Maternal and Child Healthcare experienced yet another major blow in Pakistan yesterday. A laborer’s wife in Raiwind gave birth to a child inside a bathroom after being denied medical attention at a Raiwind hospital yesterday. The lady was taken to the rural health center in Raiwind when she started experiencing labor pains. She was refused medical attention on grounds of there being limited facilities. Saying she will not be giving birth that day, the woman was told to return to the hospital the following day. She was taken home where she gave birth in a bathroom.

Image Source: Pakistan Today

This woman’s case, unfortunately, isn’t an isolated incident. Last year, in October, Sameera Bibi gave birth outside the Tehsil Headquarters Hospital. She was refused medical attention on grounds of there being no doctors available in the early hours of the day. No ambulances were available either, which is inarguably uncharacteristic of a hospital. In another case, a woman gave birth in an underpass connecting two portions of Sir Ganga Ram Hospital, Lahore. She was redirected after Lady Willingdon Hospital refused to assist her saying she did not have the neo-natal card of that particular infirmary.

And, in the most nerve wrecking incident of them all, a lady gave birth in a rickshaw outside Lahore General Hospital in November 2017. She was told to go elsewhere on account of having no neo-natal card. However, she was provided treatment after a few news channels aired the news.

Several questions arise from these incidents.

Is the life of a patient secondary to the supposed reputation of a hospital? Why was the lady only attended when the hospital was threatened with defamation? And, lastly, why are these reported incidents majorly on a rise in the province of Punjab alone? While the first two questions would warrant a moral introspection, the last one may be answered with facts. Let’s look into what the Rural Health Centre such as the one in Raiwind supposed to do?

The Punjab Health Department details the duties of a Rural Health Centre (RHC) as being able to provide care to a catchment population of 100,000 people. The center should be able to provide in-patient health care, which could potentially include expectant mothers. It is the duty of the government to ensure that the facilities at the RHC are adequate enough for all incoming patients. But of course, a statement as simple as this is something we all wish to be true.

The next logical question therefore is:

Has the Punjab government done anything to alleviate this problem?

Sameera Bibi, with her husband, on the road outside Raiwind Hospital

It has. The government increased spending on health care from Rs30 billion to Rs 54 billion-an increase of 80 % for the fiscal year 2017-18. Moreover, Rs.1.04 billion has been allocated to National Maternal, Neonatal and Child Health Programme (MNCH). Just this month, the Punjab Health Care Commission and Unicef also announced a collaboration to set up centers of excellence. These centers will implement the Minimum Service Delivery Standards (MSDS) and provide training to medics as well. So, clearly, the government isn’t completely sleeping. Steps are being taken, just not enough to fix the problem at a faster rate.

The last question to arise then is:

Are these mishandled childbirth cases part of a grave social problem related to mindset?

The answer quite possibly to this is: yes. Maternal health care like most medical facilities in Pakistan is heavily divisive based on class. While private hospitals are busy spending bucks on the flashiest of interiors, government hospitals stand basically in ruins. What makes a rich man’s life more valuable than a poor man’s? In all cases mentioned above, the hospitals in question were public ones. And, it is common knowledge that public hospitals aren’t used by the upper class. Many would deem it too risky to go to a government hospital for treatment. If one sector of society gets to pick and choose and the other has no option, then there is a social problem of epic proportions. A problem, that cannot be done away with just an increase in the healthcare budget.

If those legislating the changes have the option to fly abroad on a whim for state of the art health facilities, then the social divide will quite likely stay the same. A revolutionary change in mindset will enable change to bear fruit. Pakistan has one of the worst infant mortality rate for newborns. With the current class politics practiced in the health care system, the situation will only worsen. Turning patients away at the door for whatever reason is a disservice to the honorable profession of doctors both locally and internationally. We must demand more. We must see that the government implements it promises with stricter repercussions so no mother will have to give birth to a child in unsanitary circumstances ever again.


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