That quacks are ruining the lives of the people, perhaps, is not as much scary as the fact that they are abetted by none other than the professional and qualified doctors to carry out this nefarious business. Doctors have been found at the back of many quacks, making their arrest and elimination difficult. In courts, legal documents are presented to prove that, professional doctors, and not the quacks, own the clinics. The standard practice is that doctors, leave their clinics to their untrained staff or any fake healer, to check patients and prescribe medicines, in return of a profit in the overall gain. The question is why a doctor would put a scar on his professional integrity and promote counterfeit methods of treatment? Why quackery proliferates in a developing country like Pakistan and is allowed to run afoul until the Supreme Court (SC) throws an axe on it? These are some of the pertinent questions that need to be answered, debated, and analyzed till the point that people have a sense of security that their life and limb is safe from the hands of non-professional healers.
Professional integrity is compromised in two situations. One when a person is not committed to professional duties and responsibilities. Two when the legal framework of the country is so lax that minting money at the cost of anybody’s life becomes easy. The first reason is normative in nature and depends on the character and seriousness of the person about his professional obligations. The other part of the answer is about the structural flaws in the system that provides space for the irregularities to thrive. In Pakistan, unfortunately, for decades the profession of medicine has been unregulated in the sense that no overarching regulatory body had been created to develop service delivery standards for the healthcare establishments. Misuse of authority, funds and responsibilities, all combined to reduce the public health sector into shambles. As government grew indifferent and refused to invest and brainstorm for the development of medical sciences, professionals started leaving the country. This exodus was so relentless that no sooner there was a dearth of reliable and dependable doctors. Such an environment is always responsive to malpractices. Many doctors started renting out their names, places of practice and even degrees to provide space to the quacks against a few thousand rupees.
So, in the absence of a professional environment, the promotion of counterfeit method of treatment became the easiest way to earn more money and become rich. Barring the behavior of the young doctors, their demand of service structure is absolutely in line with having a professional life that gives them a sense of hierarchy and a thoughtful career path. Repeated demands falling on deaf ears of the government resulted in a violent attitude in doctors. Not only did the young doctors ransacked hospitals during their protests they even closed down emergencies causing children women and serious patients to die without first aid. Many protest later some of the demands of the young doctors were met, but the matter of service structure has remained unaddressed to date.
A time came when the number of quacks exceeded those of professional and qualified doctors. The irony has been that the medical councils, such as, the Pakistan Medical and Dental Council, which has the mandate to regulate doctors, remained a silent spectator to the support the professional doctors have been giving to quacks. It was not until the Punjab Healthcare Commission (PHC) began taking action against quackery in 2015 that, this menace became the talk of the town, and people, along with the local administrations, were awakened to their responsibilities to keep a check on these fake doctors. The PHC faced enormous criticism, most of it from the professional doctors and their respective councils. However, the commission refused to bend and kept moving towards the complete elimination of quackery from society.
Sources privy to the health department inform that quackery has been deliberately allowed to survive in rural areas, where the government has failed to provide basic healthcare services. As such, the department had never taken a broad sweep to eliminate quackery, again until the SC handed down the verdict to the Punjab government to put its health department in order. In rural areas, where health services are either non-existent or are in bad shape, doctors often resist from serving, while medicines, medical equipment, and trained paramedic staffs are conspicuous because of their absence. To add to the misery, the local feudal, landlords, and other influential people, are more in control of these units than the local administration.
A glaring example of an inefficient public sector in rural areas came to the fore in the recent crackdown against quackery. According to the media reports, because of insufficient doctors in various districts of Punjab, especially in the rural areas, people had been found running from pillar to post for treatment. Even hospitals in Lahore, faced with a sudden influx of patients, were in difficulty because of inadequate doctors and other resources. Many people coming from far-flung areas would return undiagnosed every day.
In rural areas, not only health facilities are unsatisfactory, but also patchy. People have to travel long distances to avail treatment.
The PHC also viewed this situation with alarming concern. The concerned authorities were duly informed that if an alternative to quackery—-basic health facilities at the doorstep—- is not provided in time, the chances are that, once this drive slows down, quacks who had run away, would return, and people will have little choice but to allow these imposters to restart their nefarious businesses. This will throw down the drain all the collective efforts of the Punjab Health Department and the PHC.
In hindsight the proliferation and strengthening of the business of quackery have not been because there were more imposters in the country; it developed because there were more loopholes and lack of seriousness at the part of the medical professionals to curb corruption in their domain.
Ever since SC has assigned PHC as a lead agency in the fight against quackery, the commission has visited 9,512 outlets of quackery and had sealed 3,250. Overall, since 2015, the PHC has shut down 13,161 outlets of quackery across Punjab.
The writer is a freelance journalist based in Lahore.