PMA Considers 2020 as Unfortunate Year for entire World due to Covid-19
Pak Chronicle Report
Karachi
Pakistan Medical Association (PMA) considers 2020 as unfortunate year not only for Pakistan but for the whole world due to pandemic of Covid-19, stated a press release issued by PMA Centre on Thursday.
PMA Charter of demand for health care falls on deaf ears: Pakistan went through so many political and economic problems along with increasing number of health issues which have raised the burden of diseases more. Although PMA has always offered recommendations and places a charter of demands for the government to implement to improve the healthcare system in Pakistan.
Unfortunately state of affairs shows that, the voice of PMA always falls on deaf ears.
Things go from bad to worse in health sector in 2020: Nothing has been changed in health sector during the year 2020. Instead of any improvement things have gone from bad to worse.
Death toll due to COVID-19 reaches to 1.8 million: Since the end of 2019 Pakistan and the whole world has been facing the pandemic, Covid – 19.
A novel coronavirus outbreak was first observed in Wuhan, Hubei Province, China in December 2019. The pandemic reached Pakistan in February 2020 and the first case of Covid-19 was detected on 26th February 2020. It has world widely affected, 83,178,070 human being and death toll of COVID-19 has reached 1,814,649 which is increasing day by day.
The 3rd variety of Covid-19 60% more contagious: Now along with many other countries of the world we have been facing the second wave of Covid–19. Presently the Coronavirus has mutated into the 3rd Variety which was initially detected in South Africa and has reached fifteen counties of the world. The 3rd Variety is 60% more contagious and 70% more transmissible. Now till today the tally of the total confirmed cases in Pakistan has reached to 479,715 and the death toll is 10,105.
No Action taken on PMA’s Suggestions to Control Covid-19: PMA was the first to sniff out the difficulties Pakistan is going to face due to the spread of pandemic in coming days. From the very first day when Coronavirus erupted in China and the number of death toll then just rose to six, PMA through a press release on 22-01-2020 came out with the suggestion for the government to take up some urgent steps to avoid spread of coronavirus in Pakistan.
We also suggested installing scanners at all air ports, sea ports and at all border entries to check the suspected cases of Coronavirus. We also issued preventive measures for public. Unfortunately when we asked people to use mask and sanitizer the prices of these items were increased and similarly when few medicines, oxygen cylinders and other medical devices were discussed in media for treatment their prices also reached many times higher. Then there was no proper guideline for public to reach hospitals. Many people died on their way to reach the Corona Designated hospitals. Even doctors died in the same way.
Unfortunately despite our regular warnings regarding Coronavirus nobody acted upon our advice. Even the public has never followed the preventive measures seriously and the government also seems to be failed in implementing SOPs. Now the 2nd wave is proving to be more lethal and deadlier as the virus has mutated itself and has become more transmissible and more infectious. It has been observed that people are not getting fully recovered even after being declared negative.
154 doctors lose lives in Pakistan during second wave of Covid-19: The increasing burden of disease of the second wave in the community is proving to be more fatal for doctors. Till now 154 doctors have lost their lives due to Covid –19 in Pakistan. During this second wave which started from November, 45 doctors have lost their lives (Punjab-16, Sindh-14, KPK-13, AJK-02). The situation is very alarming. The government seems to be very careless about the welfare of the families of the deceased doctors. They announced Shuhda Package for these families but never implemented it.
Polio eradication continues to be a dream in Pakistan: The Polio infection remains endemic despite over 100 rounds of vaccination being carried out in the past decade. Our Polio program has deteriorated; in 2018 polio program seemed to be on the brink of eradicating wild poliovirus transmission but unfortunately during the year 2019 as many as 117 cases were reported and in 2020 the tally of polio cases reached 83. This shows that we have not improved much. This is very unfortunate that the International Monitoring Board (IMB) had declared the Polio program and the importance of delivering polio Vaccine as “Political Football” in the country. It also observed that there is lack of political unity behind polio resurgence in the country.
Pakistan and Afghanistan only two ill-fated countries where polio still exists: PMA believes that things have not been changed and the situation remains the same. Pakistan and Afghanistan are the only two ill-fated countries in the world which have failed to eliminate polio so far.
15 million people affected with hepatitis B and C in Pakistan: Meanwhile 15 million people are affected with hepatitis B and C in Pakistan. Thousands of new patients are added every year due to lack of prevention, testing and treatment resources as well as poorly screened blood transfusion, improperly sterilized invasive medical devices and unsafe injections.
Hepatitis B and C deadlier than coronavirus in Pakistan:
Hepatitis B and C causing 325 deaths daily in Pakistan
Hepatitis B and C are several times more lethal viral diseases than the coronavirus infection and resulting in around 300 to 325 deaths daily in Pakistan, while COVID-19 is causing far fewer casualties than viral hepatitis. PMA believes main reason for the rising number of hepatitis C cases in Pakistan is the presence of a large number of quack doctors.
200 million Pakistanis in major cities don’t have access to potable water: It is neither terrorism nor natural disasters but the unavailability of safe drinking water which leads to the highest number of deaths in Pakistan. The release of untreated industrial waste, unsafe sewage system, agriculture run-off and unplanned urbanization, has downgraded water quality over the years, especially in the big cities, depriving almost two-thirds of over 200 million Pakistanis of potable water. According to the UN, consumption of contaminated water which leads to several waterborne diseases contributes to 40 percent deaths nationwide every year.
Poor water quality causing 40% of all deaths in Pakistan: It is estimated that, in Pakistan, 30% of all diseases and 40% of all deaths are due to poor water quality. Diarrhea, a waterborne disease, is reported as the leading cause of death in infants and children in Pakistan while every fifth citizen suffers from illness and disease caused by the polluted water. The outbreak of XDR-Typhoid cases in Karachi and interior Sind reached in thousands. It is a serious water-borne infection caused by the bacterium Salmonella Typhi that spreads through contaminated food and water. This is because of extensive use of antibiotics causing resistance to typhoid disease.
Pakistan having 1, 83,000 HIV/AIDS patients: The number of HIV/AIDS patients in Pakistan currently stands at 1, 83,000. The ratio of spread of HIV/AIDS cases in Pakistan is at 57 percent, similar to Philippines, which is very alarming. Out of big number of estimated positive cases only 25,000 cases are registered. This shows our poor performance. There is dire need to increase testing capacity to check HIV/AIDS patients. HIV and Hep. B and C is mostly spread through Reuse of injection syringes, unsafe blood transfusion and mishandling of hospital waste are the reasons behind spread of this disease and these reasons are unrestrained even today.
Different researches have revealed that most of the cancer cases in Pakistan (around 60%) were diagnosed in women as compared to men. The most common cancer among women is breast cancer, followed by oral and then esophageal cancer, while in men it is oral cancer. Research indicates that cancer, often a hereditary malady, is also linked to environmental factors and poor dietary habits, as in the case of oral cancer that affects those who regularly consume tobacco products, paan and betel nut and naswar . The increasing incidence of cancer in Pakistan has made it the second leading cause of death, every year, around 148,000 new cancer cases are reported in Pakistan.
Pakistan ranks first in Asia for most deaths caused by traffic accidents: Meanwhile unfortunately Pakistan ranks first in Asia for most deaths caused by traffic accidents. According to the latest WHO data published in 2018 Road Traffic Accidents Deaths in Pakistan reached 30,046 or 2.42% of total deaths.
The World Bank estimates that Pakistan’s annual burden of disease due to outdoor air pollution accounts for 22 000 premature adult deaths and 163 432 DALYS lost, while that for indoor pollution accounts for 40 million cases of acute respiratory infections and 28 000 deaths/year. This is the worst situation due to the air pollution but again no significant change has been observed. Even the Sindh High Court ordered three times to improve the polluted environment but no improvement has been made. The laws in this regard are never implemented; even you cannot see the implementation of Prohibition of No Smoking Law 2002.
Aerial firing not being stopped: PMA has been very vocal on the increasing tendency of aerial firing in our society during wedding or other celebrations. This practice is an open violation of law, which often kills innocent people. Unfortunately this bloody practice has never been stopped and these horrifying incidents take place regularly. PMA being a patient friendly organization has written letters to the present and previous Prime Ministers to take notice of the situation and ban this ugly tradition of aerial firing for any celebration to save the lives of the innocent people of Pakistan but unfortunately the practice continued in 2020.
The year 2020 will also be remembered as critical for medical education because instead of opposition of all the stakeholders Federal Government established Pakistan Medical Commission (PMC). The stakeholders never accepted it as due to its grave defect they consider it to be disastrous for medical education and health delivery system in Pakistan. Islamabad High Court dissolved PMC and also declared it illegal hence the PMDC was restored by orders of the court.
PMA has been demanding for the last many years to strengthen PMDC as a democratic, autonomous, independent and transparent body to regulate medical education in the country but unfortunately in contrast to our demand government passed PMC and Medical Tribunal Act, in haste, through joint session of the parliament on 16 September 2020 because government wants to keep this regulatory body under its control. Now PMC seems to be at mess and under bad governance. Instead of improving, the situation is continuously deteriorating and doctors and medical students are facing huge problems. Both the medical education and health delivery system is worsening.
Violence against healthcare workers in 2020: We have been raising our voice for years for the security of doctors and paramedics but our rulers never heard us. So many incidents of violence against healthcare workers took place in 2020 also.
PMA has been advocating for investing more on prevention of the diseases rather than curative side but nothing has been done and as a result the burden of diseases is increasing day by day. By just providing clean water to all the citizens of Pakistan we can prevent 60% diseases. If we eliminate mosquitoes we can prevent all mosquito born diseases which are 40% of our total burden. We are lacking virology labs in the country, there should be virology labs at least at every provincial capital of Pakistan.
According to WHO recommendations, the health budget of any country should at least be 6% of the national GDP. In our case, the health budget, despite repeated PMA pleas and reminders to the government, has remained less than 1%.
PMA believes that proper planning; political will, honesty, increase of health budget and its proper allocation and above all the consolidated preventive measure can improve the health delivery system in 2021, the press release concluded.
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