It is no secret that doctors and medical teams in Pakistan are often guilty of blatant medical negligence when it comes to treating patients, especially in life-saving procedures.
Medical audit laws are as good as absent. With the Pakistan Medical and Dental Council (PMDC) choosing to protect medical professionals instead of safeguarding patient welfare and safety, medical malpractice is rampant and doctors are almost completely free to do as they wish at the cost of human lives.
Being a medical professional, I have heard not one but many accounts of medical malpractice.
Here, I am penning a traumatic incident that my cousin Najeeb went through to highlight this deeply troublesome issue.
My cousin, who was born and raised in Saudi Arabia, has congenital Factor XIII deficiency. He underwent surgery for the evacuation of haematoma from his cerebrum twice in Saudi Arabia.
The doctors, despite coming to a hospital in a rush in both instances, had been communicated the initial diagnostic findings over the phone and were able to evacuate the clots, on both occasions at a local hospital in Dhahran, at only a 4-5 hours notice. Najeeb's health was restored on both occasions.
Unfortunately, after his father’s retirement, my cousin’s family moved to Pakistan, where most doctors are unaware of the Factor XIII deficiency and treat patients with the same protocol as that for other hemophiliac patients (Factor V and VIII deficient), as per common disease protocols taught at Pakistani medical and nursing schools.
Moreover, there are no laws governing the obligation of doctors to render complete medical information (about the prognosis or disease diagnosis) to their patients or attendants, even at leading hospitals (read: big business) of the country.
One day, my cousin started showing symptoms of neural shock. He was immediately rushed to a private clinic in Rawalpindi. The clinic provided first aid treatment and then referred the patient to a hospital.
On reaching the facility, Najeeb was sedated to provide symptomatic relief. He was then retained for a few hours at night, but the hospital staff did not take the initiative to treat a complicated case of spinal shock because they said they did not have the expertise.
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And so my 26 year-old cousin was then rushed to another newly built hospital. At this institution, Najeeb was further retained for over 24 hours. The consultant neurosurgeon reached the hospital after finishing off his routine work: a complete 18 hours, just in time to see the patient being shifted to a new place: a third hospital.
All this happened despite the parents' frantic calls to the hospital administration requesting not to take the case lightly.
One would expect better from the doctor, who kept committing for a continuous 12 hours that he would be arriving within 15 minutes.
At the third hospital, Dr K — a consultant neurosurgeon — immediately rushed the patient into surgery and was successfully able to remove the clot from the spinal cord.
Although Najeeb regained consciousness and recovered from the surgery, he has been unable to walk or perform normal physical actions due to sustained spinal compression of over 36 hours before the procedure was undertaken.
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This recklessness has led to the disability of a 26-year-old who was trying to settle in Pakistan and work as a management intern at Bahria Town. The parents, who are worried sick for the future of their child, seek no compensation, except the assurance that other children like Najeeb will not be treated the same.
The negligence of the doctors at the first hospital has caused the patient’s family an expense of over two million rupees in physiotherapy and other procedures, all without the satisfaction of having their child’s health restored to normal.
The point of recounting what is just one of hundreds of similar stories is to protest the glaring absence of medical audit in Pakistan. Having the patient's complete medical profile at hand is the first prerequisite to proper treatment. In Pakistan, the procedures for this are grey at best.
Not only does the lack of verified information lead to medical malpractice, but it allows the so-called medical boards of private hospitals to neatly brush aside the complaints of non-medical persons.
For patients with rare diseases, the issue of acquiring orphan drugs is another grave problem still waiting to be tackled. There are no institutional arrangements to acquire these drugs at the government or private level. For legal reasons, pharmaceutical companies are reluctant to bring orphan drugs to Pakistan.
Bear in mind that orphan drugs are so termed since they offer a very small market in a predominantly poor country and remain commercially undeveloped. Access to these drugs in Pakistan is usually linked to purchasing power, which is constitutionally and morally wrong.
Institutions like the newly made Drug Regulatory Authority must do more to bring drugs — in particular, orphan drugs — and healthcare within equitable reach of ordinary citizens.
Medicine, like education, is a subject where private interests and money-minting at the cost of patient welfare must be shunned at all costs.
The government should make a ‘Centre of Rare Diseases’ and formulate stringent laws to tackle medical negligence. We have a population of over 180 million, with thousands of rare disease patients with means for treatment equally rare and extremely expensive.
Our healthcare system is a criminally inadequate and crumbling edifice as it is. For patients of rare diseases, like Najeeb's, it can prove to be a landmine.
It is time the authorities took meaningful action.
