Hospitals costs, cloth and more political analysis
June 22, 2009
Bismillah, alhamdulillah.
It was an interesting day today. An earlier start than usual with a visit to the Agha Khan University Hospital. It sits on a large site on prime real estate in Karachi. Reputed to be the best hospital in Karachi and possibly the whole of Pakistan a walk through its courtyards and well manicured lawns only served to enhance the reputation. Patient flow seemed to be very well organised and the parking lot was full to capacity.
I was not surprised to find out the costs of health care at the Agha Khan were huge and it was not an uncommon story for people to rack up very large bills in short period of time as usually elderly relatives or parents are admitted. The relatives are then left gasping as they face bills of up to 800,000 RS to pay. Some are left with few options except to sell their houses or other major assets in an effort to raise the cash. The terrible ethics of such a situation are by no means limited to the Agha Khan hospital but are repeated time and again across the subcontinent where the unhealthy mix of medicine and money has led to the industrial exploitation of patients and worried relatives.
Central oversight is limited and the lack of good national health care options only serve to compound the situation. Coupled with an anxious and growing middle class the health sector provides any profit oriented entrepreneurs a glowing opportunity. As we settle back into our car and drive out of the Agha Khan Hospital the thought of a cap on costs especially with emergency cases crosses my mind. Perhaps the idea would work but would be unlikely to survive the interference of interested parties.
The thoughts of exploited patients recede as we drive through the dusty roads of Karachi, reminding me of a desert town. It feels we are sitting on the edge of a desert and perhaps the sands of the Rajistan desert are blowing across the Sindh plains leaving Karachi covered in a layer of dust. Later that afternoon sees us visiting a cloth shop where I learn about the different composition of cloth that is used to make the famous Pakistani men’s national dress ’shalwar khamees’. They range from 100% cotton to 50% cotton mixes with polyester or other mixed fibres and 100% polyester. I am assured 100% polyester is the warmest cloth while cotton leaves you feeling cool. An avaerage sized man requires 4 metres of cloth, while a 10 year child requires 3 to 3.5 m. Large men around 6 feet tall require 4.5 metres.
The evening ends with a dinner and listening into political analysis by concerned citizens about the situation in the frontier provinces where the Pakistan army is battling against Taliban militants. The locals in the room are convinced this is a plot of the Indians and Americans,as their army have captured men who were uncircumcised – clear proof of their non-Muslim origins. The fact that the story does not quite fit with the previous politically negotiated settlement between the government and the Taliban goes unnoticed.
Perhaps someone suggests this is a propaganda move by the government to alienate the population against the Taliban who can be painted as Indian agents. The thought is quickly dismissed as the conversation moves on to the anaylsis of their funding. One guest, a member of the Tablighi Jamat, is convinced the funding of the Taliban is coming from the USA and India, where else could they get so much money? The irony of the situation is that perhaps the same thought passes through the minds of others opposed to the Tablighi Jamat group who are frequently seen sending their members on missions all around the world as a dual exercise in self discipline and inviting others to their particular understanding of Islam. The man boasts that Nawaz Sharif himself had come with a bag of money but it was refused by the leader of the group, which only served to underline the question on their financial sources.
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