Health care: And the nurses came running
My exposure to hospitals in Pakistan had been in the context of bringing patients within their distinctly smelly confines… If admitted, they would bring their minders plus ours to oversee events.
Last year, throughout the summer and autumn, I constantly found myself crossing their thresholds for personal reasons.
The first was quite traumatic. The year before, I had nearly copped it at my office in Peshawar. I had a very bad episode of gastroenteritis and I am not the one to panic; I left it rather long before asking someone to go for a doctor and a drip. Last year, when I caught some awful bug, I told my staff to take me to a new high-profile hospital in Hyattabad. My new assistant knew someone in the police. She volunteered to get me an ambulance as my back problem had become severe. Far better I was transported on a stretcher.
A real pukka ambulance arrived with sirens, lights and very hip paramedics. I was fascinated, as the last time I had been close to such an experience was when I was living in New York, studying to be an emergency medical technician (one grade below a paramedic) and was asked to work the graveyard shift on the ambulance.
Arriving at the new prestigious hospital, I was most impressed with the modern equipment and range of experts ready to assist.
Some doctors I knew, others by name. They were experts in their chosen fields of medicine.
The problem came when I asked for that basic of all hospital accessories. After repeated requests, a young Filipino male nurse thrust a plastic package on my bed. “Sorry,” he muttered, looking embarrassed. I was then to start on an almost impossible quest. I felt like rewriting a line from Shakespeare — ‘A Kingdom for a Bed Pan!’
When I returned the packaged bed pan to the male nurse, I asked my staff members, who were present, to get hold of someone in the administration. What amazed me was that although I was in hospital with acute symptoms of diarrhoea, every other consideration was attended to — tests, blood pressure, temperature, pulse, and even stomach x-ray — but the service I needed most appeared unavailable.
I was admitted upstairs to a small ward, empty save for one patient. A one hour ridiculous situation followed. Three very large Pakistani women, dressed in regular clothes, except for an overall over the top, advanced towards my bed, brandishing rubber gloves as they pushed a trolley in front of them. With gestures, I asked them please to leave the trolley and go. Meetings with the management ensured.
They only had 33 properly trained nurses, who were from the Philippines and Thailand. They were desperately short. The same situation prevails in other hospitals, including CMH in ‘Pindi. In Pakistan there are some fine doctors and specialists, brilliant surgeons, and, in the case of CMH, ‘Pindi, really stunning up-to-date equipment, but nursing and after care is a problem. Why should a renowned hospital like CMH in ‘Pindi be short of nurses? More than half the population is uneducated. To train as a bona fide nurse, the person must first be educated.
Another problem I have come across, constantly in Pakistan, is that not only within the confines of one hospital all doctors involved in a case do not know what the patient is suffering from, as there is no central point of reference, but on a wider scale, doctors and specialists do not know what is available for patients.
I have suffered from spondylosis for years. One year ago I had never heard of ozone therapy, a minimally invasive treatment for lumbar disk herniation that exploits the biochemical properties of a gas mixture of oxygen and ozone. Neither had I heard of having a laminectomy, a surgical procedure to remove a portion of the vertebral bone called the lamina; implants are then installed.
One is more likely to be told not to go near a surgeon’s knife, or look on the internet (so as not to be reduced to hypochondria) and both patient and doctor remain in ignorance.
Fortunately or unfortunately, I have never been the one to listen to what people tell or advise me to do. True, I did remain quiet on this issue for a long time, but extreme pain can sometimes cut through restraint. I rebelled and started fishing around. On the internet, among physiotherapists, and, finally, when I could no longer walk or stand, I called it quits. I paid a visit to a local doctor, and, as I waited for my turn, I watched as another entered in a wheel chair. I glanced away. Was that going to be my fate for the rest of my life?
Days later, I opted for a major operation. Prior to that, I had to go to a local hospital for tests.
One morning, lying on a stretcher, my driver left me carrying my mobile. Damn it! I was trapped. I could not move. I could not contact anyone. Then a nurse, or I assumed it was a nurse, (orderly) appeared. Then another, and then another came running, until I had a fair crowd around me. “What is your country?” “Where do you come from?” I glanced at their curious glances and smiles.
I told them and that I had been here for 32 years and that Pakistan was my home.
“But why are you in a government hospital? No foreigner ever comes to a government hospital!”
The die was cast. I would go to CMH, ‘Pindi, where I knew they had fantastic equipment, and an expert surgeon, so the chief medical officer, a neuro surgeon of CMH, Peshawar, told me.
Few aspects of my sojourn there are indelibly printed on my mind. First, my brilliant surgeon for his expertise and then the anaesthetist who was obviously bent on terrifying me. “You know this will not be like other operations you have had. You have this problem, that problem,” even though all my tests had pointed to my being in very good health — normal blood pressure, normal this and good this and that. The third impression, I had was also very favourable — the nurses and the orderlies, fine and dedicated women serving as nurses and orderlies, kind and competent.
One day, I was struck by the arrival of a very, very VIP, the brigadier in charge of the family ward. A woman brigadier. As I glanced at this smiling lady and clasped her outstretched hand, I had a vision of Hollywood movies. The lady was gracious and immaculately made up and attired in her army uniform. My staff told me that as she had entered the ward she had told them not to wait and to wear smart clean clothes. She also ordered chairs for them — a woman to be reckoned with.
Now, I am well on the road to recovery…