Monday, January 31, 2011


By Rabia Ahmed

 The death of debate

Debate has been dying by inches for some time in Pakistan. It however did the whole symbolic death rattle shudder thing right about the time Dr Firdous Ashiq Awan galumphed onto the scene like a rampaging bison. 

The fact that Dr Awan represents a trend is much more ominous than the vulgarity she projects, because even though the MNA from Sialkot may stand out rather where her style of ‘debate’ is concerned, she is actually not alone. Most political debate (with notable exceptions) on television appears to be channelling her spirit, where each participant talks at the same time as the others, the issue at hand is rarely discussed, and participants from different parties spend the allotted time launching personal attacks on each other. Eventually, nothing is achieved beyond anarchy, and a useless, inconclusive slinging match.

Dr Awan who represents the Pakistan People’s Party, a non-religious, supposedly liberal group, calls her opponent names and accuses her of dreadful things when she disagrees with her; the so called ‘religious’ right wing groups such as the Taliban , when they disagree with someone, they shoot them.

Where’s the difference between the two?

In today’s Pakistan accepting another point of view appears an unattainable exercise. The ‘religious’ right considers itself to be the only Muslims around and all others to be heretics (aka kafirs); and the ‘heretics’ consider the ‘religious’ right, all of them, to be irrational and unintelligent.  Since this attitude precludes debate, its quod erad demonstrandum.

Where is this attitude going to take lead?

In the first quarter of the 20th century, the Soviet Union came into being by the consolidation of several states under the banner of a socialist Union. It became a strong industrialised power, but its policies were totalitarian and it grew to be a repressive single party entity.

Like most systems, it had its positive points however the negatives soon outweighed them. Politically no other view aside from that from that of the ruling party was tolerated. The economy was controlled by the state, based on state ownership of all industry and investment.

While religious freedom was constitutionally protected, in actual fact Marxism was incompatible with religion, therefore religion was discouraged. There was a period when religious studies were not allowed in schools, and churches, mosques, synagogues and other places of worship were shut down.

By the time a more moderate policy was put in place, it was too late; dissatisfaction had set in with intolerance and state control of every aspect of people’s lives, which had deteriorated. There was little freedom of speech, which meant no tolerance of debate. There was little freedom of worship, and people were imprisoned, executed, exiled for going against the official policy in what they believed in, read, spoke of, the music they heard, the clothes they wore. Wages were low, and the standard of living was poor. There was rampant corruption.  

Since the United States of America was considered to be a threat, the government was spending an inordinate percentage of its budget on defence, which led to bankruptcy.

1991 saw the disintegration of the Union of Soviet Socialist Republics.

We can draw our own parallels.

Pakistan is running on empty. Its loans are staggering, and its economy worse than bankrupt. There is rampant corruption, and our lives are controlled by those in power. There is poverty, and a decent life is beyond the reach or expectations of most people. Because India is viewed as a threat, our defence budget is inordinately high. Pakistan spends around 4.5 percent of its GDP on defence, which for a poor country indicates a definite barrier to development.

Intolerance is at its highest. Shias, Ahmedis, Christians, those who frequent shrines, almost all groups in some way or the other, have no protection and live in peril of their lives. Women are forced into marriage, the poor are enslaved, children are forced to work, and the standard of education for the common man when available, is abysmal. No one listens; no one wants to listen, unless what is said is what they want to hear.

What is Pakistan achieving today, or is likely to achieve in the future other than anarchy and disintegration?

Probably the discovery that the virtues its masses attribute to the religious right are as non-existent as for the people it elected into power; and hopefully, following that, the incentive to make a more responsible choice the next time around.

The scary thing of course is that that next time around may be a long time coming, so it may be best to stop and take stock right now: whither Pakistan?


Monday, January 24, 2011


By Rabia Ahmed

You can crush people by ignoring them, unless they crush you first.

That Iran has banned the printing and production of material relating to Valentine’s Day made me laugh. Say hello to a boom in Valentine Day merchandise, Iran, just as the sudden flooding of the markets with red heart shaped merchandise in Pakistan, come February. Not that Valentine’s Day is banned here, but the disapproval on some faces is almost as effective.

We have to realise that banning things only makes them infinitely more alluring. Remember the Satanic Verses? Even those who did not read much managed to obtain a copy, and no person with any intellectual aspirations admitted to anything but finding it most interesting, my dear.

The West makes Hallmark productions out of things: This day, that day, Secretary’s Day, and now the hype around the eight legged Psychic, Paul. Apparently they’re going to erect a statue to the octopod, and display his ashes too.  That’s the 21st century, they eat curry, we do red stuff on Valentine’s Day.

Are there not issues enough to be dealt with in Pakistan that we must raise brouhaha about this book, or that website, or even (which is not trivial at all) kill people because of their beliefs or statements? Surely living up to a certain set of values or principles in oneself makes them more respect worthy by example, than trying to bludgeon them into others by means of force or violence?

It’s bizarre mentioning the ultimate price paid by Salman Taseer in the same story as Paul the octopus, only I think it is something he would have greatly appreciated himself...but, killing Salman Taseer has only served to make his worst critics sympathise with him, and appreciate his bravery in the face of threats to his life.  Similarly, the other Salman, Mr Rushdie, would not have had such a runway best seller on his hands, including film appearances and interviews, had not his book been shot at as well.

There are ways to deal with distasteful issues. One is to ban them, which rarely works. When websites were shut down during the Danish cartoon fiasco, every man and his grandmother had ways of accessing them. The other is to discuss and argue for/against the issue, and allow the matter to be settled on the basis of ‘may the best argument win’. The third is the method we’re good at, ignoring the issue, other than banning it of course.

And thus, the majority of the population of Pakistan, poverty, illiteracy et al, since it cannot be banned, is ignored, possibly in the hope that it will go away.

The people of Pakistan require schools. A news item in the Dawn of 2nd November 2010 reports that the government of Sindh has decided to close down 1,100 government schools in the province because they have proved to be ‘non viable’ and to use their buildings ‘for some better purpose’.  What better purpose? Dividing them into plots to be distributed among the provincial assembly?

The people of Pakistan need to be fed. So on the 8th of January 2011 there is another news item in the Dawn about how food prices have soared by approximately 100 percent. With the common man in Pakistan unable to afford food, onions and potatoes are being exported. What else would you have them do? Allow the food to rot if no one buys it here?

It’s also interesting to see how the government uses its (non-existent) funds. They dole out Rs 330 million in ‘development funds’ to eleven independent MNAs from FATA, and then asks them to identify and work out details of public welfare projects. Has it been that hard to identify what to do for the welfare of this public? Or is the public maybe invisible?

Meantime, what does the PM Mr Gilani, and I quote from a story on the 4th of January, Pakistan today: ‘Saving his government – PM running from pillar to post’ which goes on to say that ‘.... the prime minister could not touch any other issue except seeking the PML-N’s support for the survival of his government.’

Vachel Lindsay was a poet who said, ‘You can’t crush ideas by suppressing them. You can only crush them by ignoring them.’

Unfortunately the same applies to people, unless of course they crush you first.

Wednesday, January 12, 2011


By Rabia Ahmed

What is there about Pakistan that fosters extremism and terrorism?

I normally write of issues with some lightness, but my heart is heavy following the death of Salman Taseer, and it is not just I who feel this way. The atmosphere in Pakistan following the assassination of the Governor of Punjab on the 4th of January is different to that following previous political assassinations. Despondency this time is more pervasive, almost to the point of saturation. There is a sense of being at the end of the road, any fork in which appears out of sight, and of a certainty fraught with danger.

To speak out means unpleasant repercussions from those who blow people up like others blow soap bubbles. To commit violence against them would be to barter in their own coin. To debate with them is impossible, to live alongside them proven imprudent, to reason with them against their own creed.

 And so, now what?

There is a solution to every conundrum, and the solution to this one lies in the question: What is there about Pakistan that fosters people like Mumtaz Qadri and his sympathisers?

On Friday the 7th of January political parties such as the Shabab-i-Islami Pakistan (SIP), Sunni Ittehad Council (SIC) and Tehrik Fidayan-i-Khatm-i-Nabuwwat (TFKN) took out processions in support of Qadri, which comes as a rude shock for those of us who appear to have led a blinkered existence in this country; for whom also the catch phrase has been that education is the key to changing the Qadri mentality.

If ‘education’ is synonymous with ‘literacy’ for the purpose of this discussion, then that kills the argument, because Qadri appears to be literate at least, and his fan club savvy enough to set up a page supporting him on Facebook.

If we are referring to an ‘appropriate’ content of education, achieving it means a lengthier process which includes (from my vantage point) changing the mindset of our teachers who after all are members of the same public which does not appear to be amenable to change from the fanatical, intolerant, angry views they hold at present. The result, as Irfan Husain says, is a ‘hydra-headed monster that seems to have become too powerful for state institutions to decapitate.’

It is the underlying cause of this monster’s inception that needs to be addressed, which means improving the living conditions of the Pakistani public which lives in squalor and faces deprivation and frustration at every step.

None of the issues above can be addressed without a) dedication b) planning c) funds.

The last few days has given us proof, if any were needed, of the lack of both planning and dedication to the cause of development by our government. On the 6th of January the Government announced a reversal of the latest hike in fuel prices. For those assailed by misty eyed notions of governmental benevolence, kid yourselves not.  It was only the MQM’s withdrawal from the coalition and the subsequent loss of majority for Gillani’s government that led to this decision, not any concern for the people’s plight, a shameful example of our government’s blatant wimpiness when faced with a gun.

The requirement for funds is at present being addressed by means of handouts from the IMF and donor countries. The only alternative is to generate funds from within the country by means of effective taxation, which method is also in the terms of foreign loans to Pakistan.

Says David E Sanger in the New York Times ‘Pakistan’s wealthy elite rarely pay taxes, and the huge divide between them and the country’s desperately poor breeds resentments. Those feelings, in turn, create conditions that insurgents can easily exploit.’

The fact that those responsible for enforcing collection of tax in Pakistan are themselves the worst tax dodgers means that they are responsible to a great extent for the mess we find ourselves in today.

The only conclusion I reach is that my vote will go to the people who can manage to make all tax dodgers pay their dues, and then can re-invest this money into development projects for the sake of the mental and bodily health of all citizens of this sad country, Pakistan.

Thursday, January 6, 2011


By Rabia Ahmed

Ignorance, the biggest Weapon of Mass Destruction

My God, did you see that photograph on Page 9 of Pakistan Today on the 14th of December 2010?

The photograph taken by Nadeem Ijaz at Akbari Mandi shows an LPG cylinder placed on bricks, a fire burning under it. Apparently this is how a street food vendor maintains gas flow to his stove.

That picture epitomises two very powerful things, or shall we say three, because the first of course is that bomb waiting to detonate. The second is the Pakistani state of mind at present, and the third is the disastrous and lethal ramifications of ignorance,

For the first, I wonder if this street vendor knew what the results of his desperate ingenuity could be? Maybe he did, and maybe he was beyond caring. I wonder if Mr Ijaz spoke with the man and what the man had to say.

For the second, at wits end, frustrated and beleaguered, our common man is, like the owner of that cylinder unable to function and willing to do anything, however insane and dangerous, to get something out of the nothing he possesses.

What does a person do when he tosses and turns all night because there is no power to run the fan, and no power to run his machines the following day? When people come home at night, exhausted, grimy and hungry to find that there is no power again, no water to wash away the grime, and no food to fill their stomachs?

It was reported in the paper in December 2010 that many areas in Gujranwala are without any gas, so women in that city took to the streets, breaking windows and furniture in the local office of the Sui Northern Gas Pipelines, while in Lahore workers of the Pakistan Steel Mills burnt tyres in protest against a similar shortage.

Power outages started end of December last year, of anything between four and six hours a day. The Director General of PEPCO public relations claims that they have coping strategies in place, saying that generation is better this year than it was the last. Well, Mr Jalil, we shall see, because we are used to such statements, and none of them ever proves to be true.

As for the third, it is perhaps the most dangerous of all three put together, and then some.

The Dalai Lama said: Where ignorance is our master, there is no possibility of real peace.

Or safety, or progress, or happiness, or sense.

I wrote once about a man in a village, who, in spite of being directed to wire the electrics red wire to red, and black to black, did them the other way around. When questioned he said he’d done it because it looked prettier that way.

How many more such examples will we find, within the ambit of just our own restricted lives?

It is probably the charges of ‘blasphemy’ that best illustrates our ignorance. Born of frustration, ignorant understanding, and a vicious desire to vent spleen, individuals not only find victims to label with this charge, but they are supported in these accusations by our ignorant clergy in the name of religion.

Dr. Naushad Valiyani
What else is the charge against Naushad Valiyani, the doctor who threw a visiting card in the bin, but just such ignorance? Or the charge against that poor woman, Asia Bibi?

In 1992, Akhtar Hameed Khan, then 80 years old, the man behind the world renowned Orangi Pilot Project in Karachi and a person who had contributed almost as much to this country as Edhi, was arrested for blasphemy. And the charge? That he wrote a children’s poem that was considered blasphemous.

In 1993 Salamat Masih a little boy then only 11 years old was given the death sentence for allegedly writing blasphemous words. He was later acquitted, when it was proved that he was illiterate. However the judge who handed down the decision was assassinated.

The crimes that are being committed today in the name of religion by ignorant people are no less explosive than the cylinder in that picture, or the wiring done all wrong. They are worse than any weapon of mass destruction. Given time, they will lead to the extinction of all sense in our lives just as religion in the hands of the enlightened will bring the peace that we crave into it.

Tuesday, January 4, 2011



By Rabia Ahmed | Published: December 30, 2010
A news report few days ago reported that a ‘man masquerading as the Health Secretary’ was arrested at the Sialkot Civil Hospital. 
It appears the enterprising gentleman, needing a medical certificate for a friend, arrived at the hospital, made his way to the Medical Officer on duty, and demanded to be issued with the required document. When the doctor refused, he threatened him (the MO) and other medical personnel with ‘dire consequences’, in his capacity as the Health Secretary.
The MO called the police, the man’s real identity was discovered, and he was placed under arrest.
What a refreshing story. A man has the temerity to do something that he shouldn’t, and is arrested for his pains. Not something that happens very often out here. One wonders, though, about varying scenarios…would the MO have summoned the police if the man really had been the Health Secretary demanding an undeserved certificate, and would the police have arrested him if so.
The fake Health Secretary was so obviously emulating the corruption of important government officials who swagger and bluster in public places, make unreasonable demands…and get away with it. It was his bad luck that he was detected, and didn’t succeed. But oh my goodness, the number of people who do! They actually are the big noise, they aren’t pretending, and they manage to break the law and get away with it. This is what big noises in this country do, and it is what the public has come to expect of them.
There are many cases that illustrate this point. Here are a measly few, of comparable significance:
Mr Shah Mahmood Qureishi
In October this year, our Foreign Minister Mr. Qureishi was accused of trying to push his favoured candidates into foreign office jobs. Officials at the ministry who prefer to remain anonymous agree that under a quarter of the jobs went to people pushed through by the Foreign Minister and his junior Minister Malik Amad Khan. The Ministers remain at large, unlike the hapless gentleman at the Sialkot Civil Hospital.
And then there’s the case of the Prime Minister’s son who’s Mercedes car was stopped by a traffic warden earlier this month, because it sported tinted windows.
As a precaution against terrorism it is illegal to drive a car that has tinted windows in Pakistan. So, what applies to the goose should also apply to the gander, right? Not, as we all know, in the land of the pure.
Not only did very senior persons such as Rana Sanaullah and the chief Traffic Officer rush to the Prime Minister’s house, no less, to soothe ruffled feathers and tut tut over the situation, but it was denied that the warden was made to apologise to the ‘Gilani scions’ (are the Gilani’s a dynasty or something, like the Bhuttos?)
Now when something is denied in Pakistan, it’s a sure indication that there’s a ‘no smoke without a fire’ lurking around somewhere in the picture. So hmm.
The report also said that the Gilani ‘scions’ were assured that action would be taken against the warden if it was found that he had been negligent.
Action? Negligent? The man should have been commended for doing his duty and stopping the car never mind to whom it belonged. I hereby do it now, for what it counts.
And then of course the Interior Minister, Rehman Malik (bless the man he’s always in the thick of everything) is said to be using four official cars while he is entitled to just one. The last time I checked there was just one Mr. Malik, maybe he’s cloned himself, or something? What a charming thought… four Rehman Maliks! Four of him telling the nation very definitely and exactly what happened, and who was responsible, following every episode of terrorism.
Not only are these people never brought to book, but should it ever that someone is, it is always the underling, the dispensable junior officer who is pushed forward and who takes the flak.
Imran Khan has been quoted as saying, ‘Personally I don’t think solving corruption is such a big problem.’ Maybe it’s your turn at the wicket, Mr. Khan. Let’s see you hit that lot for a six if you can. Please make it a six, six and a four, like you did once, a very long time ago.

This news was published in print paper (Pakistan Today) To access the complete paper of this day. click here

Monday, January 3, 2011


A regional grand opera

By Rabia Ahmed | Published: December 22, 2010
Premier Wen Jiabao 
You’d think with its present culture of shootings and suicide bombings Pakistan would discover an alternative method of welcoming VIPs, but no, the Chinese Premier Wen Jiabao arriving in Pakistan was treated not just to a normal gun salute, but to a gunshot for each step he took. That may be our idea of honouring someone, but the Premier, poor man was probably a nervous wreck by the time he wobbled off the tarmac and into his car, in no fit state to handle his chopsticks for quite some time to come...and that is a pity, because Pakistan has done well to retain China as a close ally, and would do well to keep it so. The last thing we need is the responsibility for Mr Jiabao being driven to an overdose of Ativan, or a frantic course of acupuncture, after he arrived for a three day diplomatic visit to Islamabad on the 17th of December. 
Pakistan’s friendship with China dates back to 1949 when Mao Zedong’s People’s Republic of China (PRC) came into being. An innate suspicion of Mao, his communism and his communist party among the capitalist world, meant that Pakistan in its own interests was one of the few nations to recognise the PRC at the outset.
China has stood by Pakistan as a staunch ally. With the threatening presence of India to the East, a turbulent Kashmir, and a troubled border with Afghanistan on the West, the friendship has been in China’s interests as well as Pakistan’s.
For Pakistan, it has been reassuring to possess a powerful ally to its north, particularly given the massive presence of Russia over its shoulder, and the now added threat of India’s overreaching ambitions. China’s superpower status has added a measure of balance to the regional grand opera (one can hardly call it harmony), in which the US has played the role of the unreliable (albeit powerful) interpolative voice.
Mismanagement of its affairs, corruption, a disorganised lay abed mentality and a tendency to rhetoric has made Pakistan something of a perpetual adolescent, from which it appears unable to extricate itself. China has played the role of an overindulgent parent to Pakistan’s immature demands, always willing to come to its financial aid. Unlike the US which offers conditional aid, China’s aid has always come without any strings attached. As such, China has assisted Pakistan in many fields, education, transport, defence, construction, and now nuclear, and Pakistan is always looking for more.
While the Premier’s current visit to Pakistan holds a further promise of deals worth several billion dollars as a result of Chinese investment in various projects in Pakistan, his visit follows on the heels of one to India, with the announcement of deals worth substantially more, between those two countries.
Pakistan’s growing volatility and its worsening financial condition is cause for concern for the world community, and no less for China, which has thus far supported, what it hoped, was Pakistan’s progress towards stability. However, the unchecked activities of terrorists within Pakistan’s borders and the threat they pose not just to Chinese investment, but to Chinese persons on Pakistani soil, is enough to make even an overindulgent parent reconsider their policies. It may be that in future, China’s relations with India will improve further, which should have interesting implications for Pakistan.
The Taliban’s anti American rhetoric does not exclude a rabid view of other nationalities. This was illustrated by the kidnapping in 1998 in Pakistan of the Chinese engineer Long Xiaowei. Although Xiaowei’s release was subsequently brokered, Beijing’s reaction to the event was terse. Given the previous analogy of the regional situation to an opera, the image is similar to the comparatively delicate Jose Carreras administering a kick in the shins to Luciano Pavarotti.
It is probably to Pakistan’s good if China does amend its policies. It is time Pakistan was painted into a corner, and forced to bring about some much needed changes on its domestic front. This, however, will not happen so long as our leaders see any scope of profit to themselves in the status quo. The strings, if attached, will one hopes be finely tuned so that they ping in all the right places, without snapping and hurting the common man as American aid often does. This is an expectation one can have only have from a friend such as China has proved to be.

This column was printed in Pakistan Today on the 22nd of December 2010


(By Rabia Ahmed and Imran Ahmed)

By Rabia Ahmed:

A Hospital is no place to be sick, said Samuel Goldwyn. Well, my husband was sick, and he was asked to check into a hospital in Lahore for a procedure the following day.

We reached the hospital in the evening, a cousin accompanying us for moral support, and made our way to a Reception desk in a room full of gloomy persons who looked suspiciously at us from their seats.

Unlike the English, who even when alone are said to ‘form an orderly queue of one,’ Pakistanis take the whole process of being served as a challenge, and the fact of not being served first as a personal affront. We waited, second in line while five consecutive first in line persons were served. 

Eventually checked in by a man who printed a form, handed it to another, who made a dot on it, and a third who removed the hospital’s copy and gave us the duplicate, we spent another twenty minutes at the cashier, then were directed to the ward, up a slippery ramp.  My husband, who doesn’t believe in being unfit unless unfit comes along and bites him on the bum, strode up, only to slip back to the beginning, arms flailing.  We tried again.

The room was nice enough, quiet and clean. The bed was comfortable, with a restful sofa bed in the corner. The TV worked, and so did the fridge.  We were both glad that my husband did not require a wheelchair, because the bathroom door was too narrow to let one through. I suppose sick people seldom use wheelchairs in Pakistan; to start with, ramps (if any) are too predatory as we just saw, so people prefer just being hurled through wherever they need to go; it’s quicker that way.

We made sure the patient had everything he needed, and then, since he was perfectly mobile and well enough to be left alone, left.

The next morning I was at the hospital by 8am, and my husband told me that after I left, he got into bed looking forward to some rest, when along came a nurse, to give him a drip, saying that he would have to fetch the medication from the pharmacy himself. A bit startled, since hospitals don’t normally expect patients to run errands for them, he asked her where the pharmacy was. ‘Outside,’ she told him, waving a vague hand towards the back of the hospital.

He braved the ramp and set off to locate the pharmacy. He said individuals from the milling crowd outside, even at that hour, were the ones to help him locate the pharmacy, not the staff.  Medicine’s procured, he returned, only to be told that a canula was needed. Annoyed, he asked why she hadn’t given him both prescriptions at the same time, and was told that this was ‘procedure’. He set off again, and when he returned, another man popped in the door and said a payment was required, for a blood test, and shrugged when my husband protested.  In short, he made five trips that night, the last three to: have a blood test at the lab which was located in the basement of a building next door, make a payment for an x-ray, and then to have the x-ray. He finally got the drip.
A mobile drip stand

It was past 2 am, when he was allowed to sleep.

Interestingly, a mobile drip stand, a common and standard piece of equipment was not available at this well known private hospital.  Without a stand patients have to hold the bag of medication in the bathroom, which is difficult, particularly for someone unfamiliar with the process.

The surgery was uneventful and on time.  In the recovery room still under the effect of anesthesia my husband said some interesting things. Later, being a doctor himself, he realized the nurse was making up fictitious vital signs figures because that equipment was broken. He questioned her, she muttered something.  At one point his heart rate was unduly erratic, and when I told the nurse about it, she made faint clucking noises, and said it was okay, without examining him, adding something that sounded suspiciously like ‘procedure’.  

Mercifully, we got through the next four or five hours and returned to the room after tipping several people hanging around clearly in wait for a handout.

An inveterate smoker, one of the first things my husband did when he was able to walk was make his way onto the balcony, which was quite raised off the ground, and looked out on to a narrow pathway. He left his pack of cigarettes and lighter on the window ledge, but when he went back for them later, they had disappeared.

I stayed with him for two days, and the same scenario was repeated: visits to the pharmacy all times of the day and night, and to the laboratory, and the cashier for payment for mundane medical equipment, all per procedure. I was glad at least it was I doing the legwork.

What happens to patients who have no one to look after them during their stay at the hospital? What’s more important is that if this is one of the better private hospitals in the country, what on earth are the others like, given this one’s inefficiency and lack of systems?

It was Florence Nightingale who said: The very first requirement in a hospital is that it should do the sick no harm.

Such penetrating statements should be translated, framed and tenderly placed in prominent places in med schools, nursing institutes and hospital all over Pakistan. 


By Imran Ahmed MRCP

After working as a hospital doctor in England for twenty five years I moved to Lahore and recently, had the novel experience of being a patient myself.

The initial outpatient encounter was good. Arriving at the hospital the day before the surgery however, it was the chaos that struck me, the number of people behind the reception desk each one flapping around in a muddle.

Admission over, I made my way to my room up a steep soapy ramp, and promptly slithered back. Four decades ago that would have been a fun experience.  

As no further activity beyond a visit by the nurse had been indicated my wife and cousin who had accompanied me left, and I settled down to some TV and, as I hoped, sleep.

The fun started at midnight. I believe my wife has detailed my experiences that night.  By the time I was able to crawl back into bed, exhausted, and annoyed, it was 2am.

Most of my discomfiture was the direct result of a lack of communication between the healthcare staff, and myself, as patient. Hospital staff should be trained to help their clients just as they would help a guest. To require a patient or attendant to make repeated forays for minor pieces of equipment and payment betrays an utter lack of organisation and consideration. Items could be billed at the end of the admission, or payment taken at the outset as a larger deposit.

I would like to offer some suggestions which are neither difficult nor costly; they simply require some planning and a desire to make the patient’s life easier.

At their consultation I suggest that consultants hand out a patient information leaflet outlining the ‘whys and hows’ of elective surgery, how long to fast before the procedure and what tests/examinations/medication to expect on admission. This should be followed with information on common after effects, what to worry about or to accept as normal after the operation.

Prior to admission, it would have been useful to receive an information leaflet, or even just to read a notice board displaying the procedure for admission; what and how much clothing, paper records, old x-ray films, medication, toiletries and money ought to be brought in. Are credit cards, cheques, or cash preferred or acceptable as forms of payment? Details of public transport to the hospital, and of amenities available within, such as a restaurant, car parking, availability of attendant’s bed, on site pharmacy and laboratory; a map of the hospital and a price menu for the selection of rooms makes life easier.

The hospital policy on tips to staff should be clarified.

Upon admission, the admitting nurse should volunteer information and instructions on what examinations, tests, and visits by doctors the patient can expect, and when. The patient and attendant should be given friendly advice on the location of shops and restaurants.

My experience with the junior doctor who visited me in my room pre and post surgery was the most abysmal. The doctor failed to take a competent history, ask relevant questions or to conduct any relevant examination; he even failed to fully record crucial information on drug allergies and past operations that I volunteered myself. This makes it clear that he did not double check the appropriateness of the management or diagnosis proposed by his consultant, which is one of the responsibilities of a junior doctor.

He failed to take informed consent, or rather he obtained my signature to a form, but no information accrued to it.  In other words, he did not attempt to educate his patient. He did not deign to inform me let alone explain why he would be ordering (at different times, all after midnight) blood tests and x-rays or medication. A second junior doctor despite enquiring, neither recorded nor explained, nor passed on my postoperative symptoms and concerns to his boss. This dismissive and contemptuous attitude by doctors towards patients would not be tolerated by a civilised society.  These junior doctors clearly neglected to ensure that all bases were covered, so as to prevent mistakes, and to protect the patient. Pakistani medical teachers and consultants need to start teaching respect for the patient to their pupils.

The room itself was pleasant with a large TV, refrigerator and comfortable bedding. However, the bathroom was a disaster. The light switch was inaccessible until well inside, and the door so narrow that a person with a frame or wheelchair could not have passed through. Just within the door was a step that could easily trip an unsteady or unwary person.

There were no alarm cords and the floor was slippery. People fall and injure themselves frequently in bathrooms. One expects hospitals to give more thought to the design of bathrooms on their premises.

Nurses and doctors traditionally have scant regard for the privacy of patients. A knock on the door, a smile and a polite request for admission can smooth feathers ruffled by a doctor or nurse barging in on a sleeping patient and suddenly switching on bright lights. Unfortunately my feathers remained ruffled.

There was a large wipe board at the entrance to my ward where I was horrified to see the names of each occupant of the ward with details of their ailments and proposed operations. This practice dates to the dark ages: my medical details are private, not meant for the public at large.

My consultant kindly came to chat with me after my operation while I was still groggy. He chose this time to tell me in front of my wife, my son and several other people that (although this needed confirmation) he thought I had cancer, and spoke of five year survival rates. This disclosure that ought to have been made in private was gauche, and (mercifully) plain wrong and I hope he refrains from inflicting unnecessary pain on patients and their families in future.

Successful lawsuits have been lodged in the West on such occurrences and rightly so. 

The above article was printed in The Friday Times on the 24th of December 2010.