Daily Times

Humiliation is the abasement of pride, which creates mortification or leads to a state of being humbled or reduced to lowliness or submission. It is an emotion felt by a person whose social status, either by force or willingly, has just decreased. It can be brought about through intimidation, physical or mental mistreatment or trickery or by embarrassment if a person is revealed to have committed a socially or legally unacceptable act.

Doctors are socialized to respect and reproduce hierarchy from the start of medical college, where they learn not to challenge authority.

In Sindh provinces, Doctors working in Basic Health Units (BHU) under the Peoples Primary Health Initiative (PPHI) and many of Rural Health Canters (RHC) are also working under control of different NGOs. All the BHU, RHC, Taluka Hospitals, District Headquarter Hospital, and Teaching Hospitals are being visited by different honourable judges to check the performances of Hospital and same way District and Taluka administration is also inspected.  Visiting of Hospital is not objectionable but sometimes doctors suffer humiliation at the hands of these visiting personalities. Even relatives of the patient create problems with doctors, when they are coming to Hospitals.

Humiliation of one person by another is often used as a way of asserting power over them, and is a common form of oppression or abuse used in a police, military, or prison context during legal interrogations or illegal torture sessions. The now obsolete public punishment was deliberately designed to be humiliating, e.g. tarring and feathering lawbreakers, pillory, a mark of shame (stigma) as a means of making an example of a person and presenting a deterrent to others.

Without fully understanding the realities and limitations of our health care system and those working in it, both digital and print media have painted a picture of the doctors’ community using colours of misinformation and hearsay. News headlines such as “a patient died due to the carelessness of doctors” has given birth to the common perception among the public that doctors are merciless money-oriented butchers.

A doctor can be careless for two reasons: First when they are forced to work long hours, which not only affects their own health but also compromises patient care. In tertiary care hospitals across Pakistan, medical practitioners including house officers, medical officers, and resident physicians have to work between 80 to 90 hours a week, causing exhaustion and compromising the judgment of doctors and their ability to render treatment. When a fatigued doctor makes a mistake, it creates mistrust between him and his patient and leads to the impression that doctors are wilfully negligent.

In western countries where the provision of health care is better than ours, the working hours of physicians are limited for the safety of patients. In the United Kingdom, junior doctors work eight hours a day and 40 hours a week. The longest shift is of 12 hours and comes with extra pay and compensatory off, the next day. There are two days off in a week and those made to work on weekends are given replacement holidays in the same week. The American health care system follows similar criteria.

A recent study revealed that physicians who work more than 24 hours a day are 73 percent more at risk of protraction needle-stick injuries and are more likely to get involved in car accidents than doctors who work lesser hours. The study also states that 24 hours without sleep slows down the reaction time of doctors as though they were intoxicated.

Often Pakistani doctors are made scapegoats by the patient’s attendants who bring their patients to hospitals after the patient has become incurable. Despite rendering all efforts, the attendants of the departed patient hold on-duty doctors accountable and demand justice while it gets reported in print and electronic media as the negligence of doctors

The second reason Pakistani doctors can be careless is the tremendous patient load. According to official reports, in Pakistan, only one doctor is available for every 6,325 people. There’s also a poor provision of health in basic health units, rural health centers, and taluka headquarters, which form the primary and secondary healthcare levels.

Patients with minor complaints, who unnecessarily burden outpatient and emergency departments of tertiary hospitals, should be treated and filtered at the primary and secondary level in order to reduce the patient load in public and private hospitals.

Moreover, often Pakistani doctors are made scapegoats by the patient’s attendants who bring their patients to hospitals after the patient has become incurable. Despite rendering all efforts, the attendants of the departed patient hold on-duty doctors accountable and demand justice while it gets reported in print and electronic media as the negligence of doctors.

Doctors also working outdoor programs of Health department like polio and other Health awareness programs for public and these programs are sometimes under the control of the District administration. In Sindh polio vaccine program is under the Deputy Commissioner in every District, they may sometimes humiliate the doctors Community by the administrative officers.

There is no harm to work or under cooperation with different management’s officers but doctors needs full respect, dignity, and services for the betterment to the patient’s life. Humiliation itself is a disgrace for everyone, if we will respect each other then the emotion can be transformed into moral support.

The writer is a retired doctor of the Sindh Health Department

Published in Daily Times, October 29^th 2018.