Living in a developing country with economic instability, meager health budget, incompetent and lazy public administration and scarce sense of civic duty, its not surprising to find a chaotic health system. Even though progress of a country crucially depends upon sound health of its work force, healthcare has yet to become a priority of government. Having worked in a tertiary care hospital in Lahore, I have witnessed horrible circumstances faced by patients as well as doctors but superiors are mostly interested in getting a pat on back by showing a report of “All is well” and if anyone speaks up against the shortcomings, he faces the heat of propaganda. Young doctors have specifically become an excellent scapegoat material for government to hide their lack of performance. You can find its evidence in daily news where everything wrong with health system is plastered on “ghaflat” of doctors without any in-depth research. If I map out the factors responsible for this situation, it largely comes down to miscommunication. Media never shows account of doctors so, public is unaware of their side of the story. Resultantly, its convenient for government to cover up their inability to provide basic health care. Every protest by young doctors is just another opportunity for our administration to prove its point.

Our hospitals have a plethora of problems but today I'm going to show side of the picture never revealed by media- bleak working conditions of young doctors. I have recently finished my house job- one year training doctors are supposed to do after graduation. My house job journal has only ten entries in whole year because at the end of the day I was either too tried or extremely traumatized to recollect my experiences. Considering the stressful nature of job and innate gloominess of hospitals, it’s neither unusual for junior doctors to go through this nor is it limited to house job year only. The night is long and full of terrors (or “khatmals” in this case).

On my first night in the hospital, I was on a 32-hours long call with two other female colleagues.  It was past midnight when we got done with our long task list (we had been working since 8am) and finally decided to get some sleep before a patient knocks at door with grievances. We made our bed and switched off lights. After exact thirty minutes, all three of us were up with itching all over our bodies. The only sofa that we converted into a bed was infested with bed bugs and they were in no mood of sharing their habitat with three tired doctors. Needless to say, they banished us. With no place to sit, let alone lie down, we dragged ourselves from one department to other in search of a bed to sleep. However, in one of the largest tertiary care hospitals in Lahore, we found no place for a doctor to sleep because every doctors’ office was either too small hence crowded or had no air conditioning in sweltering June. Plenty of bed bugs to mock us, though. After three hours of fruitless exercise, we came back to our floor and already it was time for morning vitals and patient notes. Also, despite such horrible night, we were supposed to look fresh so that professor doesn’t humiliate us in front of patients by lecturing on the need of a pedicure. The only conundrum was no bathroom attached to our room. We had to go two floors down if nature called.

This is just one incident reminisced by one individual entering into clinical life. Everyone has his own story to tell. My year was filled with filthy toilets, blood stained bed sheets, no pillows, bug-ridden mattresses, mice-infested rooms and too many people in small spaces. Twice a week in emergency room, I used to sleep on a single bed with four other people. It reminded me of Nazi camps that I had read about; where if one prisoner changed side, the whole room had to do same to accommodate. One night even that spot wasn’t empty so, an hour that I got free out of 24 hours shift, I spent sitting on a chair trying to take a power nap. Two of my colleagues got bitten by rodents. One of my wards had no separate room or bathroom for females and a cardboard was erected to maintain some dignity. The cherry on top was shameful ogling and harassment of female doctors by attendants and utter lack of security. Most of the times, we had to work without basic facilities like ECG machines, sufficient beds, working computers, ventilators and proper medical equipment.  The saddest part was that despite everything, we were expected to go on with our lives because hospital didn’t have enough manpower to accommodate desperate doctors whining about their strained necks instead of doing their jobs. So, with sleep-deprived bodies, we carried ourselves through days handling throngs of sick people, sometimes for 72 to 96 hours per week. Peripheral hospitals have it worse with meager facilities and  decayed buildings. So, many opt for CSS after graduation because they don't find due respect; others choose to leave this country altogether.

I understand we also have black sheep among us. Which department doesn’t have those? Doctors are humans after all and should be held accountable for their wrong-doings. But giving them such abysmal arrangements and expecting them to conjure magic on daily basis is ridiculous. If government is at all interested in formulating an efficient healthcare system, first it needs to come at peace with its providers, however, it seldom seems the case because propaganda is easier than performance.