“Vaccines don’t work. It’s all a big fraud. You just watch a documentary on YouTube ‘Truth about vaccines’ and you come to know everything,” a friend sitting beside me, in class of final year MBBS, uttered that with a confident demeanor. Although I was conscious about the anti-vaccine campaigns all over the world and had been reading books, articles and watching different documentaries on the issue, never before had I met an anti-vaccer in person. One look on his face sent cracks into my calmness. I thought about children of three countries of the world, including Pakistan, whose fate to enjoy independent lives is haunted by ghosts of a vaccine-preventable crippling disease, poliomyelitis.
I thought about the children in his home and could see the whole neighborhood turned into such red cursors. Imagining the globe the red cursors went on increasing, the threat undefendable, and I was feeling exhausted in AC room.
Pakistan is a country where fair supply of doctors and paramedics has always been a big issue. A repot published in Dawn makes it clear: only one doctor is available to 957 people. On etiological note, in this case, following causes top the list: (1) An upsurge in number of young graduates who dream to work in USA, European and Gulf countries. (2) No scent of public understanding of medical health sciences can be smelled in air around, there is no such institution working in this direction. This leads to a never-ending tension in doctor-patient relationship. Many doctors are humiliated, beaten, even murdered by patients and their attendants. The fear of facing such dire consequences to work here results in ‘let’s go abroad’ mindset. (3) Economic issue: young graduates belonging to opulent families don’t work in clinics but enter either into bureaucracy or business empires of their parents. The rest who work in clinics, either to earn or being inspired by the idea to serve suffering people here, don’t show much-needed efficiency and are always in search to leave for abroad because of low salaries, absenteeism of any bonus and basic facilities.
For example, a house officer in Lumhs hospital, a tertiary care, is paid Rs 30,000 per month. Such low amount, in government setup in Sindh, can only make doctors dream not to be part of health system of Sindh, for they can’t expect good treatment here. Given that above is our standing, people here are left with no choice but to consult Hakims, babas, even medical students, for health advice and consider it ‘the final word.’
That’s why I couldn’t face any reluctance in fancying my friend as a red cursor of threat. I thought about the children in his home and could see the whole neighborhood turned into such red cursors. Imagining the globe the red cursors went on increasing, the threat undefendable, and I was feeling exhausted in AC room. “Where is your mind, Hello?” class teacher, who was pronouncing the slide like a parrot, suddenly caught my mind.
University education is meant to produce socially responsible professionals, that no longer is an objective of ours. We have been infusing young minds with medicine of pseudoscience, irresponsibility, alienation and capitalist desires to travel abroad and earn fortunes, etc. When a child dies in Thar, when a woman gives birth to a baby in washroom of Lumhs hospital due to absence of lady doctor, when we read reports like ‘One doctor for 957 patients’, when people refuse to take medical advice and go to Hakims, Babas, and traditional healers who can offer them nothing but placebo, when doctors and medical students themselves start believing that vaccines, the miracle of medical science, are of no beneficial use, when we observe all this public ignorance—we are supposed to admit our failure as intellectuals of society, if we consider ourselves that.
When a professor of human anatomy at Lumhs teaches me Aristotelian idea, rejected centuries ago, that the actual function of heart is ‘thinking’, isn’t it high time to realise what you are teaching the young minds who are deemed to uplift society?
Who is responsible for all this chaotic state of affairs? Whose purpose does ignorance serve? Isn’t it, first of all, a responsibility of medical institutions to sue teachers there for committing professional dishonesty? When a professor of human anatomy at Lumhs teaches me Aristotelian idea, rejected centuries ago, that the actual function of heart is ‘thinking’, isn’t it high time to realise what you are teaching the young minds who are deemed to uplift society? We are being taught nothing about the history of medicine, research or social responsibility. We are not being endowed with modern methods of education, the old semester system, wherever it’s followed, seems totally unsuitable to learning efficient clinical skills.
“Each year this number of deaths occur due to snake bites in USA, this number of measles cases are reported in USA!”—this is what we are taught. I want to practice here, I want to serve people here, and I am left with no choice but to doubt the ability and credibility of teacher who teaches me nothing about HERE. It’s only good choice to use books of eminent western scholars because we couldn’t have been able to produce good books ourselves, but isn’t it responsibility of health sector and medical institutions to empathise teachers to search out and teach epidemiological and other health statistics that a clinician who wishes to work HERE finds beneficial?
What changes medical institutions be reminded to consider?
First of all, there should be a cell that scrutinises the abilities, scientific literary and social responsibility elements in teachers. Teachers should be trained in basic sciences and reminded not to include their personal beliefs while teaching a subject that needs curiosity in students be praised rather than be perished.
Second, it should be considered to update the syllabi. History of medicine, and Biomedical ethics (the precious doctor-patient relationship being its part), should be included as major subjects so that students don’t fall prey to mistakes of past—this will help them understand why modern medicine is the best of past we could extract, why vaccines are not fraud but our only hitherto available weapon in our fight against germs, and the fact that the prestige of all this is supported by objective scientific trials.
This way they would be able to tame their demigod attitude towards patients who are poor and ignorant, for when you are literate it’s your moral obligation to teach others because human societies are a web of mutualism and illiteracy anywhere will directly or indirectly affect your own survival. It’s also the only way to relieve the tension in doctor-patient relationship.
Third, they should find the alternatives to semester system so that effective clinical skills are learned.
Fourth, there should be research departments functioning properly on clinical grounds with fine monitoring. It’s only through updating our medical institutions that we can stave off the challenges of disease and disaster.