On killer YDA strikes

When healers become selfish

Four in Faisalabad’s Allied Hospital and two in Jinnah and Service hospitals of Lahore, with the total number of patients who lost their lives on being denied treatment in Lahore reportedly rising to 12 by Wednesday, is a barometer that can be used to gauge the sensitivity of doctors nowadays.

The historical notions of protests and demonstrations date back to indefinite period of time, but what has remained definite throughout history is the spectrum of forms it acquires. Ranging from individual statements to mass demonstrations, protestors have been organising themselves in various forms in an attempt to make their opinions heard and influence a government policy or public opinion. They are supposed to be non-violent and peaceful for achieving a particular objective by building up pressure as a tool of persuasion. These various forms of self-expression can hike up to any magnitude but should ideally be retained to a level that does not directly harm any other being. Yes, strike actions and walkouts are all about work stoppage caused by the mass refusal of employees to work and, in case of the latter, them leaving the workplace collectively. But what should be done when the workplace is a hospital and the work, treating patients?

Similar trouble has been frequently surfacing from time to time in the form of strikes organised by Young Doctors Associations that are functional and operating across Pakistan. Our young doctors going on a strike is synonymous to shutting down emergency wards, operation theatres (OTs) and outpatient departments (OPDs) of public sector hospitals. However, another phenomenon has emerged recently and that is of becoming totally indifferent and ignorant of the agonies suffered by patients who come to these government hospitals from far-off areas and with limited resources.

Four in Faisalabad’s Allied Hospital and two in Jinnah and Service hospitals of Lahore, with the total number of patients who lost their lives on being denied treatment in Lahore reportedly rising to 12 byWednesday, is a barometer that can be used to gauge the sensitivity of doctors nowadays.

Dr Khurram Niazi, a graduate of a medical college from the 80’s, expressed his opinion on the current scenario by saying, “We, too, had been involved in strikes on certain issues during late ‘80s and early ‘90s, but we never stopped attending patients. Maximum we had been doing was putting hand-made posters on the walls of hospitals, tying black ribbon on our arms, and raising slogans for a short time. But we never ceased to perform our duty”.

Dr Syed Shahmeer Raza from Khyber Pakhtunkhwa, regardless of being not directly associated with the currently prevalent issue in Punjab, justifies this nature of strikes on being asked for his opinion. “The types of problems young doctors are facing in Khyber Pakhtunkhwa, such as the abolition of Post Graduate Medical Institute (PGMI), are putting their careers at stake. The doctors on strike are mostly trainee medical officers (TMOs) and you usually do not find specialists/consultants or medical officers among them”, he professed.

Dr Raza also shed light on why it is so, “It’s because it is the young doctors who are going to be affected the most. It is our right to protest for our genuine demands and it is the responsibility of the government to sit with us and sort the things out in the best interest of patients and doctors”.

Whether interests of the medical fraternity should be kept a priority or saving the lives of patients that are already in a miserable condition is an unremitting debate because both sides have several points to vindicate.

“When doctors take Hippocratic Oath at the time of receiving degrees”, expounded Dr Niazi, “they promise that their top priority will always be their patients. The immoral attitude being demonstrated by young doctors is way below the conduct of even a simple human being, irrespective of demands of young doctors whatsoever. But one thing is for sure that after having refused to attend patients in a public sector hospital’s emergency ward they do not deserve to be called doctors”.

Dr Raza, on the other hand, insists on listening to the concerns of young doctors before reaching any conclusion. “Attacking doctors is equivalent to attacking the whole doctor community and I strongly condemn that. Nobody forces doctors to get out of the OT and emergency services are provided to the patients”.

Regretfully, this was not the case in Punjab. Not only were OPDs completely shut in public sector hospitals of Multan, Faisalabad, Lahore and Rahim Yar Khan during the latest strike, like every single time, doctors refused to attend patients in wards and OTs. Several operations were postponed due to the absence of medics.

A similar strike in November 2016 claimed a two-year-old girl’s life as she was denied treatment that resulted in her succumbing to her burn wounds in Paediatric Surgery Ward of Mayo Hospital, Lahore.

The young doctors of Punjab took to roads this time to demand removal of the provincial health secretary, Najam Ahmad Shah, because of the Central Induction Policy (CIP) introduced by him. Put into effect back in 2016, the CIP for postgraduate training aimed at ensuring fair distribution of postgraduate trainees in specialisation programmes while fulfilling specialists’ requirements in neglected specialities as per requirements of the prevalent health system.

“It was a modus operandi of an organised group within hospitals to get their candidates inducted in postgraduate programmes over and above the available seats without pay and then, after a few months, start raising the issue of unpaid postgraduates, holding protests and strikes in hospitals to make the health system hostage to their whims”, Shah had said while introducing the merit-based online centralised admission system.

“My condition is not good. I cannot lie down or sit properly. I am having problem in breathing and coughing because of the piercing pain I am experiencing in my neck. I have not been checked by any specialist doctor since morning. My son has gone to arrange some money for our return but we don’t know where to go for treatment”, said Rab Nawaz, an elderly man sitting outside a renowned public sector hospital in Lahore on Thursday

YDA leaders, however, have repeatedly asked the government to withdraw the CIP, saying that the policy was full of loopholes and required modifications to serve the best interest of the students willing to appear for post-graduation as majority of the doctors have graduated from private medical colleges. They also demand the dismissal of the health secretary on the basis of him being an engineer and, purportedly, being “unable to understand the issues of the health department”.

Let me ask two simple questions being a non-doctor and a prospective patient. What harm would it do to innocent patients if they are given treatment in a government hospital with the health secretary being an engineer or under the influence of the CIP? And what good could it bring to these helpless patients if they are denied treatment with the health secretary being a doctor and in the absence of the CIP?

This is exactly how bureaucracy operates. One’s degrees are relevant until one clear the exams and interview of Central Superior Services after which one is allocated to a suitable department where one is expected to serve with utmost utilisation of calibre after having received relevant training. Thus the stance of any bureaucrat not having his degree matched with the department he is serving in cannot stand in the house. Were the doctors absolutely not going to strikes at all when the health secretary was a doctor by qualification?

And this is exactly not how doctors should ignore the patients who come from remote areas of the province in hope of being provided medical aid. They would have never rushed to urban cities had basic health-care facilities been present in their areas. Furthermore, their financial conditions and resources with which they manage to travel and pay expenses of treatment are worse than the salaries and lucrative packages young doctors are deploring about not being offered. Yes, their demands should be addressed and only the valid ones should be met with, but the foremost expectation of the white coat they get to wear is to put patients first. Is this the day for which parents invested millions in their children’s education so that they could become doctors after attending a private medical college and protest for all of their demands to be met as soon as they are mouthed? Is this what our private medical colleges are instilling in worthy young doctors, the reformed values of putting self-interests before that of needy and incapacitated patients?

“My condition is not good. I cannot lie down or sit properly. I am having problem in breathing and coughing because of the piercing pain I am experiencing in my neck. I have not been checked by any specialist doctor since morning. My son has gone to arrange some money for our return but we don’t know where to go for treatment”, said Rab Nawaz, an elderly man sitting outside a renowned public sector hospital in Lahore on Thursday.

There certainly are plenty of other ways through which disapproval of the prevalent system can be manifested, refusing to take the pay and not doing more than the minimum required (shortening the duty hours by taking registrars into confidence, to illustrate) being two of the many options. The only question is: Should patients be denied treatment for personal or fraternal stakes? We just need to open our eyes and realise the worth of every single human’s life. The answer lies within the question.