Quackery quagmire
Quackery quagmire
Quackery quagmire
Quackery quagmire
Lahore is home to scores of unqualified medical practitioners -- some even administering animal vaccines to their patients
By Rasheed Ali
When Muhammad Shahid failed his matriculation examination for the second time, his father put him into a clinic in his locality to add a few hundred rupees to his meagre monthly income. Shahid was supposed to open the clinic on time and clean it up before the doctor arrived.
With the passage of time, he started learning other jobs at the clinic too. One day, when doctor's assistant, a paramedic, had to leave to attend to his ailing mother at home, Shahid was asked to take over the responsibility for the time being. He prepared patients' drug doses and even administered injections to at least two patients that evening 'successfully'.
He was very happy. It was the first step towards what he had been planning for over six months -- to become a 'doctor'.
After some months, the doctor got rid of his assistant, as he had to pay a 'bigger' salary to him. During his two-year stint with the doctor, he learnt almost all jobs that are performed at a small clinic. And then one fine day, he decided to part ways with the doctor "due to his harsh attitude", and set up his own clinic.
Now, he claims, he is a respected and famous 'doctor' of Jhuggian Nagran Road slum area of Lahore.
It may be an interesting anecdote, but not a new one. There are hundreds and thousands of 'doctors' like Muhammad Shahid.
"When parents find it hard to send their children to schools, mostly they send them to three places: madrassas, auto-workshops and clinics," says Maqbool Ahmad, a pharmaceutical trader.
"With the passage of time, they become imam masjids, mechanics and doctors, respectively," adds Maqbool in a lighter vain.
Maqbool Ahmad, a former regional manager of a famous pharmaceutical company, knows dozens of people who are non-qualified but 'successful doctors', running their clinics in various parts of Lahore.
"Look at Badami Bagh area alone. The locality, home to over one million people, has become a hub of quackery, like many other parts of Lahore.
"To cater to the medical needs of this big population, only five qualified, MBBS doctors are available in the entire locality. On the other hand, dozens of quacks are playing with the health of the people," Maqbool Ahmad regrets the state of affairs.
Punjab Medical Association (Unity Group) President Dr Muhammad Abdul Rauf agrees with Maqbool Ahmad's viewpoint. Elaborating, he says: "These quacks can be divided into three categories: (a) almost uneducated, untrained people, who spend some months with a doctor or a quack, and then open their own clinics; (b) homoeopaths and hakeems, practising allopathy; and (c) paramedics, who are allowed limited medication tasks under the law."
A separate category is of dentist quacks that can be seen running their shops and stalls in various parts of Lahore, especially the walled city and public places including railway station, general bus stand and Data Darbar etc. They are the biggest source of spreading hepatitis, AIDS, cancer and other fatal diseases in the city, he adds.
Being unaware of the ill-effects and side-effects of medicines, these quacks give patients different medicines at will. Mostly, they give their patients a combination of different tablets and syrups, hoping that one medicine or the other would surely cure the patient.
The most criminal aspect of the practice is the use of veterinary medicines, steroids and banned drugs for human beings by these quacks. They use steroids for treatment of even minor ailments like cough, fever, flu and allergy, says Dr Tariq Khokhar, a general practitioner, sitting at a private medical facility in Badami Bagh area of Lahore. When people taking these steroids become habitual, other medicines become ineffective in treating them. The steroids silently damage patients' immune system, increase body weight, cause heart ailments, weaken bones and disturb kidney functions, adds Dr Khokhar.
Children are the worst affected. When they are given heavy doses of antibiotics and steroids in their early age, they become prone to fatal diseases in the years to come, says Dr Khokhar. It is an irony that these quacks take their children to qualified doctors when they become ill, but continue playing with the poor children's health, he complains.
The steroids commonly used by quacks are Prednisolone tablet, Decadran injection/tablet, Dexamethasone tablet, Divalproex tablet and Pholcodine tablets and syrup.
Dr Abdul Rauf said various veterinary medicines are also used by quacks for the treatment of human beings. These medicines include Chloroquine 50 ml vial, Vitaman B12 50ml vial, Dipyron 50 ml vial, Dexamethazone 50 ml vial, B-Complex 50 ml vial, Prednisolone 50 ml vial, Oxteracycline 50 ml vial and Phenyl Butazone ampule and vials. All these drugs are injurious to human health and have been banned by the health ministry for human use.
A veterinary medicine, B12 50 ml (vial), is administered to humans in the form of injections by the quacks for general weakness. A vial is available for about 10-15 rupees, and quacks 'earn' hundreds of rupees from it by making eight to 10 injections out of it. "They use one syringe again and again, injecting their patients with hepatitis and other viruses," warns Dr Abdul Rauf.
Another disturbing aspect of the situation is that various MBBS doctors are hand in glove with the quacks in this inhuman business. They rent out their nameplates to the quacks and charge thousands of rupees on monthly basis. The nameplate of one particular MBBS doctor could be seen at clinics of at least four quacks in Badami Bagh area of Lahore. The said doctor charges these quacks Rs6000-7000 a month, and helps them out in case of a raid by the health department authorities. And he is not the only one of its kind.
"It is really hard to stop this practice. If a doctor says he sits in all these clinics during different hours of the day, it is very difficult to check him or challenge him," believes Maqbool Ahmad.
The Punjab Health Department seems ineffective in curbing the menace. The drug inspectors, supposed to check these illegal practices, are more interested in making money through quacks. Getting bribes on monthly basis is now a thing of the past. Now they have turned it into a business. These drug inspectors buy various herbal medicines and supplements from Lohari market on very cheaper rates and then force the quacks to buy these products on high prices. Almost all of them have their front men for the purpose who supply these 'drugs' to the quacks at their clinics and collect cash from them.
The mafia is so strong that the government has so far failed to make an anti-quackery law in the province, says Ahmad Alam (not original name), the owner of a 24-hour health facility in Badami Bagh area. When the Pakistan Muslim League-N government was formed in 2008 in Punjab, a vigorous campaign was launched against quackery all over the province. The Supreme Court of Pakistan had also directed the federal and provincial health secretaries on August 28, 2009, to launch a crackdown on quacks, fake doctors and hospitals. Chief Justice Iftikhar Muhammad Chaudhry had issued the order while hearing a suo moto case of amputation of an arm of a baby girl, who had also lost her eyesight due to a wrong injection by a quack in Faisalabad. However, soon after that the campaign fizzled out when the PML-N realised the party might lose support of lakhs of its voters if the action is not stopped, alleges Ahmad Alam.
Dr Saeed Elahi, Chairman Chief Minister's Task Force for Control of Spurious Drugs & Health, does agree that the campaign could not keep its pace, but he has some other reasons to relate.
The Pakistan Muslim League-led Punjab government was fully aware of the severity of the situation and the need for an urgent action against quackery when the campaign was launched, says MPA Dr Elahi. However, soon it was felt the efforts would fail to produce the desired results if a comprehensive strategy is not made and legislation is not done to handle the issue effectively.
For the purpose, the Healthcare Commission Punjab was constituted, which, in collaboration with the CM's Task Force for Health, consulted all stakeholders. Their input was sought to prepare a draft bill on healthcare. At various meetings with all stakeholders, in-depth discussions were held on different aspects of the healthcare plan for the masses. Now the draft of Punjab Healthcare Bill has been tabled in the Punjab Assembly, which will be taken up for discussion and passage after the budget session, added Dr Saeed Elahi.
He said anti-quackery article is the first part of the bill. Once the bill is signed into a law, it would be helpful to a great extent in curbing all malpractices including quackery in the health sector.
He rejected an impression that legislation was delayed due to pressure of quacks' mafia. "There are about two million quacks in Punjab," says the task force chairman. "Of course, they are a strong mafia but the PML-N government is committed to providing good health services to the people of Punjab, come what may," assures Dr Saeed Elahi.
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