Health care for all: empty slogan

By Zubeida Mustafa

“Healthcare for all” s been proclaimed to be the focal point of the Prime Minister’s five point programme. The Government claims that by i990 every Pakistani will be provided access to health facility so that none will have to undergo needless pain and suffering should he fall ill.

No one would dispute the nobility of this goal. But given the present trends one feels sceptical whether the government will succeed in achieving its objective. The hurdles are numerous and the efforts not substantial enough.

Take the case of Mohammad Khan. His experience shows we still have a long, long way to go in providing healthcare for the rural areas. This is what he has to say:

For me, and many like me, when this goal of “health for all” is achieved it will be a red letter day. The hardships I have endured to provide a modicum of medical care for my family have been unimaginable.

I come from Srogolo, a village of about 1,500 inhabitants in the Buner district of Swat. When I go home from Karachi the bus drops me at Budal Shareef which is approximately 200 miles from Peshawar. To reach my village I have to walk for two days over steep hilly terrain, for here there are no roads and no public transport. Underdeveloped though it is and lacks in the modern amenities of life, I love my birthplace.

Yet I have lived in Karachi for the last 32 years as I have to earn a living for my family — a sick wife and eight children. I work as a driver here for an organisation and am well looked after when I fall ill. I receive a small medical allowance from my employers who also help me when I need cash to buy medicines. Doctors and hospitals are not difficult to find in Karachi — provided you have money to spend.

But I have to leave my family in Srogolo. That is how they like it. Three years ago I brought my wife to Karachi but she could not adjust to the fast pace and noisy life of a big city and had a severe nervous breakdown. Thrice she had to be hospitalised.

As soon as she was fit to travel we decided that she should return to the calm serenity of Srogolo to which she had been accustomed from childhood. Last year when I went home to visit my family I found my wife serious ill. She was again in a state of nervous collapse and semiconscious. She lay listless and would not move. In our village when illness attacks we call the local mullah. He knows the tricks of his trade — taaveez, special prayers, totkas, holy water and so on.

Exorcism

Normally I would have turned to the mullah, for in such cases as my wife’s ailment we believe that an evil spirit has struck and must be exorcised. But this time I acted differently. I had myself witnessed my wife’s miraculous recovery in Karachi after she had taken the medicines she had been prescribed.

In fact I had carefully preserved that prescription since intuitively I had felt it might be needed again. But here in Srogolo there is no doctor, no chemist, no health visitor, not even what they call a quack.

The nearest tehsil hospital is at Dagar which is two days walk over hills and mountains from my home village. I badly wanted to help my wife. Saeeda would obviously have to be carried, not being in a state to walk. So I lined up a team of 16 men, including my nephew and me. After having fastened Saeeda securely to the charpoy; which served as an improvised stretcher, we carried her for two days.

It was a strenuous task for the weather was hot and the charpoy with the patient on it had to be skilfully balanced on the steep slopes. Four of us would take turns at the charpoy. Since the men who accompanied me were my kith and kin they demanded no money for their services. But they expected to be served meals. Back home we believe in serving good food to our guests, especially when they are doing you a favour. So I had to arrange for chicken curry for every meal. Incidentally one chicken costs Rs 80 in those regions.

When we reached the hospital, I encountered a new difficulty which I had not anticipated. The doctor would not admit Saeeda in the ward. He hinted that if I paid him Rs 500 he would oblige. Who cared that this was a government hospital and health care for all is the government’s professed goal? So we bargained and we finally settled for Rs 400 — that is all I could spare then.

Saeeda was provided a bed. Now the illness had to be diagnosed and medication given. The prescription from Karachi came in handy and the doctor handed me a list of drugs which he said I would have to buy from the market. Some of them were available in Dagar. But for the injection I had to catch a bus to Mingora. I was away the whole day and the bus fare cost me Rs 32. But mercifully it was not a futile exercise. Mingora is a bigger town and I found the injection I was looking for. Saeeda was now under treatment. We had no idea how long she would have to stay in the hospital. So I sent my kinsmen back home. My nephew stayed on with me. We would take turns in the ward and ate and slept in a restaurant nearby.

After ten days, the doctor said I could take Saeeda home. She was partially recovered. But she was too weak to undertake the journey back home on foot. So I sent my nephew back to fetch our relay team.

The homeward journey was equally trying. The improvised stretcher. The heat. The steep hilly ascent. The perilous descent. But we managed. We were home, and more importantly my wife was feeling better. I was one of those fortunate ones who could afford to spend Rs 1,500 on her treatment — that is the amount it added up to when I did my calculations. But at least technically it can be said my wife was provided health care!

Source: Dawn 12 Dec 1986