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  • Dear Editor and the readers:

    Authors’ Disclaimer: I am not a member of any political party, nor YDA or PMA. Nor do I work at a government hospital. The article does not reflect the policies of the international affiliations I have. The author did not provide the picture nor its text. Thank you.
    These are just plain facts.

    Anis

  • I am closely analyzing the doctor’s issue from the first day. Author of the article try to dig out the realities and issues of doctors in Pakistan. I am agree with him, but partially. First dont compare the salaries of doctors with other countries. we have no concern what others are doing or others are paying, coz in Pakistan we need to see our own resources. In Pakistan not only doctors are getting less according to their duty but also the teachers, policemen, laborers, clerks all are not getting enough money to cope with their daily needs.
    Secondly these are the doctors who force their patients to come at their private clinics to earn more. if doctors are consider themselves as most sacred then why they force their patients to visit them privately? i dont think that i need to give any precedent in this regard. Everyone knows that how a doctor loot the poor patients.

  • Mr Misaq, I too am a medical student. And the only logical answer to your stance is that doctors have better chances of moving out and settling elsewhere with better pays and better working conditions even in this global slump than any of the other professionals you mentioned. The world you live in is what everyone calls a global village. If you had been a doctor or a medical student you would have been having the same thoughts that most healthcare workers have here. And trust me, many will leave as soon as they get an opportunity. And most doctors are offended because of comments made by people like you about us looting people. Nobody raises his voice when bureaucrats and generals take bribes. Everyone just sleeps here while politicians loot your capital to start up businesses for their children in the UK or set up refineries and factories elsewhere in the world or purchase mansions in France. Also, you might not be aware of the health hazards this population poses to us. The Government says 10% people here suffer from hepatitis. But private organizations claim the figure to be as high as 40 to 50 percent. No Doctor practicing in UK or USA would agree to work in such conditions even if you give insure his life for millions of dollars. Yet doctors here still serve you even though they are well aware of these conditions. Yet you still blame them for the loss of lives during this sad incident that was sparked by none other than Government of Punjab…. Bravo!!!

  • i am very inspired from this article……………i was working on the question”what government should take step to improve the ratio of doctors to patient?”and now i got many points from this article………