Healthcare in Pakistan, Lessons from Cuba
Mahvish Zehra June 13, 2008
#18 Posted by izuber on June 19, 2008 9:36:05 pm
Re: # 17
Director (Monitoring) Dr Shagufta Shahjahan said the department carried out tests of drinking water samples collected from different parts of the province off and on. In Lahore, she said, 25 per cent water samples were found 'unfit' for drinking in the last survey. She said the department had written to the city district government and Water and Sanitation Agency (Wasa) to chlorinate and clean the water supply lines.
This is such a serious issue that the officials should leave their desks and chairs and hand deliver such letters insisting that immediate action be taken by authorities.
It awful that people have to compromise their health due to negligence of authorities responsible for providing basic necessities.
Even the thought of this scenario is hair raising.
Director (Monitoring) Dr Shagufta Shahjahan said the department carried out tests of drinking water samples collected from different parts of the province off and on. In Lahore, she said, 25 per cent water samples were found 'unfit' for drinking in the last survey. She said the department had written to the city district government and Water and Sanitation Agency (Wasa) to chlorinate and clean the water supply lines.
This is such a serious issue that the officials should leave their desks and chairs and hand deliver such letters insisting that immediate action be taken by authorities.
It awful that people have to compromise their health due to negligence of authorities responsible for providing basic necessities.
Even the thought of this scenario is hair raising.
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#17 Posted by SR on June 19, 2008 8:03:44 pm
WARNING: GERMS and ARSENIC
Half of Lahore population has been drinking water having faecal contents, and even those living in the so-called posh areas are no exception.
According to a report of the Institute of Public Health, waste discharged from toilet bowels (faeces) has been found in about half of the drinking water samples collected from almost all parts of Lahore. The samples tested by the institute were sent to it by different agencies including the city district government during the first two weeks of the month. IPH's Epidemiologist Prof. Farkhanda Kokab says the institute had tested some 92 drinking water samples between May 1 and 15 and found faeces in 43 of them. "The presence of faeces in potable water is very dangerous and alarming. The authorities concerned must take a serious note of it and do the needful," she said and maintained that posh areas were no exception in this case. "The best solution to ensure the cleanliness of drinking water is to boil it," she suggested.
"Because of the poor quality of water being provided by the public utility, people are switching over to bottled water. The number of bottled water users is going up by the day and the number of such companies is also on the rise. The price of 1.5 litre bottle of water is Rs 30, or equivalent to one litre of milk. This price is about 70 per cent of the soft drink of the same size. Time is not far off when the water, milk and soft drinks will be available at about the same price.
Punjab Environment Protection Department (EPD) Director (Monitoring) Dr Shagufta Shahjahan said the department carried out tests of drinking water samples collected from different parts of the province off and on. In Lahore, she said, 25 per cent water samples were found 'unfit' for drinking in the last survey. She said the department had written to the city district government and Water and Sanitation Agency (Wasa) to chlorinate and clean the water supply lines.
An EPD survey shows that the defective sewerage system is one of the main reasons of water contamination. "Due to defective infrastructure, sewage mixes with the water supply lines. The survey suggests that the discharge of industrial effluents into the subsoil should be banned in order to avoid ground water contamination."
The findings above were released in June, 2008, when it was announced that there is heavy "fecal" contamination in drinking water.....
NOW its been confirmed that there is "arsenic" contamination in drinking water.....
"UNICEF Chief Provincial Officer Dr Deepak Bajracharaya & his team conducted ARSENIC and BACTERIAL surveys throughout Punjab.
Arsenic contamination is widespread throughout the province. Arsenic levels above 10 parts per billion-ppb. (A threat).
Bacterial contamination is prevalent in more than 50 per cent of cases."
WHAT'S NEXT????
These are the REAL ISSUES that are faced by real Pakistanis everyday, yet there is little awareness of these issues even amongst the educated.
There are no protests on the streets about these (and similar) issues, and no suicide bomb threats against WASA, while bogus non-issues like Danish cartoons and so-called "judges restoration" bring out mad crowds on the streets.
How much more screwed up can be our civic priorities in Phukistan...??
...SR
Half of Lahore population has been drinking water having faecal contents, and even those living in the so-called posh areas are no exception.
According to a report of the Institute of Public Health, waste discharged from toilet bowels (faeces) has been found in about half of the drinking water samples collected from almost all parts of Lahore. The samples tested by the institute were sent to it by different agencies including the city district government during the first two weeks of the month. IPH's Epidemiologist Prof. Farkhanda Kokab says the institute had tested some 92 drinking water samples between May 1 and 15 and found faeces in 43 of them. "The presence of faeces in potable water is very dangerous and alarming. The authorities concerned must take a serious note of it and do the needful," she said and maintained that posh areas were no exception in this case. "The best solution to ensure the cleanliness of drinking water is to boil it," she suggested.
"Because of the poor quality of water being provided by the public utility, people are switching over to bottled water. The number of bottled water users is going up by the day and the number of such companies is also on the rise. The price of 1.5 litre bottle of water is Rs 30, or equivalent to one litre of milk. This price is about 70 per cent of the soft drink of the same size. Time is not far off when the water, milk and soft drinks will be available at about the same price.
Punjab Environment Protection Department (EPD) Director (Monitoring) Dr Shagufta Shahjahan said the department carried out tests of drinking water samples collected from different parts of the province off and on. In Lahore, she said, 25 per cent water samples were found 'unfit' for drinking in the last survey. She said the department had written to the city district government and Water and Sanitation Agency (Wasa) to chlorinate and clean the water supply lines.
An EPD survey shows that the defective sewerage system is one of the main reasons of water contamination. "Due to defective infrastructure, sewage mixes with the water supply lines. The survey suggests that the discharge of industrial effluents into the subsoil should be banned in order to avoid ground water contamination."
The findings above were released in June, 2008, when it was announced that there is heavy "fecal" contamination in drinking water.....
NOW its been confirmed that there is "arsenic" contamination in drinking water.....
"UNICEF Chief Provincial Officer Dr Deepak Bajracharaya & his team conducted ARSENIC and BACTERIAL surveys throughout Punjab.
Arsenic contamination is widespread throughout the province. Arsenic levels above 10 parts per billion-ppb. (A threat).
Bacterial contamination is prevalent in more than 50 per cent of cases."
WHAT'S NEXT????
These are the REAL ISSUES that are faced by real Pakistanis everyday, yet there is little awareness of these issues even amongst the educated.
There are no protests on the streets about these (and similar) issues, and no suicide bomb threats against WASA, while bogus non-issues like Danish cartoons and so-called "judges restoration" bring out mad crowds on the streets.
How much more screwed up can be our civic priorities in Phukistan...??
...SR
#16 Posted by rozaiba on June 18, 2008 9:26:35 am
Lessons from the commies?
The lesson which can be learned from the Cuban commies is that free public healthcare is possible.
Copying the methods of the cuban revolutionaries would require a similar leap of faith where the Army, aristocratic elite and the All Mighty would suffer - like they did in Cuba.
The lesson which can be learned from the Cuban commies is that free public healthcare is possible.
Copying the methods of the cuban revolutionaries would require a similar leap of faith where the Army, aristocratic elite and the All Mighty would suffer - like they did in Cuba.
#15 Posted by akcheema on June 17, 2008 11:32:24 pm
Re: # 14; Mahvish,
I appreciate that but unfortunately the situation in Pakistan is more peculiar to its socio-religious atmosphere. I still can't understand how having more GPs in rural areas can disseminate that sort of information around when majority of those doctors have strong 'beliefs' in the very religio-social set up you are trying to change.
Being from a medical background I tried to do a fair bit of work (mostly on voluntary basis) in that part of the world. Quite honestly, it is a lot easier to do the same in India where one can openly discuss issues such as family planning and sex education! You try telling that to a patriarchial husband in pakistan, rural or otherwise, and the futility of having to 'justify' you helping another human being wears you down. That is the obstacle, nothing else.
Similar taboos can also be found elsewhere in the third world; unfortunately, I reckon it is much better to work on education and change attitudes than healthcare...that would be a byproduct of the society being mature enough to 'demand' eventually...not just as a "survival" instinct, but as a primary "right".
And we all know that one has to have some level of mental maturity before demanding these rights....they have to be earned (at a national level) and not simply granted.
Should you wish to discuss this further, please feel free to drop me a line....my e-mail is: akcheema@live.co.uk
Thanks
I appreciate that but unfortunately the situation in Pakistan is more peculiar to its socio-religious atmosphere. I still can't understand how having more GPs in rural areas can disseminate that sort of information around when majority of those doctors have strong 'beliefs' in the very religio-social set up you are trying to change.
Being from a medical background I tried to do a fair bit of work (mostly on voluntary basis) in that part of the world. Quite honestly, it is a lot easier to do the same in India where one can openly discuss issues such as family planning and sex education! You try telling that to a patriarchial husband in pakistan, rural or otherwise, and the futility of having to 'justify' you helping another human being wears you down. That is the obstacle, nothing else.
Similar taboos can also be found elsewhere in the third world; unfortunately, I reckon it is much better to work on education and change attitudes than healthcare...that would be a byproduct of the society being mature enough to 'demand' eventually...not just as a "survival" instinct, but as a primary "right".
And we all know that one has to have some level of mental maturity before demanding these rights....they have to be earned (at a national level) and not simply granted.
Should you wish to discuss this further, please feel free to drop me a line....my e-mail is: akcheema@live.co.uk
Thanks
#14 Posted by mzehra on June 17, 2008 11:57:52 am
Re: # 11
The majority of healthcare provided in Cuba is by general practitioners or family doctors. “the family doctor-and-nurse team, who live and work in the neighborhood they serve. Now providing care to 99.4% of the Cuban population, each is responsible for the health of 150-200 families”.
Even if these doctors are mediocre, making healthcare available to such a huge part of the population is truly an achievement.
Moreover these doctors can help with counseling of their patients and increase sex education. The potential for decreasing fertility rates with sex education in Pakistan has already been shown by the Lady Health Workers program. Due to this program total fertility rates have declined from 4.5 in 1998-99 to 3.8 in 2005-06. Family doctors can also help by increasing awareness about sex diseases, mostly importantly AIDS.
The Cuban healthcare system is not perfect; it has a lot of problems like low wages for doctors and poor facilities. But it has achieved a lot of success given the circumstances and the model can be improved upon and implemented by other third world countries to provide extensive healthcare.
The majority of healthcare provided in Cuba is by general practitioners or family doctors. “the family doctor-and-nurse team, who live and work in the neighborhood they serve. Now providing care to 99.4% of the Cuban population, each is responsible for the health of 150-200 families”.
Even if these doctors are mediocre, making healthcare available to such a huge part of the population is truly an achievement.
Moreover these doctors can help with counseling of their patients and increase sex education. The potential for decreasing fertility rates with sex education in Pakistan has already been shown by the Lady Health Workers program. Due to this program total fertility rates have declined from 4.5 in 1998-99 to 3.8 in 2005-06. Family doctors can also help by increasing awareness about sex diseases, mostly importantly AIDS.
The Cuban healthcare system is not perfect; it has a lot of problems like low wages for doctors and poor facilities. But it has achieved a lot of success given the circumstances and the model can be improved upon and implemented by other third world countries to provide extensive healthcare.
#13 Posted by mzehra on June 17, 2008 11:55:39 am
Re: # 11
The majority of healthcare provided in Cuba is by general practitioners or family doctors. “the family doctor-and-nurse team, who live and work in the neighborhood they serve. Now providing care to 99.4% of the Cuban population, each is responsible for the health of 150-200 families”.
Even if these doctors are mediocre, making healthcare available to such a huge part of the population is truly an achievement.
Moreover these doctors can help with counseling of their patients and increase sex education. The potential for decreasing fertility rates with sex education in Pakistan has already been shown by the Lady Health Workers program. Due to this program total fertility rates have declined from 4.5 in 1998-99 to 3.8 in 2005-06. Family doctors can also help by increasing awareness about sex diseases, mostly importantly AIDS.
The Cuban healthcare system is not perfect; it has a lot of problems like low wages for doctors and poor facilities. But it has achieved a lot of success given the circumstances and the model can be improved upon and implemented by other third world countries to provide extensive healthcare.
The majority of healthcare provided in Cuba is by general practitioners or family doctors. “the family doctor-and-nurse team, who live and work in the neighborhood they serve. Now providing care to 99.4% of the Cuban population, each is responsible for the health of 150-200 families”.
Even if these doctors are mediocre, making healthcare available to such a huge part of the population is truly an achievement.
Moreover these doctors can help with counseling of their patients and increase sex education. The potential for decreasing fertility rates with sex education in Pakistan has already been shown by the Lady Health Workers program. Due to this program total fertility rates have declined from 4.5 in 1998-99 to 3.8 in 2005-06. Family doctors can also help by increasing awareness about sex diseases, mostly importantly AIDS.
The Cuban healthcare system is not perfect; it has a lot of problems like low wages for doctors and poor facilities. But it has achieved a lot of success given the circumstances and the model can be improved upon and implemented by other third world countries to provide extensive healthcare.
#12 Posted by mzehra on June 17, 2008 11:54:30 am
Re: # 11
The majority of healthcare provided in Cuba is by general practitioners or family doctors. “the family doctor-and-nurse team, who live and work in the neighborhood they serve. Now providing care to 99.4% of the Cuban population, each is responsible for the health of 150-200 families”.
Even if these doctors are mediocre, making healthcare available to such a huge part of the population is truly an achievement.
Moreover these doctors can help with counseling of their patients and increase sex education. The potential for decreasing fertility rates with sex education in Pakistan has already been shown by the Lady Health Workers program. Due to this program total fertility rates have declined from 4.5 in 1998-99 to 3.8 in 2005-06. Family doctors can also help by increasing awareness about sex diseases, mostly importantly AIDS.
The Cuban healthcare system is not perfect; it has a lot of problems like low wages for doctors and poor facilities. But it has achieved a lot of success given the circumstances and the model can be improved upon and implemented by other third world countries to provide extensive healthcare.
The majority of healthcare provided in Cuba is by general practitioners or family doctors. “the family doctor-and-nurse team, who live and work in the neighborhood they serve. Now providing care to 99.4% of the Cuban population, each is responsible for the health of 150-200 families”.
Even if these doctors are mediocre, making healthcare available to such a huge part of the population is truly an achievement.
Moreover these doctors can help with counseling of their patients and increase sex education. The potential for decreasing fertility rates with sex education in Pakistan has already been shown by the Lady Health Workers program. Due to this program total fertility rates have declined from 4.5 in 1998-99 to 3.8 in 2005-06. Family doctors can also help by increasing awareness about sex diseases, mostly importantly AIDS.
The Cuban healthcare system is not perfect; it has a lot of problems like low wages for doctors and poor facilities. But it has achieved a lot of success given the circumstances and the model can be improved upon and implemented by other third world countries to provide extensive healthcare.
#11 Posted by akcheema on June 16, 2008 4:56:04 pm
Mahvish,
I haven't read the artical fully but my take on provision of healthcare in any third world country would be very different.
Cuba is a bad example; like someone said, they are hardly producing any cutting edge stuff and by just churning out more and more (mediocre) doctors, one can't say the healthcare is ideal and examplary (I say mediocre as I have had personal misfortune of working with many of them in different parts of the world).
Medicine and provision of healthcare is becoming an expensive business all over. Even state supported systems such as the NHS in the UK are stretched to the limit. In the third world, although healthcare is not universally accessable, the population growth rates are stupendously high; Pakistan is going to be the fourth most populous country in the world by 2020 (despite high infant mortality rates and poor overall healthcare provision). Given its small size, it simply is ridiculous.
Herein lies your problem. Just whitewashing the surface with patchy provision of a western healthcare system is not the answer; attitudes have to be changed at grass root levels and I don't see that happening in Pakistan anytime soon.
It is a cruel world out there and simple emotional arguments are not going to cut it I am afraid. This is no different to the imported political philosophies (secular OR religious) that we keep trying to impose on a population without actually undersatnding the psychology of that population. By simply (emotionally) working on say improving the infant mortality figures, the wholw problem is not going to improve; rather worsen to allarming degrees.
The issues are those of working on attitudes towards life overall (and what people want to get out of life) and not simply throwing more money or doctors (mediocres) at it, hoping it'd go away!
I haven't read the artical fully but my take on provision of healthcare in any third world country would be very different.
Cuba is a bad example; like someone said, they are hardly producing any cutting edge stuff and by just churning out more and more (mediocre) doctors, one can't say the healthcare is ideal and examplary (I say mediocre as I have had personal misfortune of working with many of them in different parts of the world).
Medicine and provision of healthcare is becoming an expensive business all over. Even state supported systems such as the NHS in the UK are stretched to the limit. In the third world, although healthcare is not universally accessable, the population growth rates are stupendously high; Pakistan is going to be the fourth most populous country in the world by 2020 (despite high infant mortality rates and poor overall healthcare provision). Given its small size, it simply is ridiculous.
Herein lies your problem. Just whitewashing the surface with patchy provision of a western healthcare system is not the answer; attitudes have to be changed at grass root levels and I don't see that happening in Pakistan anytime soon.
It is a cruel world out there and simple emotional arguments are not going to cut it I am afraid. This is no different to the imported political philosophies (secular OR religious) that we keep trying to impose on a population without actually undersatnding the psychology of that population. By simply (emotionally) working on say improving the infant mortality figures, the wholw problem is not going to improve; rather worsen to allarming degrees.
The issues are those of working on attitudes towards life overall (and what people want to get out of life) and not simply throwing more money or doctors (mediocres) at it, hoping it'd go away!
#10 Posted by shaider51 on June 16, 2008 7:15:45 am
Mahvish, you write a good piece. Quite a few folks have little clue about the Cuban healthcare system and its successes. The parallel you draw in terms of where countries see priorities, even in the face of adverse conditions, is what one should take from this piece. Write on...
Salman Haider Zaidi
Salman Haider Zaidi
#9 Posted by nkg on June 15, 2008 8:34:44 pm
#1 Leaden...
This is very stupid. To invest in healthcare, you need good tax collection. Furthermore, huge expenditure on military keeps the Govt. very less option on investment on healthcare and health education. Govt. need to prioratize it....
#6 ahmed...
Indian private healthcare is not very bad compared to UK or USA....
Naresh Trehan's Escorts
Devy Shetty's Narayana Hrudalaya
Manipal Hospital
Appolo Group
Hosmat Hospital
CMC Vellore
http://www.sparshhospital.com/laxmi.php
#JP....
If we could have checked population growth, the doctor to people ratio would have been quite good. Furthermore, India should have strengthen its old medical system,Ayurveda. Harmless and effective...
This is very stupid. To invest in healthcare, you need good tax collection. Furthermore, huge expenditure on military keeps the Govt. very less option on investment on healthcare and health education. Govt. need to prioratize it....
#6 ahmed...
Indian private healthcare is not very bad compared to UK or USA....
Naresh Trehan's Escorts
Devy Shetty's Narayana Hrudalaya
Manipal Hospital
Appolo Group
Hosmat Hospital
CMC Vellore
http://www.sparshhospital.com/laxmi.php
#JP....
If we could have checked population growth, the doctor to people ratio would have been quite good. Furthermore, India should have strengthen its old medical system,Ayurveda. Harmless and effective...
#8 Posted by nkg on June 15, 2008 8:34:44 pm
#1 Leaden...
This is very stupid. To invest in healthcare, you need good tax collection. Furthermore, huge expenditure on military keeps the Govt. very less option on investment on healthcare and health education. Govt. need to prioratize it....
#6 ahmed...
Indian private healthcare is not very bad compared to UK or USA....
Naresh Trehan's Escorts
Devy Shetty's Narayana Hrudalaya
Manipal Hospital
Appolo Group
Hosmat Hospital
CMC Vellore
http://www.sparshhospital.com/laxmi.php
#JP....
If we could have checked population growth, the doctor to people ratio would have been quite good. Furthermore, India should have strengthen its old medical system,Ayurveda. Harmless and effective...
This is very stupid. To invest in healthcare, you need good tax collection. Furthermore, huge expenditure on military keeps the Govt. very less option on investment on healthcare and health education. Govt. need to prioratize it....
#6 ahmed...
Indian private healthcare is not very bad compared to UK or USA....
Naresh Trehan's Escorts
Devy Shetty's Narayana Hrudalaya
Manipal Hospital
Appolo Group
Hosmat Hospital
CMC Vellore
http://www.sparshhospital.com/laxmi.php
#JP....
If we could have checked population growth, the doctor to people ratio would have been quite good. Furthermore, India should have strengthen its old medical system,Ayurveda. Harmless and effective...
#7 Posted by nkg on June 15, 2008 8:33:54 pm
#1 Leaden...
This is very stupid. To invest in healthcare, you need good tax collection. Furthermore, huge expenditure on military keeps the Govt. very less option on investment on healthcare and health education. Govt. need to prioratize it....
#6 ahmed...
Indian private healthcare is not very bad compared to UK or USA....
Naresh Trehan's Escorts
Devy Shetty's Narayana Hrudalaya
Manipal Hospital
Appolo Group
Hosmat Hospital
CMC Vellore
http://www.sparshhospital.com/laxmi.php
#JP....
If we could have checked population growth, the doctor to people ratio would have been quite good. Furthermore, India should have strengthen its old medical system,Ayurveda. Harmless and effective...
This is very stupid. To invest in healthcare, you need good tax collection. Furthermore, huge expenditure on military keeps the Govt. very less option on investment on healthcare and health education. Govt. need to prioratize it....
#6 ahmed...
Indian private healthcare is not very bad compared to UK or USA....
Naresh Trehan's Escorts
Devy Shetty's Narayana Hrudalaya
Manipal Hospital
Appolo Group
Hosmat Hospital
CMC Vellore
http://www.sparshhospital.com/laxmi.php
#JP....
If we could have checked population growth, the doctor to people ratio would have been quite good. Furthermore, India should have strengthen its old medical system,Ayurveda. Harmless and effective...
#6 Posted by ahmedmadani on June 15, 2008 6:10:16 pm
Re: # 5 write aBOUT india medican system. Not much different I guess. India and pakistan good medical treatment means no treatment. Indoa and pakistan move in tendom , nothing good is going to come out from either regarding medical treatment. Most poor people do not get any medical treatment as it is luxury to get heart transplant and buypass surgery. And they are killing people by feeding millions of tons of palm oil and killing people by heart attacks.
#5 Posted by oak on June 15, 2008 4:05:06 pm
Solid article. However, although it certainly holds weight, there are added levels of complexities. There is a half decent number of physicians in the country - after all Pakitan is a developing country. In many African countries there is a dire need - in Gambia the whole medical force is foreign trained (and mostly Cuban). The first graduates over there from the medical school have only graduated last year.
Hence to have 150,000 doctors plus registered in Pakistan is a major asset, and one which is chronically under-utilised. Doctors cluster in urban areas and ignore rural care, middle and aristocratic classes appropriate private healthcare resources leaving the poor to fend for themselves.
Another aspect of Pakistani healthcare that is very frustrating is general perceptions of healthcare within the population - patients and doctors. Doctors do not cure patients just by looking at them. In addition to a thorough medical history, examination and investigations, there needs to be relationship with the patient and team involvement. The phenomena of 'doctor shopping' where patients fail to develop a relationship with a single doctor leads to several diagnoses being missed or mismanaged. Similarly there is a lack of intergration of health services and appropriate referrals. Unbelievably there are a handful of nurses in the country - I have never understood how a nation can have more trained doctors than nurses. How can you possibly provide a service on this basis? I think it is a prestige thing - as a nation we are not concerened with actually treating our patients but in chasing the prestige of claiming that we, or our children, are 'doctors'.
Similarly, of-course the health budget at 19.2 billion Rs. is appalling. It is estimated that this covers about 10% of actual medical costs within the country. It is a good point you make, however, about Cuba having been stuck for cash but still establishing a workable system. Now Cuba has successes in medical care but also its failures. Cuban training, sheerly for technical expertise, does not compete with Western models. In the final year of medical school, having returned from electives where we have interacted with Cuban doctors around the world, I have heard many students make the same observation. Nonetheless there is no doubt that accessibility and health equality are the watchwords for Cuban healthcare, and remarkable progress has been made.
Finally, perhaps it should be remembered that a number of the merry band of Cubas revolutionaries were physicians. Maybe this was influential in Cuba's medical revolution. It seems ironic that Che Guavera, the unfulfilled Argentine medical student revolutionary, may have made his most lasting impact by inspiring the profession he left behind.
But, Ms. Zehra, looks like you have done your homework and given it some thought.
jk
oak
Hence to have 150,000 doctors plus registered in Pakistan is a major asset, and one which is chronically under-utilised. Doctors cluster in urban areas and ignore rural care, middle and aristocratic classes appropriate private healthcare resources leaving the poor to fend for themselves.
Another aspect of Pakistani healthcare that is very frustrating is general perceptions of healthcare within the population - patients and doctors. Doctors do not cure patients just by looking at them. In addition to a thorough medical history, examination and investigations, there needs to be relationship with the patient and team involvement. The phenomena of 'doctor shopping' where patients fail to develop a relationship with a single doctor leads to several diagnoses being missed or mismanaged. Similarly there is a lack of intergration of health services and appropriate referrals. Unbelievably there are a handful of nurses in the country - I have never understood how a nation can have more trained doctors than nurses. How can you possibly provide a service on this basis? I think it is a prestige thing - as a nation we are not concerened with actually treating our patients but in chasing the prestige of claiming that we, or our children, are 'doctors'.
Similarly, of-course the health budget at 19.2 billion Rs. is appalling. It is estimated that this covers about 10% of actual medical costs within the country. It is a good point you make, however, about Cuba having been stuck for cash but still establishing a workable system. Now Cuba has successes in medical care but also its failures. Cuban training, sheerly for technical expertise, does not compete with Western models. In the final year of medical school, having returned from electives where we have interacted with Cuban doctors around the world, I have heard many students make the same observation. Nonetheless there is no doubt that accessibility and health equality are the watchwords for Cuban healthcare, and remarkable progress has been made.
Finally, perhaps it should be remembered that a number of the merry band of Cubas revolutionaries were physicians. Maybe this was influential in Cuba's medical revolution. It seems ironic that Che Guavera, the unfulfilled Argentine medical student revolutionary, may have made his most lasting impact by inspiring the profession he left behind.
But, Ms. Zehra, looks like you have done your homework and given it some thought.
jk
oak
#4 Posted by Naqshbandi on June 15, 2008 11:04:55 am
ah but pakistan has not had a great man like castro as its head...
#3 Posted by Delirium on June 14, 2008 10:47:02 pm
"Cuba now has 66,600 physicians, 83,880 nurses, and 9,841 dentists. It's density of physicians per 1000 population is 5.91"
The statistics presented here bring us to a very interesting point. With close to 160,000 physicians inhabiting a percentage of nearly 0.6 % of total population, the total population of Cuba comes out to be around 27 million today. Atleast 6 times lesser than the current officially stated population of Pakistan!!! So is that the overwhelming population of Pakistan or the less number of physicians that is the root cause here?
Besides, with communist’s laws prevailing in Cuba, what are the wages of these physicians as compared to the rest of the professionals and how do they compare internationally?
The statistics presented here bring us to a very interesting point. With close to 160,000 physicians inhabiting a percentage of nearly 0.6 % of total population, the total population of Cuba comes out to be around 27 million today. Atleast 6 times lesser than the current officially stated population of Pakistan!!! So is that the overwhelming population of Pakistan or the less number of physicians that is the root cause here?
Besides, with communist’s laws prevailing in Cuba, what are the wages of these physicians as compared to the rest of the professionals and how do they compare internationally?
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