SITTING with two of his friends in front of Balochistan Kebab House on the main Brewery Road in Wahdat Colony, a heavily populated area of Quetta, elderly Haji Abdul Zaman Zehri shares that his daughter had recently survived a pregnancy complication after undergoing surgery.

Mr Zehri hails from Norgama town situated in Zehri tehsil, Khuzdar district, and talks about how there isn’t a single gynaecologist for the women of the town he hails from, which has a population of around 5,000 people. He had travelled to Quetta to be with his daughter who was brought to the Bolan Medical Complex for surgery.

“Luckily, we brought her to Quetta. Otherwise, my daughter would have met the fate of other women in our areas and elsewhere in the province that do not have female doctors, and would have died during pregnancy,” he says, adding that it was hard to come across good gynaecologists or female doctors even in Quetta.

Living in the capital of Balochistan, one often hears people complaining about a lack of female doctors in the city. But in the rest of the province, where the tribal codes governing social relations make for a deeply conservative social structure, it is rare for women to visit male doctors for consultation and treatment. Some families don’t take women to male doctors for treatment at all.

“Recently, I took my cousin to the Kidney Centre Hospital of Quetta because she had a problem with her kidney. At the time, there were no female doctors, so we had to consult a male doctor,” recalls a man, who has requested anonymity. “He kept staring at my cousin and asked her personal questions over which I reacted. Since then, I have not taken her back there.”

It is no secret that there is scant presence of women in Balochistan’s deeply patriarchal society. Most girls get married at a young age, often even against their will, and very few women get a chance to pursue careers or personal aspirations. Despite a decent number of female students at the Bolan Medical College (BMC) of Balochistan — the only medical college of the province — there are hardly 100 gynaecologists in Quetta.

Hence the question: why is there a dearth of female doctors in Balochistan?

Naimat Gichki, a Quetta-based senior doctor who has formerly served as the principal of the BMC, agrees that there is a shortage of female doctors even in the city, and the situation for the rest of the province is more serious.

He recalls, “In the past, it is true that there were a handful of female students, because 10 per cent of all students enrolled at the BMC were female students. Gradually and slowly, their number increased.”

He feels that women should pursue medicine as a career because “compared to men, they study a lot and do not roam around”. However, he feels that it is unfortunate that most of them get married soon after completing their education and have to stay in the city so as to balance their professional and familial duties. “They do not want to be posted in rural areas of Balochistan. Because, in rural areas, the social conditions are not developed; they feel more insecure and the hospitals are also abandoned.”

He recalls from his days of being the director at the BMC that often, after barely a month of being posted in rural areas, the fathers of female doctors would come visit him and complain: “Do you only see our daughter?”

However, there are some who blame the provincial government for not being bothered about the scant number of women practising medicine.

Lack of opportunity

Quetta-based Dr Sakina points out, “There are more than 500 female doctors who are jobless. We have not been paid our stipend for the last nine months. Besides, the posts are either announced late or only a handful number of seats are allocated for females. Due to these reasons, you would barely find one female doctor for thousands of patients in Balochistan.”

In response to a question about the shortage of female doctors, Balochistan Health Minister Rehmat Saleh Baloch retorts: “You can visit any hospital in Quetta to see a large number of female doctors.” He adds that it’s not that there aren’t many female doctors but it is actually a lack of women in the specialist cadre.

He concedes that there are more than 400 vacant posts but the reason for a lack of specialist doctors is that Balochistan has only one medical college. “There are several female doctors who are [soon] graduating, specialising and are doing their MCPS and FCPS. It takes a long time period to complete this process.”

The health minister agrees there has been a lack of female doctors in the past, but insists that his government has tried its best to meet the requirement. For instance, after completing FCPS, Mr Baloch says they refer female doctors ahead as gynaecologists.

Security situation

However, Balochistan’s deteriorating law and order situation remains a hurdle. Mr Baloch concedes: “Several female doctors who, after completing their specialisation, quit their professions, go abroad, and sometimes even leave without receiving payment. I have personally traced and terminated the services of several female doctors who were living abroad and they were not performing their duties.”

The government plans on bringing more women to the profession by opening three new medical colleges for the province, he says. “Human resource is a big challenge over here, and it will take us another 10 years to fill the gap of the specialist cadre.”

Most female doctors in Quetta give three reasons why they do not want to be posted out of Quetta — security; lack of facilities from the government; and the question of their children’s education, considering the abysmal state of education facilities in Balochistan’s rural areas.

“I am looking after patients in seven districts in Balochistan. There is not a single female doctor. Nor are there any other health facilities available. That is why the maternal mortality rate is so high. Compared to midwives, female medical officers are better equipped to deliver babies,” Dr Zeenat Shahwani says.

Dr Shahwani also complains about a lack of seats in division quotas, and adds that when posts are announced through commission exams, only 20 out of 100 posts are allocated for women. The health minister disagrees and insists that the government allocates posts on an equal basis.

While many believe that female doctors quit the profession after marrying into well-to-do families, Dr Sadia Ali Baloch, who is also a women rights activist, disagrees. “I have not come across a single female doctor who has quit her profession after getting married. I am myself married and have children. Despite that I am performing my duties as a doctor.”

She recalls when she was posted to Kharan in 2014. “I went there happily to serve my own people because I hail from there. Unfortunately, I did not have access to any facilities while I was there. I had been sent there to conduct surgeries and normal deliveries but there were no facilities to conduct either of these. There was no anaesthetist, nor was I given the facility of residence or basic operators. Therefore, I refused to work there because there was no way I could perform my duties in such conditions or could I serve the people in the absence of basic medical facilities,” she recalls.

“If the government provided medical facilities in Quetta and elsewhere in the province, there is no doubt that female doctors and gynaecologists would love to perform their duties. Nor would Balochistan ever run out of female doctors.”

Published in Dawn, September 2nd, 2017