Confessions of Pakistani doctors
We all grew up hearing the importance of medicine sciences and most of us were encouraged to adopt it as a profession. We were told that serving humanity, saving lives and helping people in distress is an essential component of developed societies, which is truly noble and fulfilling in their own way. In fact, doctors were considered the epitome of prestige and grace in Pakistani society, an echelon which remained unmatched by all the other significant and emerging professions.
However, the situation has changed drastically over a period of time. The plight of Pakistani doctors reverberates across the globe and remains an open question mark to our ‘political leaderships’ and law enforcing agencies. It is not just the security of these professionals which is at stake in our country but it is also the ‘wellbeing’ and ‘health’ of the nation which is impeded by not providing them with protection and justice.
New Year across the world is marked with ceremonies and resolutions, however, the last few days of 2011 were marked by the brutal deaths of various doctors in Pakistan, including police surgeon Dr. Syed Baqir Shah, who was the primary forensic investigator responsible to probe into the famous ‘Kharotabad incident’.
Slain doctors are not an uncommon sight in Pakistan and serve as a deterrent for people to work as one. Saying that the deteriorating political and security situation in the country is threatening everyone, sounds extremely clichéd but it sums up the sense of insecurity which is acting as a noose tightening around our necks, with the passage of every single day.
A young doctor who now serves at New York University Medical Centre, on being asked what brought about his move from Pakistan and Jinnah Postgraduate Medical Centre (JPMC), on the condition of anonymity, said, “When I joined JPMC, I was very excited about my work and practise because the traffic in government hospitals and constant flow of variety of patients help young professionals to learn immensely within a short span of time. I remember being called on emergency duty after a bomb exploded in a local mosque. Ambulances stacked with wounded and dead came pouring in from everywhere which was a traumatic experience in itself.
“However, one of the people representing a local political faction came in with a dead body and pointed a gun at me demanding to ‘cure’ the patient. I was in a state of shock because I knew that the ‘man in question’ was already dead. The ‘pointed gun’ and the man scared the living daylights out of me and I decided to put the ‘corpse’ on ventilator because I knew I had no other way out. From that day onwards I really did not feel thrilled to work for Pakistan or the Pakistani people.”
Another doctor who resigned from Civil Hospital and now runs a private clinic narrated his experience saying, “I left because most of the officials working as Head of the Departments are assigned their respective positions because of their ‘political affiliations’. Moreover, they feel threatened by anyone who has a command over research and is more competent, hence ‘references’ supersede ‘academics’.”
He added, “Induction and career growth through reference is a common ‘modus operandi’ in Pakistan but the reason why I resigned was specifically because of insecurity and injustice prevalent in the government sector. Patients admitted in intensive care units (ICUs) are given priority as per their respective ailments and issues. However, someone with a political background would always demand more attention and his/her ‘accompaniments’ would ‘order’ all the doctors to stand by the bed, neglecting other patients. This generally took place with the help of ‘armed men’ ready to kill the doctors on a whim.”
Death of a political or religious figure generally sparks a spate of vandalism and arson attacks, resulting in further damage to the already derelict government hospitals. Political factors, contributing toward harming doctors and obstructing justice, are depriving Pakistani society with the best of resources.
The exodus of doctors to more civilised countries is bringing about a constant decline in our ‘intellectual pool’ making health facilities more and more expensive. Furthermore, doctors leaving government hospitals for private institutions are creating a gap between the poor masses of Pakistan and appropriate health measures, a gap which is widening by the day.
Brain drain remains one of the many reasons why Pakistan has not progressed much since the time of its establishment. Lack of benefits and being underpaid are clearly not the only factors which ‘shoo’ our doctors away. Defensive mechanisms and proper protection to ensure the interests of doctors are much needed in Pakistan. Without protection brain drain would not cease to continue and will only add on more to our woes and predicaments.
The writer is a Reporter at Dawn.com
Nice post over a harsh truth.
Doctors in Pakistan are no angels……remeber Wasim Akram's wife debacle….doctors are money hungry and they are not good enough to be honest…….It has all to do with our modified culture (wasnt like that before the 80s) which supresses individualism and innovation.
As a Shia doctor whose parents sacrificed a lot for me and I was able to obtain a medical degree from a Pakistani institute. After graduation I was employed in a government hospital where I experienced neglect, discrimination and death threats not only from my fellow doctors, administrators and even my patients. I finally decided to leave Pakistan and worked in a Gulf country for 2 years before getting a temporary working visa in the United States. I found right off the bet that a Pakistani medical degree was completely useless in America because the system demanded initiative, advanced technical training, medical ethics and responsibility which were never taught in Pakistan. Unfortunately I overstayed my visa limit and was hounded by U.S Immigration to be deported to Pakistan. Knowing fully well what fate and predicaments I will face in Pakistan, I sought asylum in Canada and was accepted as an immigrant. For a while I worked as a hospital orderly in order to stay connected with medical profession, but was unable to support my wife and two children on the income I was making. I am happy to be in Canada where unlike Pakistan, I can smell freedom, security and a bright future for my children. My wife who never worked outside the house is now working in a fast food outlet and I with a medical degree from Pakistan am driving a taxi in Ottawa. Imagine a doctor driviving a taxi to make a living.
Your story seems false as not even a full professor from Pakistan (or any other country) can practice in US, unless he/she has done residency in US. And Pakistani medical degree is not useless in US, it is recognized by the ECFMG and anyone with it can give USMLE's and enter into residency programs in US.
well said! Dr. Naeem! I appreciate your bravery and spirit of supporting your children.
I think story is a bit worse in India due to caste politics, you face corruption and beuracracy in all fields, but it's really disturbing when you see incompetent people getting what they don't deserve, this is the biggest reason of brain drain and downfall of our society
Reena, you seem to be completely brainwashed. I as a sucessful doctor in India and am grateful that I get all the support and facilities I want to look after my patients in this country. Doctors by and large do quite well in India irrespective of so called caste system. Many Indian doctors who had pacticed abroad and earned fame and fortune are returning to India and opening large numbers of clinics and hospitals throughout the country. The out put of medical graduates from Indian medical colleges coninues to increase and we in fact are facing shortages of qualified specialists. To compare situations between Pakistan and India is naive and absurd. There is no comparison.
I was recently selected as medical officer through Punjab public service commission with top ten merit.
I was appointed at Jinnah hospital Lahore.But 10 days later due to political pressure , secretariat transferred us to remote areas and adjusted adhoc doctors(safarish , rishwat).when asked from secretariat they made plane reply.!yeh merit waghera kuch nahi hota ,yahan hamari marzi chalti hai! two from top ten doctors left abroad .
Is it so easy for Pakistani doctors to emigrate ? My cousin who is a doctor found that order to practice in US, you need to get state license which requires at least 3 yrs of "Accredited American Graduate medical education"(RESIDENCY) according to AMA(American Medical Education). Simple MBBS degrees are just not recognized over there.
I didn't know MBBS was simple. How do you get off calling MBBS simple ?
As a physician myself — I would like to recommend the Pakistani doctors to quit acting like Prima Donnas — your poor country spent a lot of money and scarce resources on your 5 years education and another 3 years minimum training to make a decent doctor. Spend at least 2 years giving back some of of that debt that you owe to your country and your community — by working at minimum pay in rural clinics and city ghetto areas — before considering yourself high fluting researcher or high paying bookish clinicians.
There are no rural clinics in Pakistan and no such thing as a ghetto area. We call them slums here and there are no hospitals there. Funny that you should lecture to Pakistani doctors while living comfortably in the USA!
I, totally agree with Nasah. There is a lot of money spend for the education and training of doctors. And, not all but few doctors, exhibits the kind of attitude while treating patients is horrible. These few doctors do it as if they are doing any favors to the patients. They must realize the sanctity of this noble profession.
I worked in Mayo Hospital Lahore prior to leaving for the UK (I still think I did the right thing by leaving), I saw it all: some good and great doctors, however quite a few incompetent and selfish ones, corrupt administrators, lazy staff. I had a gun pointed at my face by a dead patient's relative (even though I was not involved in the that patient's care) and on several occasions doctors would get beaten up from gangs of armed patients' relatives. We were poorly paid, worked hard (I did an average of 120 hrs a week in the surgical rotation) yet was sad to leave. I am not sad anymore
Watch this movie
"Ek Doctor ki Maut"
Its old movie staring Pankaj Kapoor. It aligns all this issues that Doctors faced 22 years back and well they still face the same issues may it be Pakistan or India.
I left Pakistan in 1992. I worked in Aga Khan University Hospital after graduating and completing my internship at Civil Hospital Karachi. My experience at both institutions was excellent. In the meantime, I had applied for the Sindh Public Service Commission and got selected as a Medical Officer. In the Sindh secretariat, when I reported for joining, I was asked for for posting of my choice at a price of their choice. I declined and wanted to be posted according to merit. It was Sindh Govt Qatar Hospital in Orangi Town, Karachi. A world of difference in standard of care, ethics of practice of medicine, working conditions and beurocracy opened on me. This was year 1991. I decided to leave Pakistan, disgusted by the state of affairs and left in 1992.
I am sure there are hundreds like me who have been victims of the system and ultimately the country suffers!
What the writer has revealed is no surprise to one who saw the same things back in 1975. At that time the unions were the new thing. They often threatened this or that action if the doctors did not do what they asked e.g. using the ambulances to transfer their union members back home. In the middle of the night, with them lurking in every hallways which doctor in his right mind would refuse their request.
I am glad that your brain wasn't drained. The man who pointed gun at your head could have made it so. Nobody can blame you for leaving such a country? Just think, isn't that a more acceptable brain drain for any sane person?
It's a big issue. But all the doctors are not the saviors, majority of them, in our country, work for money. A can bet, a candidate for the seat in a medical universty, will not go for self, unless he/she is not expecting good business from that. Money has become a very strong purpose for all the proffessionals. Whole the creed is trying to persue the wealth. If we follow the slogan,"first work, then wages" we can be able to count ourselve in developed countries.
A country spends money on educating you,when it needs you to make a difference,you leave for greener pastures to make more money.Sad,very sad,as you still owe a debt to it.You will always be a second class citizen no matter how long you live overseas,you can change your accent,your clothes and style but you can never change your skin color.
Not certain if these few lines would make any difference.
Yes, life of everyone is important but do we know also know how much this poor country has to spend to prepare a doctor? We all must be blamed for the current situation and perhaps get the credit where we have made any conscious contribution for improvement. Everyone wants security and better life – but leaving country is not the best of solutions as that may also mean our contribution to worsen the situation.
There isn't a simple answer to the question 'how to get out of the current problem' but the answers lives in optimism and resolve. Let me steal some words – Failure is not an option.
The exodus of doctors to more civilised countries is bringing about a constant decline in our ‘intellectual pool’ making health facilities more and more expensive…..
Good to admit that Pakistan is less civilised. Admission of a fault is the starting point where correction can start.
"Moreover, they feel threatened by anyone who has a command over research and is more competent…".
Its true for every profession. I once talked to one of my senior engineers at my current work place (Europe) and mentioned something exactly similar. His reply was " I would rather prefer to quit my job then to deprive you from transferring what I know and to learn from you if I don't have a command over the subject". No wonder why they have risen to professional excellence where they are.
Every where in World doctors are acoountable for their action–and medical negligence is an offence punishable in the courts except in Pakistan.I think the reason for the loss of the Massayah stastus lies with the profession aand the individual doctors –We need to put patients and profession first and money last.
Hmmmm … Yes personally i also experience say issues as a doctor in Pakistan.. I serve free of cost for 2 years in Civil hospital Karachi… While facing all treats and dangers… By the end i decide to leave Pakistan .. its not about money Its about our life
May be the land of the pure is becoming land of the purest….
Thanks for bringing this issue…
Eyes wide open, yet many can't see the folly of the system. We are proud and feel reasonably well trained before we leave Pakistan. Our training in Pakistan makes us robust and flexible to work in any system. once abroad our training makes it unfit to work in Pakistan's environment.
Similar situation prevails in Universities where highly qualified faculty members are leaving the country because of insecurity while on duty and expediency in promotion and cereer growth.
I left Pakistan more than 40 years ago. Pakisatan has made real progress in many areas. Unfortunately the doctors have changed a lot, to make money is more important than to treat the patients. I have heard some horror stories harvasting organs before the patient has died etc.
Thanks for writing this blog. I also want to point out the recent trend when a patient dies for whatever reason, the relatives start making trouble that it was due to negligence and our irresponsible TV channels start airing these news live. What follows is a that police registers a case against the hospital and physicians.
This i behavior is uncivilized. Nowhere in the world is medical negligence considered criminal offence and police is never involved.
Question remains on how to fix this in the presence of an incompetent government and incompetent governing bodies.
Not only that, those of us who wish to return are resisted. PMDC has rules which do not recognise overseas experience in full. Hence, someone who qualified in Pakistan will become a professor ahead of one who qualified abroad at the same point in time. This is irrespective of the quality of training, research and credentials.