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Economic pressures challenge Pakistan’s healthcare

By Updated:9 Mins Read
Economic pressures challenge Pakistan's healthcare
  • Collaborative efforts, community support, and targeted reforms can help build more resilient system in the country
  • LRBT offers accessible, high-quality eye care through free or subsidised services, charitable funding and efficient operations

Interview with Dr. Malik Ahmed Saeed (Lt Col Retd) — Administrative Superintendent, LRBT Hospital Korangi, Karachi

PAGE: Tell me something about yourself, please:

Dr. Malik Ahmed Saeed:

I’m proud to be both an Iqbalian and a Ravian, having attended the esteemed Government College, Lahore (now University), founded in 1864. I earned my MBBS from the Prestigious King Edward Medical University, Lahore, the oldest college in Pakistan(1860) and sixth oldest Medical School in South Asia.

My journey then led me to serve in the Army Medical Corps for 21 years, where I had the honour of working in diverse environments, including Siachen and the Northern Areas.

My experiences extended to the Pakistan Air Force and Navy, where I served on ships and even submarines. A highlight was performing medical duties for the Haj Medical Mission in 1993 and later serving as a Flight Surgeon in Riyadh KSA. After taking early retirement as a Lt Col in 2004, I continued my passion for medicine in the private sector.

My civil service journey includes 13 years of work with Charity Hospitals, starting with the renovation and running of Karwan-e-Hayat Psychiatric Hospital in 2004. I then became the Medical Superintendent at Ziauddin University Hospital for four years, and for the past eight years, I’ve been with LRBT as the Administrative Superintendent Korangi Hospital.

At LRBT, we strive to prevent blindness, providing free eye-care to those in need, saving the sight of millions. My time as Chief Medical Officer at K-Electric for five years (prior to joining LRBT) also enriched my career. Each step of my journey has been driven by a deep commitment to serving others and making a difference in their lives. May Allah accept my humble contributions. Ameen.

PAGE: What is your take on the quality of medical facilities at LRBT?

Dr. Malik Ahmed Saeed: At LRBT, we are deeply committed to providing exceptional eye care services across Pakistan.

Here’s what sets us apart:
  1. Specialisation in eye care: LRBT’s focus is on delivering comprehensive services for eye conditions like cataracts and glaucoma. This specialization allows us to offer top-notch treatment.
  1. Accessibility: With 20 hospitals and 54 clinics nationwide, LRBT ensures that even the most underserved communities can access quality eye care.
  1. Qualified staff: LRBT’s team comprises highly skilled ophthalmologists and medical professionals. We prioritize continuous training to keep our staff at the forefront of medical advancements.
  1. State-of-the-art equipment: LRBT has invested in cutting-edge technology to provide the latest and most effective treatments to our patients.
  1. Affordability: As a charitable trust, LRBT offers free or highly subsidized services, ensuring that no one is denied medical care due to financial constraints.
  1. Community outreach: LRBT’s outreach programs educate communities about eye health and help identify those needing treatment, allowing for early intervention.
  1. High patient volume: Managing a large number of patients annually showcases LRBT’s capability to deliver extensive and efficient care. During the last 38 years LRBT has treated 56 million patients and done 5.5 million operations.

The quality of care at LRBT is something I am immensely proud of, as we continue to uphold our mission of making high-quality eye care accessible to all.

PAGE: Healthcare has become too expensive. What is your standpoint with regard to LRBT?

Dr. Malik Ahmed Saeed: In a world where healthcare costs are soaring, LRBT stands out as a beacon of hope by offering accessible, high-quality eye care at little or no cost.

Here’s how we tackle the challenge:
  1. Free and Subsidised Services: LRBT’s mission is to ensure that everyone, regardless of financial status, can access essential eye care. We provide treatments either for free or at a minimal cost(affording patients).
  1. Charitable Funding: LRBT relies heavily on donations and charitable contributions. This model allows us to offer services at a fraction of the cost compared to private healthcare providers
  1. Efficiency and High Volume: With numerous clinics and hospitals across Pakistan, LRBT benefits from economies of scale. This enables us to handle a large number of patients efficiently, keeping costs down without sacrificing quality.
  1. Focus on Preventive Care: LRBT’s outreach programs stress the importance of prevention, helping reduce long-term healthcare costs by catching eye issues early before they become severe.
  1. Training and Development: By investing in our staff’s continuous training, LRBT maintains high standards of care, reducing the need for costly repeat treatments.
  1. Sustainable Practices: LRBT’s efficient use of resources and implementation of sustainable practices contribute to maintaining low operational costs while delivering high-quality services.

LRBT’s approach exemplifies how healthcare can be made affordable and accessible, overcoming financial barriers that often deter people from seeking necessary medical attention. Our focus on specialised care, efficient resource utilisation, and charitable support makes us a model for mitigating the high costs of healthcare. Through combined hard work and dedication, we continue to improve and expand our services, ensuring that every individual receives the care they deserve.

PAGE: How will you rate Pakistan in healthcare globally?

Dr. Malik Ahmed Saeed: Evaluating Pakistan’s healthcare on a global scale involves looking at several key factors. Here’s my perspective:

Strengths

  1. Commitment to public health: Pakistan has made progress with initiatives like the Expanded Programme on Immunization(EPI) and efforts to eradicate polio.
  1. Private sector contribution: The private healthcare sector provides quality services with advanced facilities and highly skilled professionals.
  1. Specialised institutions: Facilities like LRBT for eye care and other such institutions/hospitals, offer excellent healthcare and training.
  1. Medical education: We have reputable medical colleges producing a large number of healthcare professionals.
Challenges
  1. Healthcare accessibility: A significant portion of the population, especially in rural areas, lack basic services, creating disparities between urban and rural healthcare.
  1. Healthcare financing: A significant portion of expenses is out-of-pocket, which is burdensome for families, and public spending is low.
  1. Infrastructure: Public hospitals often face underfunding, overcrowding, and lack of resources.
  1. Health outcomes: Issues like high maternal and infant mortality rates, malnutrition, and infectious diseases are prevalent.
  1. Chronic diseases: There’s a rising burden of non-communicable diseases needing more attention and resources.
Comparative global perspective:
  1. Developed countries: Compared to robust systems in Western Europe and North America, Pakistan faces gaps in quality, accessibility, and funding.
  1. Developing countries: Among developing countries, Pakistan’s healthcare system shows some strengths in specific areas, such as specialised care and private sector contribution, but also shares common challenges like inadequate public healthcare funding and infrastructure.
  1. Regional context: In the South Asian region, Pakistan’s healthcare system is comparable to its neighbours like India and Bangladesh, with similar challenges and progress. However, countries like Sri Lanka often perform better on health indicators due to more effective public health policies.

Rating

Given the strengths and challenges, Pakistan’s healthcare system might be rated as “developing” with notable areas of excellence in specialised care. However, improvements in accessibility, infrastructure, and health outcomes are essential to enhance our global standing

Overall, while Pakistan has pockets of high-quality healthcare services and institutions, the system as a whole faces substantial challenges that need to be addressed to improve its global healthcare ranking.

PAGE: Every citizen is under compulsions to cut corners. Has it taken its toll on health sector?

Dr. Malik Ahmed Saeed: Yes, the compulsion to cut corners due to economic pressures and prevalent inflation has indeed taken a toll on the health sector in Pakistan. Here are some ways in which this manifests:

Impact on Individuals:
  1. Delayed medical care: Many delay seeking treatment due to costs, worsening conditions and making them more expensive to treat later.
  1. Self-medication: People often resort to self-medication, which can be ineffective or harmful.
  1. Poor nutrition: Inflation affects food prices, leading to compromised nutrition, impacting health, especially for children and the elderly.
Impact on healthcare providers:
  1. Underfunded public hospitals: Public healthcare facilities, already underfunded, face further strain, as budgets are stretched thin. This results in inadequate supplies, outdated equipment, and overworked staff.
  1. Quality of care: Financial constraints can lead to compromises in the quality of care provided. Hospitals might cut costs by using cheaper, lower-quality medical supplies or by reducing staff numbers.
  1. Staff morale and retention: Economic pressures can affect healthcare workers’ morale and job satisfaction, leading to burnout and higher turnover rates. This impacts the continuity and quality of care.
Impact on the healthcare system:
  1. Rising healthcare costs: Inflation drives up the cost of medical supplies, pharmaceuticals, and operational costs for healthcare facilities. This leads to higher charges for patients, further limiting access to care.
  1. Private sector challenges: While the private sector often fills gaps in the public system, it is also affected by inflation, which can result in higher fees for services, making them less accessible to the average citizen.
  1. Increased burden on charitable organisations: Organisations like LRBT face increased demand as more people turn to free or subsidised services. However, they too must contend with rising operational costs, which can limit their capacity to serve the community.
Broader societal impact
  1. Widening health disparities: Economic pressures exacerbate health disparities, as those with fewer resources have even less access to quality healthcare. This can lead to a cycle of poverty and poor health.
  1. Public health risks: Compromised individual health due to economic constraints can lead to broader public health issues, such as the spread of infectious diseases, which can strain the entire healthcare system.
Coping mechanisms and solutions:
  1. Government interventions: Increased public healthcare funding, subsidies for essential medicines, and policies aimed at controlling inflation can help mitigate these effects.
  1. Community support: Community health programmes and NGOs can provide critical support, education, and services to those most affected by economic pressures.
  1. Healthcare reforms: Long-term reforms focused on improving healthcare infrastructure, increasing efficiency, and ensuring universal access to healthcare are essential for building resilience against economic pressures.

In conclusion, while economic pressures and inflation have challenged Pakistan’s health sector, there is hope for improvement. Through collaborative efforts involving government interventions, community support, and targeted healthcare reforms, we can build a more resilient system. By addressing these challenges proactively, we have the opportunity to create a healthcare environment that ensures accessible and quality care for all citizens, paving the way for a healthier future.