The public healthcare system in Pakistan is premised on the principle of ‘universal healthcare’. It means that any citizen of this country will be treated almost free of cost at hospitals run by the government. In theory, this system is better than the ones in place in countries like United Kingdom or United States. In practice, however, the system is rotten to its core, from tertiary care hospitals in major cities to Basic Health Units in villages. Having spent almost a decade in the profession, very few things actually surprise me about the poor state of our health sector. The recent news story about a ‘Fake Neurosurgeon’ working for nine months at a major hospital in Lahore initially shocked me. It was unfathomable even by Pakistani standards. However, the devil as they say, was buried in the details. In reality, the person accused of being a ‘Fake Neurosurgeon’ was nothing more than an intern, doing House Job at the hospital. Her degrees were proved to be ‘bogus’ and she had landed the position only because of some ‘string-pulling’ by the Young Doctors Association (YDA). The news report mentioned that she ‘operated upon many patients’.
I believe that the story misrepresented facts just for the sake of a sensational headline. Having worked in the same hospital for a year, I can confirm that interns are not independently ‘operating’ upon any neurosurgery patients. During my time at the hospital, only those of my friends chose Neurosurgery rotations who wanted some spare time to study, since internees at the department are not burdened with too much work as opposed to other departments. I don’t recall any of my friends even assisting a surgery while they were at the department. The maximum that an internee in surgery can do is to hold retractors during procedures and one doesn’t require a medical degree to be able to hold a retractor. The person in question, an impostor, worked in General Surgery ward for three months before her Neurosurgery rotation. She didn’t become a ‘General Surgeon’ just by virtue of spending three months at the wards and she didn’t become a ‘Neurosurgeon’ either. It takes almost seven to eight years after graduation to specialise in Neurosurgery, which is considered one of the hardest specialties in the world. As Pakistan’s unofficial ‘newspaper of record’, Dawn should have exercised some ‘editorial discretion’ before publishing the story.
Instead of outraging about a ‘fake’ doctor, there are serious structural issues that underlie this story. The first one pertains to reporting on health issues. In my opinion, reporting on healthcare in Pakistan is almost as atrocious as the sector itself. Reporters have little information about the dynamics of the profession and they end up relying on ‘sound bites’ and clichés. It is for this very reason that many doctors don’t trust the media at all. Stories like this erode the already-waning trust that the public has in doctors. I would expect a clarification and an apology from the newspaper about this misleading story.
The issue of ‘fake degrees’ has been going on for a while. A federal minister had to leave the cabinet because of a fake degree, a ‘diploma-mill’ was exposed last year by an international news organisation and the Higher Education Commission spent a long time verifying degrees of our lawmakers. I don’t believe that public hospitals are equipped with any mechanism to independently verify degrees of medical graduates so this person could have easily slipped through the cracks. However, members of the YDA played a negative role in facilitating the impostor. In light of this event, a centralised degree-verification program should be instituted to avoid similar mishaps in future.
As a young medical student, I was fascinated by the brain and dreamt of becoming a Neurosurgeon one day. With time however, I realised that Neurosurgery in Pakistan is hampered by lack of basic facilities in most centres. A critical requirement for Neurosurgery patients is the availability of an ‘artificial ventilator’ after the operation. Till two years ago, there were less than 200 functioning ventilators in the city of Lahore, with a population of 12 million people. Despite these circumstances, there are Neurosurgeons working in various hospitals and their work is no less than heroic. The Punjab Assembly should perhaps debate the budget allocated to health and how much of it actually reaches the hospitals?