Rehan Toqeer
Though the healthcare system is not ideal anywhere in Pakistan, but the situation in its administered territory of AJK paints a very bleak picture. The health care system here has been neglected over the years by successive governments to a point where standards of health care delivery are almost non-existent here. They have never made any attempt to improve the situation and deliver affordable and quality health care to the general public. As a result, the healthcare system is in shambles here in AJK. The fragility existing across the entire health sector of AJK has been glaringly exposed by this pandemic. As the corona virus is spreading its tentacles here in AJK now, the shoddy infrastructure of existing hospitals is entirely incapable to handle the situation and is almost near to exhaustion now.
There are so many fault lines in healthcare framework that I don’t exactly know where to start. At the primary health care levels, there are some BHUs and RHCs at union council levels but their situation is extremely dreadful. They are almost non-functional because they are under-funded, under-staffed and don’t even offer basic medical services like first aid adequately.
Then come the THQs at tehsil level and 150 to 200 bedded DHQs at district level and two combined military hospitals, one in Muzaffrabad and other in Rawalakot district. All of these can be included in secondary healthcare because they lack any advanced and specialized healthcare. But what is mindboggling is that there is not a single hospital which can be loosely categorised as tertiary health care facility in the entire AJK of 4.4 million population. Mind you not even a single hospital. The existing ones don’t have enough ICUs and only six ventilators, no MRI/CT scan in any public health sector of AJK, even the very basic tests which are called baselines in medical lexicon are unavailable in public sector hospitals. Most of the people have to get them done from private laboratories. Because of these appalling conditions, almost 70 percent of the patients who present with medical emergency in ER are referred to hospitals of Rawalpindi, Islamabad and Abottabad for treatments because the emergencies here are unable to handle critical cases and their complications and this results in increased number of casualties because most of them expire on the way because of time constraints in medical emergencies.
All of this also takes a huge financial toll on the already poverty stricken population because most are low income families here and they can’t afford advanced and privatised healthcare so they take loans or invest their hard earned life-long savings for the treatment of their loved ones and end up plunging below the poverty line.
The number of healthcare workers especially doctors is abysmally low. There are only 900 doctors for the population of 4.4 million that comes out to be nearly 1 doctor for nearly 5 thousand people which is no way near to the ideal standards of WHO i.e 1 doctor for thousand people. At the same time there should be one dentist for 7500 people according to who but we are lagging far behind that indicator as well as there are less than hundred dentist working here in entire AJK.
Other plethora of issues include subpar pay and service structure vis -a-vis federal the other provinces of Pakistan, extensive working hours, almost non-existent medical officer, post graduate trainees and consultant slots, even very few consultants in subspecialties.
Now young doctors of AJK are on roads for the past two months for their legitimate demands which include, establishment of tertiary care hospitals in each division, one Neurology and a cardiology centre in AJK, increase in the number of BHUs and RHCs, increase in MO and PG slots, availability of all the tests free of cost in AJK hospitals, pay and service structure equal to federal and other provinces of Pakistan and they hold every right to do so because these demands are not for their personal benefits but for the broader community welfare overall. The government, instead of lending an ear to these demands, baton charged and arrested doctors in a most despicable and shambolic manner and used threat and violence as tools to muffle their voices. It has now become a routine that whenever doctors protest peacefully for their due rights and better working conditions in AJK, they are treated as goons by the police and government here as if it is a heinous crime.
Demanding better healthcare is not a crime but the constitutional right of the people. Every state is constitutionally bound to provide better healthcare to its citizenry. AS the pandemic has made it evident to the entire world that the health of the people should be the top priority of the countries, now is the time to put the things right and kick start some sweeping reforms in the health sector and that’s what the doctors are demanding here. So it is imperative for the government to take YDA leaders and other stakeholders on board, and instead of torturing and forcing them out of the hospitals it needs to immediately pay heed to the demands of YDA and start shifting the resources towards the health sector to keep it afloat and make it viable to cater to the needs of more than 4 million people otherwise it is going to collapse ultimately.
