Healthcare in Limbo

The Grand Health Alliance suspends health services as protesters stage a sit-in outside the Sindh Secretariat

KARACHI: The stalemate between the Sindh government and healthcare providers has worsened, with doctors and paramedics staging a protest sit-in outside the Sindh Secretariat to put pressure on the government to meet their demands, which include a health risk allowance and other benefits. Furthermore, they have been boycotting outpatient departments (OPDs) and general operating rooms (OTs) in all public health facilities, including hospitals, dispensaries, and others, for nearly a month.

Their demands include a health risk allowance, promotion, service structure, time scale, payment of a two-day deducted salary due to a flood relief donation, and the appointment of new staff members such as dental surgeons, doctors, paramedics, nurses, and others.

Health services have been stopped under the aegis of the Grand Health Alliance (GHA), which was recently formed by the Young Doctors Association (YDA), the Pakistan Medical Association (PMA), the Sindh Paramedical Staff Welfare Association (SPSWA), and the Young Nurses Association (YNA).

On November 8, hundreds of thousands of doctors, paramedics, and nurses gathered outside the Karachi Press Club to protest the Sindh government and attempted to march towards the Sindh CM House. They were intercepted by the police on their way to the CM House, where there was a scuffle between law enforcement and protesters. Over a dozen protesters were apprehended and detained, including two female nurses, but they were later released. Since then, they have held a 24-hour sit-in outside the Sindh Secretariat until the publication of this report on November 10, but despite numerous meetings with demonstrators, top health officials have been unable to persuade them.

“After a consultative meeting with all stakeholders, we have given the government an ultimatum to meet the demands by Friday at noon; otherwise, we will move towards the CM House at 3 PM [on Friday] and hold a sit-in there until the demands are met,” GHA Chairman and YDA Sindh General Secretary Dr Mehboob Ali Noonari told Bol News during a sit-in.

Distraught demonstrators were also enraged by Sindh Health Minister Dr. Azra Pechuho’s insulting remarks about protesting doctors, paramedics, and nurses.

He stated that while a couple of healthcare providers in Sukkur, Badin, and Umerkot were issued show-cause notices and some were relieved by the government, the GHA will not budge on the issues.

He added that the health risk allowance, which was abolished last month, should be denotified immediately, that a committee should be formed to address other issues, and that the GHA would give the health department’s top officers ample time to resolve the remaining issues.

“We requested that the special health secretary follow the Khyber Pakhtunkhwa (KP) healthcare system in Sindh while providing more incentives in terms of allowances and facilities, such as a significant increase in the health professional allowance and other facilities, if Madam Dr. Azra Pechuho is adamantly opposed to the restoration of the health risk allowance,” PMA Sindh President Dr. Mohammad Khan Shar said.

According to Akhlaq Ahmed Khan, president of the SPSWA, dialogues between top health officials and protesters have failed.

“There will be no compromise on the health risk allowance, as it is a difficult task for lower-level employees who are already struggling financially due to skyrocketing food inflation. The government has given some justification that there is a deadly low case of the COVID-19 pandemic; therefore, on October 14, the government abolished the health risk allowance worth Rs 35,000 for grades 17 to 20 and Rs 17,000 for grades 1 to 16. We are constantly treating patients who have serious diseases that can harm our health. The allowance must be restored as soon as possible,” he stated.

Aijaz Ali Kaleri, President of the YNA Sindh, stated that there are a number of issues that the secretaries involved could resolve, but they are hesitant so that helpless staff can grease their palms for the notifications. He also said that the service structure for nurses was approved in 2019, but it is still in abeyance, and there are no recruitment rules in place as of yet. He added that nurses have not been promoted in 20 years because a nurse is appointed on grade 14, and they will die on the same grade due to the department’s incompetence.

“A total of 614 nurses have been waiting for promotion, while 768 positions of nurses carrying grade 17 are vacant, in addition to 172 positions of grade 18, 19 positions of grade 19, and two positions of grade 20; why is the government employing delaying tactics?” he asked. In response to the health minister’s disparaging remarks about health-care providers, he stated that nursing is a sacred profession in which no nurse is sold at market, whereas parliamentarians, senators, and ministers are for sale and purchase during the country’s elections. Sindh Health Secretary Syed Zulfiqar Shah could not be reached for comment despite several attempts.

Patients Grievances

Thousands of poor and needy patients who visit hospital emergency departments on a daily basis remain disappointed and seek treatment at private hospitals and clinics, which have profited from the situation by swindling poor patients. Patients have been suffering greatly, and they have been completely deprived of consultations and medicines about their diseases in public health facilities for nearly a month due to a squabble between healthcare professionals and the Sindh health minister over the recent abolition of COVID health risk allowance. According to cabinet sources, the provincial cabinet eliminated the COVID health risk allowance due to a small number of coronavirus cases. As per the sources, the government has to spend Rs 24 billion on this allowance each year.