Duty of care - Monday, July 12, 2010

Source : www.thenews.com.pk

Chris Cork
Barely able to walk she struggled into the accident and emergency department at my local hospital. She had an infection on her leg that stubbornly refused to respond to treatment and I had brought Sakina for some ‘proper doctoring’ – or so I thought. Chaos prevailed. Relatives pushed trolleys around, a child with an airway inserted was having a back-arching spasm and a man mangled in a traffic accident breathed his last in front of us as we waited to see the doctor. His examination was perfunctory to say the least and he made no attempt to take a history – how she came to have the infection on her leg. The x-ray showed nothing of significance and we left with a prescription for yet more antibiotics and I knew that this was not the solution.

Twenty-four hours passed, Sakina got worse, I got worried and called a friend. If there is one lesson I have learned it is the utility of networking in Pakistan, and on my network is one of the finest doctors in southern Punjab. Would he see my servant at his hospital? Messages sent on Facebook and by email produced a rapid response – come tonight at 8.30.

The contrast between public and private medicine was painfully stark. The waiting area was clean. Nobody died lying on a trolley in full view of a fascinated audience. There was a sense of calm orderliness and then we saw The Doc. I have known him for several years as a friend and we talk politics every time we meet, but he was instantly focused on a poor small woman with a painful swelling on her right leg. He asked all the right questions and it was not long before we had a diagnosis that fitted a lot more closely with my own guess – there was a foreign body in her leg causing the infection and this is why the wound was not healing. Minor surgery necessary.

Saturday morning and a very nervous Sakina got operated on quickly and effectively in sterile conditions by a man who knew one end of a scalpel from the other. He found a splinter of wood deep in her leg and it is going to take a couple of weeks to heal. The wound was dressed on Sunday by a smiling nurse who was gentle and reassuring and Sakina is going to get better.

The other option, the option outside my network, was possible death. Had a proper history been taken by the doctor at my local hospital a correct diagnosis could have been arrived at and she could have been treated appropriately. Had there not been a Doubting Thomas such as myself she would have gone on her way, the infection would have rapidly worsened and it could have been the end of her.

I have no wish to pillory unfairly a public health facility where I have been well-treated myself on more than one occasion – as has Sakina four years ago. However, I strongly suspect that the ‘gora factor’ might have something to do with this even though it did not work this time around. My unexpected appearance more or less anywhere still provokes a flurry of busy-ness and feigned efficiency, be it in a hospital or an office or even my local supermarket where I am a weekly customer. It should not be like that but it is. Perhaps I am such a familiar figure around Bahawalpur these days that the gora-factor is wearing off, and I get treated like everybody else. Mental note to self – next time you need health care Cork...go private.

The writer is a British social worker settled in Pakistan. Email: anticore73@gmail.com

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