Young Doctors on Strike: A letter to Syed Talat HUSSAIN

Dear Syed Talat HUSSAIN

Morality is a relative term. Being kind can be relative to other people’s behavior. Doctors going on strike looks like ridiculous. But if seen in a context, it might look a bit more than that. Let’s have a closer look.

The strike call by young doctors might look like an over-reacted even to many but the fact is that it has been brewing up for quite some time. Since nobody paid attention to it, it has resulted in an anarchic situation where doctors have gone on strike and people are suffering or dying unattended.

Following points are stated for your kind attention.

• Health system, as you noted in your discussion other day, is one of the most neglected sector in terms of financial and administrative terms, in whole of the country. On one side, it look like a department which is not funded properly. On the other side, which might not be visible to many, is that it has virtually collapsed under the rush of patients that visit the existing health care facilities daily. Literally speaking, no new health institutions have been developed in the country for decades and population goes on increasing. Result is over work in the outpatient as well as inpatient departments and poor health delivery.

• Government hospitals are out of medicine and every other thing that is needed to carry out procedures. Funds are already inadequate. Those that are given, go to corrupt administration of hospitals. Administration is corrupt, and reason behind that is that they are politically appointed. Every party has to bless their sympathizers, so they are appointed and given free hands.

• The disparity of power between a doctor working in the outdoor or emergency and a medical superintendent gravely affects the morale of young doctors. Doctor on duty has no authority to buy even a single thread or needle at the expense of government, yet he has to face the wrath of attendants and public when he runs out of even syringes. Public doesn’t know this reality and they think the on duty doctor has stolen all the stuff or has smuggled to his clinic. So they pass a verdict and carry out the sentence, then and there. Every other day we hear that a doctor was beaten by angry attendants on account of negligence. Many of the times, the negligence is on the part of administration and not the working doctor. But the administration sits in air conditioned rooms and medical officers face the public. I think you must highlight this issue, at least once in your programme that clinical doctors should be given a say in the financial affairs of the hospital and should have some authority, particularly those who are under training.

• In all standard operating procedure manuals, it is stated that no procedure will be carried out in the presence of relatives or attendants of the patients. Yet in our public sector hospitals, there is nothing of that kind which can keep away the attendants even during critical procedures. That creates situation for the doctor where he is at their risk. Indifferent to the nature of disease or injury, if the patient doesn’t survive, white collars of doctors are colored gray and face colored red with slaps.

• During all those years that I have spent in medical college as a student, house officer, medical officer and lastly as a lecturer, we have always been sharing such experiences and showing frustration at the state of affairs. For doctors, it might only be a matter of security sometime, but for public, it is a matter of life and death. But no one asks the regime about this problem. And why would they ask when doctor is so easily available for accountability.

• The lack of initiative at government’s behalf to create new institutions and jobs have forced thousands of doctors to move out of country, in search of better future, in pursuit of happiness. This has created an even worse situation for the country. But then again, who cares. An interesting point in this regard is here to come, although it might not please lots of my fraternity. To go abroad for a better job, a lot of investment is needed. Appearing in licensing exams of USA, UK and Australia is worth half to one million Pakistani Rupees. The interesting thing is that, those who have this investment to make, make it and go out. Those who can’t are left behind to do fellowship locally. As I said earlier, most of them come from poor families, and have struggled to become doctors, thinking that once they will become one, life will be easy for them and their families. This gives rise to financial strains, that a person with weaker resources is forced to stay here, on low salary and bad working conditions. This particular lot of doctors is kept so much hand to mouth that they can’t even marry during their years of training. And that takes them into thirties. Hearing from friends abroad and facing constrains from family fuels the flame of frustration, has been doing the same for many years, now the lava is out in street. Without any hesitation, I proclaim that I am a prime example of this group of unfortunate doctors.

• Doctors had an association of their own, called Pakistan Medical Association. What can you think about a possible reason for the birth of Young Doctors’ Association? Like every other institution in this country, PMA has also been non-responsive to ground realities of young doctors. Dissatisfied with the status quo, they decided to go for the action on their own.

• Morality is a relative term. Being kind can be relative to other people’s behavior. Doctors going on strike looks like ridiculous. But let me ask you one simple question. Why didn’t you call these boys in your studio the day they went on strike? Why did you call them after 35 days on closure? The reason is apathy. In our country, unless something goes to a critical level, doesn’t get enough attention. Media people kept on mocking the young medics on street and government didn’t listen to them, so they had to go to that limit of closing emergency. You invite innocent boys and grill them on your show about their mistake. Why don’t you ask the regime to listen to their demands? They can spare billions for the pay of soldiers, which are doubles over nights, and to pay to UN commission for carrying out a silly investigation but you can’t feed those whom you have hired to treat your masses? Why don’t you ask Nawaz Sharif the reason for getting treatment in UK?

• Treating the sick is not a duty of doctors, and I repeat it, it is not the duty of a doctor to treat a sick person. It is duty of the government to get them treated. Doctors are simply hired for the job. If they are hired and not paid for the same, they have every right to protest. And during that protest, if a person does on street, the responsible is he who collects the tax, and not those who are being screwed in the name of politics.

• The over smart chief minister has handled this matter really badly. And I tell you Talat, these politicians are still unaware of the trends of 21st century. Being hostile to your youth, and honestly speaking, cream of your youth, people who are thought to be noble, will play havoc with this country. Already we are on a path to anarchy. Please ask this regime to handle this matter carefully and satisfy the demands of doctors at earliest.

• I heard you asked young doctors other day that they never asked for an increase in health budget. You need to understand that they are not visionary or decision makers of the health system. They are reacting to a situation where they found no other option but to protest. Thinking about the size of health budget or putting it in the basic rights of the masses is the job of legislators, and yours too. It is not the duty of young or old doctors to do this. They have bad working condition, hostility, financial problems and psychological trauma and frustration, and you are asking them about their vision about health system. Have mercy on them and have mercy on poor people who are suffering in vain. Or let them suffer; just tell them straight away who is the responsible for all this, the tax collector.

• What a medical graduate starts earning after five years of studies, is paid to the fresh entry of medical cadets in army medical college. I don’t know whether you can feel the factors that must have led them to go to streets. And if you can, just try to feel how determined they must be to change this. They don’t have anything to lose. They were in worse conditions, and will stay in worse conditions whatever happens. The government is stupid if they think that they can refuse practice license to doctors on this account. Help them to wake up.

• I am a runaway doctor myself. All that I described is partly my own understanding of the situation, my own options and my own limitations. People must have other reasons to stay back in Pakistan too. But I stated what I thought was common amongst many. Now I am an HEC scholar, doing PhD in France. I request you to set your morality levels once again as I am preparing myself to find some innovative way to protest, once HEC is dissolved and I am out of money. Please don’t ask me to be rational when you invite me to your show. Ask the regime to be rational instead.

I am grateful if you read my letter down to these lines. For all practical purposes, you can use my email address.