Features
WHY ARE DOCTORS LOSING THEIR RESPECT?
SOUTH ASIA
By Dr Shershah Syed
(Illustration by Samiah Bilal)
Doctors and patients have a life-long relationship. People need doctors when they become sick. Doctors treat them till they get better or they die, depending on the severity of the illness, complications of their ailment, or in the case of failure of treatment and intervention. In the majority of cases, patients and their families are always thankful to doctors and their medical teams.
The medical profession enjoys this unique relationship where you get paid for services and at the same time are treated like a god or goddess. After treatment, patients often like to have a long-term relationship with doctors and expect that their doctor would join them on their happy or tragic occasions. Hence, doctors and family physicians, in particular, enjoy a special and respectable status in the community. I know many doctors whose names are very popular in the community and many of their patients have named their children after these doctors.
Despite the need and necessity of doctors in the community, there have been some situations where the general public has been not too pleased with those in the medical profession, particularly doctors. These are situations when we come across news of doctors being verbally abused, becoming victims of violence, and their clinics being attacked and doctors even being tortured and killed by patients or patients’ families.
Unfortunately, during the current Covid-19 crisis, this type of situation seems to be getting worse. Patients and the public seem to have lost their traditional confidence and trust in doctors. Rumours are rife that doctors are killing patients, wrongly diagnosing Covid-19 and even selling human organs to make money.
However, this kind of a situation doesn’t happen overnight. Doctors have lost their respect and status in the community because of their own actions and deeds. They have chosen to and worked hard to destroy the respect of their profession, and their esteem, in the hearts and mind of people.
With a rise in the number of reported incidences of medical practitioners being abused and physically attacked by patients and their families, it is time for, doctors to look inward.
It happened gradually and steadily when doctors became more interested in wealth, power and fame. To achieve these goals, they compromised their professional duties, and, perhaps, did not act with sympathy and empathy when it was required of them to do so.
Some doctors became involved in taking commissions, a practice in which a doctor expects a commission after referring a patient to a surgeon or physician. There are surgeons and physicians who charge hefty fees from patients in a country where almost 50 percent of the people are living below the poverty line. Doctors also demand commission from medical stores, pathology laboratories and diagnostic centres, particularly those with CT scan and MRI facilities. That doctors stoop that low to make money is neither acceptable nor permissible.
The moral and ethical integrity of physicians has deteriorated in the last few decades. In medical colleges, professor, who work as part-time faculty, hardly have time to teach and train medical students as they are extremely busy in their private practice. Among their patients and paramedics in hospitals, they are known as butchers — for extorting high medical fees for consultations and surgeries.
We are producing technician-dependent surgeons and physicians who are guided by pharmaceutical-industry representatives who are partners in medical crime. There are enough examples of physicians who prescribe multiple types of antibiotics with different kind of vitamins and painkillers to patients. It would be very embarrassing for the profession to reproduce these prescriptions here. These prescriptions of multiple drug therapy have no scientific basis, nor pharmacological justification, and doctors, who make such prescription are nothing but glorified quacks with postgraduate diplomas and appointments as faculty members at public or private medical colleges. They are only prescribing unnecessary medicines for the benefit of some unethical pharmaceutical corporate agendas.
In a system where people think that the more medicine a doctor prescribes, the better he is, the ignorance and illiteracy of the public remains a blessing for this kind of clinical practice. In fact, this is worse than quackery, as quacks at least are not expensive and they spend time to talk to patients kindly and answer every query patiently, whereas these doctors have no time for patients’ questions.
In many hospitals, renowned surgeons cannot operate as they have no skills and neither do they know how to deal with complications in surgical procedures. Behind the flashy glass walls of the operation theatre, they have experienced operation-theatre technicians in their team to perform surgeries on their behalf. At some stage, when patients learn about this, they lose their confidence and trust for these surgeons and hospitals, and it is definitely a violation of trust.
Many doctors own hospitals built on amenity plots given by the government on extremely cheap rates. The majority of these hospitals are ruthless business centres, charging enormous amounts of fees and providing substandard services. Often, patients and their relatives are lied to and no internal audit system exists, simply so that unethical medical practices can be easily and smoothly carried out.
In the past few decades, many private hospital owners have established medical colleges without fulfilling the basic criteria of the Pakistan Medical and Dental Council (PMDC) and, hence, these medical colleges are producing doctors who are good for nothing. These doctors are glorified MBBS quacks, with minimal knowledge and skills. They have no ethical considerations and hence believe it is their right to make money because they have themselves paid enormous tuition fees to study at these medical colleges.
A large number of doctors do not hesitate to travel and stay in five-star hotels at the expense of pharmaceutical companies. Many pharmaceutical companies bribe doctors, on a personal basis to boost the sales of their medicine. Unfortunately, people are unable to differentiate between good, ethical doctors and bad, unethical and criminal, medical practitioners.
Many MBBS doctors have joined the civil services, politics and the electronic media as TV anchors. It’s very unfortunate that ‘qualified’ MBBS doctors are serving as members of the bureaucracy in ministries of industry, agriculture, excise, taxation, police, etc. They use the title of doctor with their name. The majority of them conduct themselves in the same manner as the average, traditional, unhelpful government official.
No doctor who has gone into politics has created a good impression by being caring of humanity. They behave in the same fashion as other politicians in the country, who serve their political masters and work against the interests of the masses. They get involved in corruption as do their non-medical counterparts. The education and training in medical colleges has failed to make them good doctors or good people, and neither has the hospital environment inculcated empathy in them. When they studied in medical colleges and worked in government hospitals, they must have had first-hand experience of the common man’s misery and the degradation of poor people. But when they decide to become politicians, they acquire attributes of lying, misconduct, nepotism, incompetence as well as a bad reputation, despite the title of doctor prefixed to their names.
As television anchors, these doctors fail to produce shows with substance. Instead they often promote ignorance, intolerance, religious fanaticism and non-scientific thinking. In media, they have the opportunity to help unfortunate patients needing a voice for their cause, but they fail to highlight the plight of dying pregnant women, the misery of poor diabetic patients who have no place in our healthcare system, or of the masses with chronic diseases who are exploited by qualified doctors and quacks. These doctor-anchors also become a part of the corrupt system of exploitation.
Recently, a doctor became a victim of the callousness of her fellow doctors. A female physician in Hyderabad died in her third pregnancy because of the failure of her obstetrician and an unhelpful healthcare system. Another competent general surgeon in Lahore died because of the callous attitude of surgeons.
Meanwhile, hundreds of doctors and health workers, on duty to save the lives of Covid-19 patients, are dying by getting infected in hospitals, but their services are not recognised.
The medical profession should review the practice of medicine and the unethical conduct of doctors. Every doctor should question his or her practice and try to understand why people have begun to hate doctors and why they have lost respect for health providers.
When PMDC and institutes, such as the College of Physicians and Surgeons, are least bothered about these issues, like-minded doctors must show that they will not be a part of this silent conspiracy.
(The writer is the former Secretary General of the Pakistan Medical Association)
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There’s an ill more dangerous and pervasive than the Coronavirus that’s currently sweeping Sri Lanka. That is the fear to express one’s convictions. Across the public sector of the country in particular many persons holding high office are stringently regulating and controlling the voices of their consciences and this bodes ill for all and the country.
The corrupting impact of fear was discussed in this column a couple of weeks ago when dealing with the military coup in Myanmar. It stands to the enduring credit of ousted Myanmarese Head of Government Aung San Suu Kyi that she, perhaps for the first time in the history of modern political thought, singled out fear, and not power, as the principal cause of corruption within the individual; powerful or otherwise.
To be sure, power corrupts but the corrupting impact of fear is graver and more devastating. For instance, the fear in a person holding ministerial office or in a senior public sector official, that he would lose position and power as a result of speaking out his convictions and sincere beliefs on matters of the first importance, would lead to a country’s ills going unaddressed and uncorrected.
Besides, the individual concerned would be devaluing himself in the eyes of all irrevocably and revealing himself to be a person who would be willing to compromise his moral integrity for petty worldly gain or a ‘mess of pottage’. This happens all the while in Lankan public life. Some of those who have wielded and are wielding immense power in Sri Lanka leave very much to be desired from these standards.
It could be said that fear has prevented Sri Lanka from growing in every vital respect over the decades and has earned for itself the notoriety of being a directionless country.
All these ills and more are contained in the current controversy in Sri Lanka over the disposal of the bodies of Covid victims, for example. The Sri Lankan polity has no choice but to abide by scientific advice on this question. Since authorities of the standing of even the WHO have declared that the burial of the bodies of those dying of Covid could not prove to be injurious to the wider public, the Sri Lankan health authorities could go ahead and sanction the burying of the bodies concerned. What’s preventing the local authorities from taking this course since they claim to be on the side of science? Who or what are they fearing? This is the issue that’s crying out to be probed and answered.
Considering the need for absolute truthfulness and honesty on the part of all relevant persons and quarters in matters such as these, the latter have no choice but to resign from their positions if they are prevented from following the dictates of their consciences. If they are firmly convinced that burials could bring no harm, they are obliged to take up the position that burials should be allowed.
If any ‘higher authority’ is preventing them from allowing burials, our ministers and officials are conscience-bound to renounce their positions in protest, rather than behave compromisingly and engage in ‘double think’ and ‘double talk’. By adopting the latter course they are helping none but keeping the country in a state of chronic uncertainty, which is a handy recipe for social instabiliy and division.
In the Sri Lankan context, the failure on the part of the quarters that matter to follow scientific advice on the burials question could result in the aggravation of Islamophobia, or hatred of the practitioners of Islam, in the country. Sri Lanka could do without this latter phobia and hatred on account of its implications for national stability and development. The 30 year war against separatist forces was all about the prevention by military means of ‘nation-breaking’. The disastrous results for Sri Lanka from this war are continuing to weigh it down and are part of the international offensive against Sri Lanka in the UNHCR.
However, Islamophobia is an almost world wide phenomenon. It was greatly strengthened during Donald Trump’s presidential tenure in the US. While in office Trump resorted to the divisive ruling strategy of quite a few populist authoritarian rulers of the South. Essentially, the manoeuvre is to divide and rule by pandering to the racial prejudices of majority communities.
It has happened continually in Sri Lanka. In the initial post-independence years and for several decades after, it was a case of some populist politicians of the South whipping-up anti-Tamil sentiments. Some Tamil politicians did likewise in respect of the majority community. No doubt, both such quarters have done Sri Lanka immeasurable harm. By failing to follow scientific advice on the burial question and by not doing what is right, Sri Lanka’s current authorities are opening themselves to the charge that they are pandering to religious extremists among the majority community.
The murderous, destructive course of action adopted by some extremist sections among Muslim communities world wide, including of course Sri Lanka, has not earned the condemnation it deserves from moderate Muslims who make-up the preponderant majority in the Muslim community. It is up to moderate opinion in the latter collectivity to come out more strongly and persuasively against religious extremists in their midst. It will prove to have a cementing and unifying impact among communities.
It is not sufficiently appreciated by governments in the global South in particular that by voicing for religious and racial unity and by working consistently towards it, they would be strengthening democratic development, which is an essential condition for a country’s growth in all senses.
A ‘divided house’ is doomed to fall; this is the lesson of history. ‘National security’ cannot be had without human security and peaceful living among communities is central to the latter. There cannot be any ‘double talk’ or ‘politically correct’ opinions on this question. Truth and falsehood are the only valid categories of thought and speech.
Those in authority everywhere claiming to be democratic need to adopt a scientific outlook on this issue as well. Studies conducted on plural societies in South Asia, for example, reveal that the promotion of friendly, cordial ties among communities invariably brings about healing among estranged groups and produces social peace. This is the truth that is waiting to be acted upon.
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By Sanjeewa Jayaweera
It was on 3rd January 1972 that our family arrived in Karachi from Moscow. Our departure from Moscow had been delayed for a few weeks due to the military confrontation between Pakistan and India. It ended on 16th December 1971. After that, international flights were not permitted for some time.
The contrast between Moscow and Karachi was unbelievable. First and foremost, Moscow’s temperature was near minus 40 degrees centigrade, while in Karachi, it was sunny and a warm 28 degrees centigrade. However, what struck us most was the extreme warmth with which the airport authorities greeted our family. As my father was a diplomat, we were quickly ushered to the airport’s VIP Lounge. We were in transit on our way to Rawalpindi, the airport serving the capital of Islamabad.
We quickly realized that the word “we are from Sri Lanka” opened all doors just as saying “open sesame” gained entry to Aladdin’s cave! The broad smile, extreme courtesy, and genuine warmth we received from the Pakistani people were unbelievable.
This was all to do with Mrs Sirima Bandaranaike’s decision to allow Pakistani aircraft to land in Colombo to refuel on the way to Dhaka in East Pakistan during the military confrontation between Pakistan and India. It was a brave decision by Mrs Bandaranaike (Mrs B), and the successive governments and Sri Lanka people are still enjoying the fruits of it. Pakistan has been a steadfast and loyal supporter of our country. They have come to our assistance time and again in times of great need when many have turned their back on us. They have indeed been an “all-weather” friend of our country.
Getting back to 1972, I was an early beneficiary of Pakistani people’s love for Sri Lankans. I failed the entrance exam to gain entry to the only English medium school in Islamabad! However, when I met the Principal, along with my father, he said, “Sanjeewa, although you failed the entrance exam, I will this time make an exception as Sri Lankans are our dear friends.” After that, the joke around the family dinner table was that I owed my education in Pakistan to Mrs B!
At school, my brother and I were extended a warm welcome and always greeted “our good friends from Sri Lanka.” I felt when playing cricket for our college; our runs were cheered more loudly than of others.
One particular incident that I remember well was when the Embassy received a telex from the Foreign inistry. It requested that our High Commissioner seek an immediate meeting with the Prime Minister of Pakistan, Mr Zulifikar Ali Bhutto (ZB), and convey a message from Mrs B. The message requested that an urgent shipment of rice be dispatched to Sri Lanka as there would be an imminent rice shortage. As the Ambassador was not in the station, the responsibility devolved on my father.
It usually takes about a week or more to get an audience with the Prime Minister (PM) of a foreign country due to their busy schedule. However, given the urgency, my father spoke to the Foreign Ministry’s Permanent Sectary, who fortunately was our neighbour and sought an urgent appointment. My father received a call from the PM’s secretary around 10 P.M asking him to come over to the PM’s residence. My father met ZB around midnight. ZB was about to retire to bed and, as such, was in his pyjamas and gown enjoying a cigar! He had greeted my father and had asked, “Mr Jayaweera, what can we do for great friend Madam Bandaranaike?. My father conveyed the message from Colombo and quietly mentioned that there would be riots in the country if there is no rice!
ZB had immediately got the Food Commissioner of Pakistan on the line and said, “I want a shipload of rice to be in Colombo within the next 72 hours!” The Food Commissioner reverted within a few minutes, saying that nothing was available and the last export shipment had left the port only a few hours ago to another country. ZB had instructed to turn the ship around and send it to Colombo. This despite protests from the Food Commissioner about terms and conditions of the Letter of Credit prohibiting non-delivery. Sri Lanka got its delivery of rice!
The next was the visit of Mrs B to Pakistan. On arrival in Rawalpindi airport, she was given a hero’s welcome, which Pakistan had previously only offered to President Gaddafi of Libya, who financially backed Pakistan with his oil money. That day, I missed school and accompanied my parents to the airport. On our way, we witnessed thousands of people had gathered by the roadside to welcome Mrs B.
When we walked to the airport’s tarmac, thousands of people were standing in temporary stands waving Sri Lanka and Pakistan flags and chanting “Sri Lanka Pakistan Zindabad.” The noise emanating from the crowd was as loud and passionate as the cheering that the Pakistani cricket team received during a test match. It was electric!
I believe she was only the second head of state given the privilege of addressing both assemblies of Parliament. The other being Gaddafi. There was genuine affection from Mrs B amongst the people of Pakistan.
I always remember the indefatigable efforts of Mr Abdul Haffez Kardar, a cabinet minister and the President of the Pakistan Cricket Board. From around 1973 onwards, he passionately championed Sri Lanka’s cause to be admitted as a full member of the International Cricket Council (ICC) and granted test status. Every year, he would propose at the ICC’s annual meeting, but England and Australia’s veto kept us out until 1981.
I always felt that our Cricket Board made a mistake by not inviting Pakistan to play our inaugural test match. We should have appreciated Mr Kardar and Pakistan’s efforts. In 1974 the Pakistan board invited our team for a tour involving three test matches and a few first-class games. Most of those who played in our first test match was part of that tour, and no doubt gained significant exposure playing against a highly talented Pakistani team.
Several Pakistani greats were part of the Pakistan and India team that played a match soon after the Central Bank bomb in Colombo to prove that it was safe to play cricket in Colombo. It was a magnificent gesture by both Pakistan and India. Our greatest cricket triumph was in Pakistan when we won the World Cup in 1996. I am sure the players and those who watched the match on TV will remember the passionate support our team received that night from the Pakistani crowd. It was like playing at home!
I also recall reading about how the Pakistani government air freighted several Multi Barrell artillery guns and ammunition to Sri Lanka when the A rmy camp in Jaffna was under severe threat from the LTTE. This was even more important than the shipload of rice that ZB sent. This was crucial as most other countries refused to sell arms to our country during the war.
Time and again, Pakistan has steadfastly supported our country’s cause at the UNHCR. No doubt this year, too, their diplomats will work tirelessly to assist our country.
We extend a warm welcome to Mr Imran Khan, the Prime Minister of Pakistan. He is a truly inspirational individual who was undoubtedly an excellent cricketer. Since retirement from cricket, he has decided to get involved in politics, and after several years of patiently building up his support base, he won the last parliamentary elections. I hope that just as much as he galvanized Sri Lankan cricketers, his political journey would act as a catalyst for people like Kumar Sangakkara and Mahela Jayawardene to get involved in politics. Cricket has been called a “gentleman’s game.” Whilst politics is far from it!.
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Believe me, seeing certain videos, on social media, depicting action, on the dance floor, at some of these entertainment venues, got me wondering whether this Coronavirus pandemic is REAL!
To those having a good time, at these particular venues, and, I guess, the management, as well, what the world is experiencing now doesn’t seem to be their concerned.
Obviously, such irresponsible behaviour could create more problems for those who are battling to halt the spread of Covid-19, and the new viriant of Covid, in our part of the world.
The videos, on display, on social media, show certain venues, packed to capacity – with hardly anyone wearing a mask, and social distancing…only a dream..
How can one think of social distancing while gyrating, on a dance floor, that is over crowded!
If this trend continues, it wouldn’t be a surprise if Coronavirus makes its presence felt…at such venues.
And, then, what happens to the entertainment scene, and those involved in this field, especially the musicians? No work, whatsoever!
Lots of countries have closed nightclubs, and venues, where people gather, in order to curtail the spread of this deadly virus that has already claimed the lives of thousands.
Thailand did it and the country is still having lots of restrictions, where entertainment is concerned, and that is probably the reason why Thailand has been able to control the spread of the Coronavirus.
With a population of over 69 million, they have had (so far), a little over 25,000 cases, and 83 deaths, while we, with a population of around 21 million, have over 80,000 cases, and more than 450 deaths.
I’m not saying we should do away with entertainment – totally – but we need to follow a format, connected with the ‘new normal,’ where masks and social distancing are mandatory requirements at these venues. And, dancing, I believe, should be banned, at least temporarily, as one can’t maintain the required social distance, while on the dance floor, especially after drinks.
Police spokesman DIG Ajith Rohana keeps emphasising, on TV, radio, and in the newspapers, the need to adhere to the health regulations, now in force, and that those who fail to do so would be penalised.
He has also stated that plainclothes officers would move around to apprehend such offenders.
Perhaps, he should instruct his officers to pay surprise visits to some of these entertainment venues.
He would certainly have more than a bus load of offenders to be whisked off for PCR/Rapid Antigen tests!
I need to quote what Dr. H.T. Wickremasinghe said in his article, published in The Island of Tuesday, February 16th, 2021:
“…let me conclude, while emphasising the need to continue our general public health measures, such as wearing masks, social distancing, and avoiding crowded gatherings, to reduce the risk of contact with an infected person.
“There is no science to beat common sense.”
But…do some of our folks have this thing called COMMON SENSE!
