Exclusive medical colleges for Boys are needed to produce more male doctors for rural areas. The Pakistan Medical Association (PMA) recently published its Annual Health Report 2014, titled: “Health of the Nation”. The PMA office bearers: Dr. M. Idrees Adhi-Chairman and Dr. Qazi Wasiq-General Secretary along with Dr. Mirza Ali Azhar – Secretary General and Dr. S.M.Qaisar Sajjad – Treasurer, conducted a press briefing on this occasion, to highlight the salient observations, remarks and recommendations featured in this National Health Report 2014. The report states that; Due to the rapid unplanned population growth taking place in the country, and a largely illiterate population, there is already a severe shortage of amenities and resources in the country, an a dangerous rise in Food-insecurity. The challenges are intensified due to poor governance, corruption, unfair budget allocations and a volatile law & Order situation. The country's healthcare sector and medical facilities have been severely affected by these debilitating factors. Especially the increasing violent crimes against doctors and incidents of murder, extortion and kidnappings of leading health practitioners have created serious threats for the health professionals. The country is already burdened by the sixth largest population in the world (over 180 million people) while it is also one of the fastest growing populations. Intensifying major challenges like; poverty, illiteracy, energy crisis, terrorism and, indeed, a massive burden of diseases. For the last many years, PMA has been compiling and publishing this annual “Health of the Nation Report” to highlight the health care performance. Unfortunately the situation has been continuously worsening in this arena. Every year, the PMA has been placing a charter of demands for the government to implement recommended policies and effective regulations to enable a turn-around. However, the governmental authorities tend to be procrastinating, while not showing any response to the mounting challenges. The voice of PMA seems to be falling on deaf ears, despite numerous changes in government regimes. The health indicators have failed to show any positive trend over the past several years. In fact, in most of the areas, things have gone from bad to worse to utterly shameful. For example, the last year’s report claimed the level of poverty to be around 35%, which now stands beyond 50%. According to WHO recommendations, the health budget of any country should at least be 6% of the national GDP. In our case, the health budget, despite repeated PMA pleas and reminders to the government, has remained less than 1%, out of which 80% is spent on salaries and administrative costs. Of the 20% that is the share of the poor masses, corruption eats up a major chunk, leaving a terribly negligible amount for the poor patients. Pakistan carries a heavy burden of diseases because of the poor healthcare delivery system at the primary level and due to lack of awareness and ignorance about the diseases. Most diseases are preventable through vaccination/immunization or by way of simple awareness and the provision of some very basic facilities by the government. For example, just by providing clean potable water and proper sanitation to the entire population, we can get rid of diseases like Diarrhea, Dysentery, Gastroenteritis, Typhoid, Hepatitis-A and many others. The fiscally-challenged country can save billions of rupees, which at present are spent on treatment of these very diseases. Similarly, an affective vaccination/immunization program, carried out with honesty, commitment and professionalism, can eradicate for good, diseases like Polio, TB, Whooping Cough, Diphtheria, Measles, Smallpox, Hepatitis, Typhoid, Meningitis, Pneumonia, Mumps, Rubella, etc. But, as the PMA has kept saying all these years, health and education are not priority areas of our governments. Time has proved the authenticity of PMA claims, but that is not the point. The need of the hour is for our government to put its act together, focus on family planning, allocate appropriate health and education budgets, make a people-friendly health policy, concentrate on preventive healthcare, and elimination the menace of corruption. Honor & merit should prevail. The government should demonstrate a political will to address the issues of health and education in the country on a priority basis, which are the foundation of a welfare state. Speaking to the media, Dr. Idrees Adhi stated that; There has been no needs-assessment of medical services and healthcare facilities conducted by the PMDC. This could help in realignment of medical curriculum and public health procedures, with the changing needs. After the elimination of quota system in Medical college admissions, a majority of female medical students are dominating the medical education institutions all over the country. This will soon lead to a severe shortage of Male doctors to be posted in the rural and remote areas. Dr. Adhi suggested; To overcome this impending crisis, why can't we have medical colleges exclusively for Boys only. Instead of fighting these challenges, many PMDC officials appear to be busy with unfair politics. Over the past few years, corrupt officials have been minting money while carelessly approving too many poorly-structured Medical colleges all over Pakistan. Quackery is rampant while so-called medical graduates from unapproved institutions like; Nangarhaar Medical College-Afghanistan, are also found operating sub-standard clinics without any checks and balances from the PMDC. Infant mortality rates are increasing due to untrained mid-wifes playing with precious lives. Simply due to lack of awareness, young mothers are losing their lives due to excessive bleeding during child-birth, although there is a very cheap medicine available for miraculously controlling such bleeding. The vaccination programmes are also showing poor out-reach, with increasing Polio cases being reported. It is also necessary to vaccinate each and every young girl against “Human papilloma Virus” (HPV) which leads to a fatal disease called Cervical cancer. We must remember that the 2015 deadline for achieving the United Nation's Millennium Development Goals (MDGs) is just around the corner, and Pakistan is still far away from the targets set by the UNO. Being a signatory to the MDGs set by the UNO we need to work hard and work fast to remain in tandem with global transitions in wellbeing and quality of life. PMA DEMANDS: 1. PMA demands security for the doctors and health workers, with exemplary punishments for all criminals who are involved in crimes against the doctors. 2. Increase the Health budget up to 6% of GDP. Stepwise increase in heath budget from 0.6 percent to 6 percent as per the recommendations of WHO. Control on corruption in massive healthcare projects and procurement of high tech equipment. 3. PMA demands the implementation of Healthcare Commission Bills in all Provinces, to protect the rights of Medical Professionals and Patients. So far this legislation has been passed by the Punjab and Sindh Assemblies. 4. Make an effective career structure for doctors in general and teaching cadres, both in the public and private sectors. This is necessary to stop the brain drain and migration of qualified Doctors from Pakistan. 5. Invest in providing clean drinking water to every citizen of the country. Develop a scientific sewerage system in every part of Pakistan, including Azad Jammu and Kashmir and FATA. 6. Strengthening of Basic Health Units, Rural Health Centers, Taluka Hospitals by recruitment of midwives, nurse, paramedics, doctors and specialists on emergency basis. 7. An independent, autonomous, powerful and representative PMDC for the regularization of medical education and training in Pakistan. Strengthening of present tertiary care centers, teaching hospitals and medical colleges by capacity building instead of establishment of new hospitals and medical colleges. 8. Private health care and medical education system should be regulated for quality assurance. 9. Formation of high power medical education commission to look into matters of medical universities in Pakistan and functioning of medical colleges in private and public sector and audit of substandard post graduate training programmes. The country needs a nationwide postgraduate training programme for the production of competent and skilled specialists. Appointments and promotions should be done on strict merit, to ensure proper medical education and practices in the country. We need to invest in creating competent nurses, midwives, paramedics, with clearly defined and structured career development. 10. A higher committee is required to investigate the present status of medical universities in Karachi. 11. Investment in primary care to provide basic health care to poor populations living in the rural areas. 12. Effective campaign against quackery and law to stop its propagation by electronic and print media. 13. Strengthening of EPI Program and eradication of corruption to improve its activity. 14. Complete transparency in all matters of health from recruitment to procurement. 15. Complete ban on production, sale and consumption of Gutka, Challiya & Sheesha smoking.
