The ratio of deaths of patients needing special emergency treatment has increased over the last few years because of the pathetic state of health facilities in the government hospitals of Haripur, which is one of the biggest revenue-generating districts of Khyber Pakhtunkhwa.

Though the health department has no record of the total deaths of patients referred to other cities, sources in the health sector and private organisations providing ambulance services said that about 40 per cent of such patients, especially those referred to Abbottabad and Wah Cantonment or Islamabad with cardiac, neurological and general surgery problems, expired before reaching the next hospital.

“My 27-year-old son Shakir Ali suffered cardiac arrest a few days ago and we had to take him to a private hospital as we knew that there won’t be proper machinery, facilities and even the specialist doctor at DHQ Hospital who could take better care of him. We got him referred to Wah Cantonment Board Hospital, but he did not survive,” said Mohammad Ali, a local shopkeeper.

He lamented that the political leadership had hardly taken any concrete step for bringing about improvements in the healthcare facilities so as to save precious lives.

According to police record, over 12 road accidents were reported between September 18 and 29 in the district in which five people were killed and four injured. In all the cases, the patients were referred to Abbottabad and two of the five accidents-related deaths occurred either on way to Abbottabad or shortly after reaching Abbottabad.

“The doctors of DHQ Hospital, Haripur, refer 90 per cent of the emergency cases to Abbottabad only to save time for their private practice,” said advocate Javed Qureshi, former general secretary of High Court Bar Association.

He said that 40 per cent of the referred patients expired before reaching Abbottabad, but unfortunately people did not protest over the situation. He accused specialist doctors of the hospital of preferring private practice to their official duty, which he said should be banned.

For improving the health facilities, Mr Qureshi suggested that the families of doctors themselves, MNAs and MPAs should be bound to get medical treatment from government hospitals and the union activities of doctors and paramedics should be banned.

According to official sources, the 210-bed category ‘B’ district headquarters hospital attained the status of teaching hospital when it started offering teaching facilities to an Abbottabad-based private medical college a few years ago. The district has 60-bed each category ‘C’ hospitals in Ghazi, Khanpur and Khalabat Townshsip, while Dingi, Kot Najibullah and Serae Nehmat Khan have category ‘D’ hospitals with 40 beds each besides over 20 basic health units for its over one million population, including 504,483 females. Haripur has 870,007 rural and 133,024 urban population.

Khalabat Hospital has not been completed yet, but it is offering limited OPD services. Official sources said that there were 100 doctors, including 15 specialists, in the DHQ Hospital alone while around 50 doctors with a couple of specialists were working in the category ‘C’ and ‘D’ hospitals. However, most of the BHUs are without doctors and only medical technicians are running these hospitals. Official sources confirmed that the DHQ Hospital was facing a shortage of 40 doctors, including neurosurgeon, while all the other hospitals were in need of over 100 doctors.

Omar Farooq, a social activist, said that the DHQ Hospital had no facility of ICU and as a makeshift arrangement the administration had partitioned the CCU and placed 17 beds there. However, there is no trained staff for operating ventilators, defibrillator, ECG monitors and echo machines, while the doctors continue to refer patients to Abbottabad with impunity.

He said that half of the total six dialysis machines were out of order and the rest could not cater to the needs of growing number of kidney patients and as a result the doctors referred such patients to other cities.

A medical officer requesting anonymity said that all the specialists were local residents and despite living near the hospital they avoid attending emergencies, especially in the evening. He said that another factor was the ill-equipped ambulances as there was only one fully-equipped ambulance with the DHQ Hospital. He said that under the emergency treatment protocol the ambulance should be equipped with ventilator, oxygen cylinder and mask, defibrillator and an expert who could handle the emergency.

He said that a hospital where over 20 to 50 surgeries were carried out daily had no blood bank. He also pointed out the absence of facility of burn centre in Haripur where burns patients were frequently brought from the province’s major industrial zone of Hattar and then referred to Wah Cantonment Hospital or Islamabad.

When approached for comments, deputy medical superintendent Dr Dildar Ahmed said that DHQ Hospital received 400 to 500 emergency nature patients daily and of them only 5 to 10 per cent were referred to other cities for tertiary care. He said that as DHQ Hospital had no neurosurgeon the cases of head injury and some of heart patients were referred to Abbottabad.

“We refer only the patients with neuro or cardiac problem who need some procedure like operation and angiography to be conducted at tertiary level,” he said.

Medical superintendent Dr Saifullh Khalid said that 2,800 to 3,000 patients visited OPD of the DHQ Hospital daily, which included 400 to 500 emergency cases. He said that of these emergency cases one to two per cent of the patients who needed tertiary care were referred to Abbottabad. He said that as other hospitals in the district were not properly staffed patients turned to the DHQ hospital.

Answering a question, he said that the building of 40-bed trauma centre had been completed, which would be made functional this month after arrival of Rs25 million imported machinery. He said that with the start of trauma centre about 80 per cent of referrals would stop and only 20 per cent of the patients would be referred till the day when the government would post a neurosurgeon here.

Meanwhile, Hattar Industrialists Association president Malik Ashiq Awan told this correspondent that he knew a couple of philanthropists who had offered to run the DHQ Hospital and trauma centre with their own expenses on charity basis if the provincial government entered into a contract with them. He urged the provincial government to avail of the opportunity.

Answering a question, he said that industrialists in Haripur alone contributed Rs80 billion annually to the national and provincial exchequer in the shape of taxes.

Published in Dawn, December 9th, 2018