General public, especially those people who do not have a doctor in their families have the perception that a ‘doctor’ is a money making machine who charges a lot for his/ her services. If someone wants to earn a lot of money, he/she chooses the profession of Medicine. Let me correct this and tell you a story of a typical ‘doctor’ as she progresses in her life and profession (I am choosing to tell this story from a female perspective for a reason which will come later in this article). Let us name this doctor ‘Amna’.
Amna is one of most hardworking and intelligent girls of her class. Ever since she was a little girl her parents kept telling her that she has to study harder than others around her so that she can get an admission in a government medical college because they cannot afford to pay millions of rupees for private medical colleges. So her early years of life went into books and exams, while others her age partied and played. She was lucky enough to get selected in medical college.
Here she realized that her parents when they used to tell her during her FSc. “work hard for these two years, they will either make you or break you, rest will be easy” was a big lie and the real hard work was just starting. After four years of burning the midnight oil she starts her ‘house job’. Here, she gets the shock of her life when she is informed that she cannot get a paid house job and will have to work for free as paid seats are limited.
During rounds in her third and fourth year she had some exposure of real patients but dealing with them on her own especially during night duties was tough. She is sometimes afraid; sometimes confused but her seniors are really cooperative and the whole team keeps working together day and night. Now, she has started studying for ‘gynaecology’ part-I exam; as she wants to become a gynaecologist.
During her ‘house job’ what she loved most was the miracle of beginning of a new life. Now this is going to be another five years on very minimal pay which is even lower than that of a government school teacher or a front desk job in a private company, before she becomes a specialist doctor. She is lucky to get a nice proposal from a doctor and she gets married. Both of their salaries are not good enough to run a home but her in-laws are nice and financially support the couple through their specializations.
For five years both of them struggle very hard, saving hundreds of lives staying up all night and sleeping after 72 and sometimes 80 hours. Studying while doing duties, learning while doing rounds, she passed through a cut-throat competition of getting close to good supervisors and getting the maximum chance of doing a hands-on surgery training. She had to invest 13 years of her life to become a doctor, but today she has fulfilled her own dream and the long awaited dream of her parents.
Every alternate day some doctor is beaten-up or humiliated at a public hospital in Pakistan. Sexual assaults, beating, torture and verbal abuse even against female doctors is becoming routine
Only if her father was alive to see her today, how happy would he be? Other than finances she faced personal challenges of home management and time management; for her kid he is two now, and she did not get a time to enjoy the most beautiful two years of her son’s life.
After several months wait and loads of prayers finally she gets the post of a medical officer in a government hospital. She is very excited to join her first job and do her best. Despite her pregnant aching body she performs her 36 hours duty, with in next few hours she will be home with her son. She is looking forward to the long needed rest. Here comes a new emergency. She rushes to the OT to save the life of her patient. In spite of her best efforts, she is unable to save the baby, but she saved the life of the mother.
It is the hardest task for her to break this bad news to the attendants. When she does, angry uncles and father attack Amna and start torturing her physically. Her scarf is torn, her shirt is partially ripped, and she miscarries. Bleeding on the hospital floor at 5 in the morning, before she loses consciousness her whole life passes in front of her eyes. Why me? is the only question in her mind.
The end of the story may seem too dramatic. But this is becoming a common reality. Every alternate day some doctor is beaten-up or humiliated at a public hospital in Pakistan.
Sexual assaults, beating, torture and verbal abuse even against female doctors is becoming routine. Planned destruction of the Public health sector, in Pakistan and lack of awareness of true life conditions of the doctors is building anger and hatred for this sincere hardworking community. Media, bureaucracy and other authorities which have nothing better to do visit hospitals, even enter Operation theatres harassing doctors and limiting their work potential. Why does no one visit courts, jails and other places where life and death is decided or actually ‘not decided’ every day. If you visit a public hospital, you see a list of complaint cell numbers posted on the walls against doctors. Why not in jails, courts, audit offices and other government offices? Are only doctors corrupt? Lazy? Not ready to work?
These doctors have worked for decades without a clear service structure, no rest, no financial benefits, and no job security. If they speak up for their rights under forums like YDA, their image is further tarnished, and they are beaten up and pushed back? Uneducated people in peripheral areas blame a doctor for lack of medicine in a hospital, unavailability of beds, unclean hospitals and even missing lock doors on wash rooms. These are all administrative issues and not the responsibility of a doctor. If we need to stop a brain drain from Pakistan, and save public health sector, some laws need to be enacted for the protection and betterment of the community of doctors. A forum should be provided to doctors to listen to their problems and point of views. They are the cream of our community and should be trusted and respected.
The has a PhD in Economics from NCBAE, Lahore
Published in Daily Times, November 18th 2018.