Karachi hospitals ill-prepared to deal with swine flu

Swine flu that has already taken more than 1,000 lives in neighbouring India is a serious and potential threat to Pakistan, especially Karachi, but government hospitals in the city are ill-prepared to deal with this deadly viral disease.

A visit to the emergency departments of major government hospitals in the city — Jinnah Postgraduate Medical Centre (JPMC), Civil Hospital Karachi (CHK) and Abbasi Shaheed Hospital (ASH) — showed ignorance towards safety measures while dealing with flu and fever patients.

Doctors and paramedics were seen working without protective masks, hand gloves and long aprons. There were no separate desks to screen fever and flu patients who could be potential cases of swine flu, while the overall sanitary and hygienic conditions in all these three hospitals was also appallingly poor.

When asked if these hospitals have enough stock of anti-viral drugs to treat swine flu patients, a doctor said that sometimes they did not even have medicines for headaches.

The hospitals need to follow procedures and protocols to ensure safety of patients, healthcare givers and hospital visitors. According to a healthcare website, a potential swine flu patient must be provided with a mask before entering the hospital building, so that he may not infect the hospital staff. A triage or screening exam may be done to assess whether or not the symptoms are due to swine flu. The exam might be brief involving a few questions and perhaps recording a temperature assessing for fever.

At this stage the examining nurses or doctors must wear protective masks besides the patient. If swine flu is a concern, the patient may be taken directly to an isolation room so that he or she is removed from other people in a waiting room or main treatment area.

The isolation room may have a special air flow and filters to prevent the virus from spreading through coughing or sneezing. Once the patient leaves, the room needs to be cleaned thoroughly, since the swine flu virus can live on counter-tops or other surfaces for up to two hours.

These steps seem reasonable and seemingly easy to implement for one patient. But if medical facilities become inundated with scores of patients, there needs to be a systematic approach to prevent being overwhelmed by sheer numbers. Some hospitals may set up triage tents in parking lots examining patients before they enter the building.

Those who aren’t significantly ill may be sent to home allowing only those with more critical symptoms to enter the hospital.

Since the virus spreads among people in close quarters, using large outdoor spaces that provide good ventilation goes a long way towards prevention of infection. The healthcare staff must be trained on the use of face masks and compulsive hand washing to avoid getting ill or passing the infection to others. The housekeeping and laundry crew must work overtime to keep the hospital clean and as sterile as possible.

The Sindh health department must ensure that emergency departments of all government hospitals of the province, especially the three big hospitals of Karachi, follow the protective protocols while dealing with potential swine flu and other viral patients. It should also ensure maintenance of proper drug stocks and medicines in case a large number of these cases are reported there.

It is the responsibility of the directors and medical superintendents of these hospitals to properly use their sanitary and housekeeping staff to keep their facilities clean and sterile. This will not only benefit the patients and visitors, but also the doctors and hospital staff.