KARACHI: An overwhelming number of patients reporting at the emergency and outpatient departments (OPDs) along with overcrowding in wards has become a major problem at the National Institute of Child Health (NICH) in recent years, seriously hampering quality of paediatric care, it emerged on Wednesday.

A recent visit to the Sindh’s largest public sector tertiary care health facility for children revealed that the risk for hospital-acquired infections at the facility has increased manifold.

Patients’ flow at the hospital’s outpatient and emergency departments as well as other wards remained high throughout the year and the staff facing pressures from different political and government quarters was forced to treat two to three or even four to five children on a single bed.

Resultantly, sources said, the 600-bedded facility routinely admitted 1,200 patients. The mortality rate for newborns was as high as 10 to 15 per cent and five to eight per cent among children above one year, they said.

Call to upgrade other hospitals to reduce burden on 600-bed facility

The sources said the hospital had seen no major expansion in its infrastructure for two decades and faced an acute staff shortage. The hiring process for regular staff had been stalled since 2009 and the hospital’s status following the devolution was still being contested in court.

Such circumstances, the sources said, had forced the administration to seek support of non-governmental organisations to meet the human resource gap.

When contacted, NICH director Dr Nasir Saleem Saddal, also a paediatric surgeon, spoke about the multiple challenges the facility had been facing for many years. He said there was no major increase in hospital’s bed-strength though there had been a dramatic increase in the number of patients over the past one decade.

“The hospital refuses treatment to none. We explain our limitations to families and ask them to wait till a bed/s is/are vacant. It’s purely their decision to seek treatment elsewhere or wait at the NICH,” Dr Saddal said, adding that several children brought to the hospital a while back were awaiting admission.

The facility, Dr Saddal pointed out, had all relevant facilities for paediatric care and treatment and was the largest child hospital in the province with 55 ventilators and 120 incubators, a state-of-the-art main intensive care unit and five semi intensive care units.

“But these facilities are still inadequate to match the growing number of patients. We have limited space where we daily attend to around 700 to 1,000 patients in the OPD and 500 to 600 in the emergency department,” Dr Saddal said, adding that the NICH was the only hospital catering to all kinds of child emergencies and surgeries in the province.

“Many families that cannot afford costly lab tests come here to get these tests done for free,” he said. Sharing some other factors behind the overcrowding, NICH deputy director Dr Liaquat Ali Halo said the hospital’s emergency department received several patients with non-urgent health conditions.

“Using the hospital emergency for minor problems is inappropriate as it hampers the ability of physicians to give medical attention to those needing urgent care. Burden would go down to some extent here if minor illnesses are addressed at the primary healthcare level,” Dr Halo said.

Non-cooperative behaviour of attendants, who insisted on staying with their patients, also contributed to the overcrowding, he added.

Experts are of the opinion that the government should upgrade other hospitals in the province as well as in Karachi to reduce burden on the NICH and improve its quality of care.

Published in Dawn, October 6th, 2022