Pakistan: Doctors strike in a sick system

by Lal Khan

The latest strike of the young doctors has not only shaken the healthcare system in the Punjab but has laid bare its extreme decay and the callousness of the ruling elite towards the wellbeing of ordinary people. There have been a series of doctors’ strikes in the recent period particularly in the Punjab. Above all this exposes the rapid decline of the living conditions of professionals and the pauperisation of the once relatively prosperous middle classes. Burgeoning inflation, the rising cost of living, has made it difficult for especially young doctors to make ends meet. In its customary reactionary role the bourgeois media portrayed the doctors as the baddies. It shaped so-called public opinion by instilling malice into the social mindset against the striking doctors and then used it to ridicule the strike and protect the ruling elite and their rotten system that are really to blame for this wretched healthcare system. In the absence of an experienced leadership and with the isolation of the strike, the doctors were forced into a compromise under the enormous pressure of the situation that the media and the propagandists of the ruling classes had brought to bear on them. The judiciary was quick to play its role as an institution of the state to protect the status quo and its verdict, true to form, was against the strike. The military was called in by Shahbaz Sharif to bolster its dwindling image and once again present it as the saviour of society. These institutions have hardly ever in the country’s history carried out successfully the duties assigned to them. However, at the same time, they are very keen to play roles that are not related to their profession as they amass huge bounties by intervening in civilian affairs. Whereas the armed forces have failed to stop the drone strikes, they are used to break a strike where the young doctors were striving for wages of a liveable existence and demanding a structure for their jobs. The police and other repressive agencies of the state once again exhibited their real character as the custodians of this exploitative system. Their brutalities against the doctors exercising their fundamental right could be seen on the television screens. These incarcerations and atrocities are a clear proof of the nature of the present state and which class it is there to protect and who to crush when there is a slightest hindrance to the process of looting and plunder on which this system is based. One of the main arguments used by the stooges of the ruling class was the constant reminder of the ancient Greek Hippocratic oath that physicians have had to take for centuries and which has become a ritual in the medical profession. This was really pathetic in a society and in an epoch where everywhere in the state and society such oaths are meant to be broken. Their validity, authenticity and credibility have eroded almost to extinction. In a society drenched in corruption and crime it is the norm rather than the exception for the political elite in power to break oaths to the top brass of the state institutions. Those who were yelling at the young doctors about going against their Hippocratic Oath are themselves involved in massive corruption and coercion of society. The doctors were struggling with their backs to the wall. They only came out on strike when they had exhausted all other means to attain their minimum demands. The real cause of this devastation of the health sector is the failure of the state to grant the people their fundamental right to decent healthcare. According to a UNDP report 82 percent of the Pakistani population is forced into non-scientific medication. More than half a million women die every year during childbirth due to lack of basic obstetric facilities and 1132 children die every day on average due to hunger and deficiency of paediatric care. Pakistan’s budget allocation to the health sector is probably the lowest in the world. And the conditions in the rural areas are even worse. Instead of developing heath facilities successive regimes after Z.A. Bhutto’s government in the 1970’s that spent 42.3 percent on healthcare facilitation, have only eroded the state health system. With the free market reforms and aggressive “neo-liberal” economic policies, the vultures of private capital have intruded into the health sector. It is one of the most profitable enterprises and chains of private hospitals and clinics have sprung up since the 1980’s. The plight and salaries of the young doctors in the private sector are even worse. The commercialisation of healthcare has deprived large sections of society of proper treatment. They simply cannot afford scientific medication. A putrefying society, where filth and garbage are piling up due to the decaying sanitation infrastructure, exasperates the spread of diseases and infections. But there is also a stringent class divide amongst the doctors. The senior doctors and the established practitioners are making lucrative profits and accumulating enormous wealth. Not only do these senior doctors leech off the patients, they also receive huge ‘incentives’ from the pharmaceutical companies and the mushrooming laboratories. It has become a norm to write excessive prescriptions and tests that are mostly unnecessary, because they enhance the profitability of the corporate drug industry. This class contradiction also came out clearly when these established doctors, who always try to lure the patients from the public hospitals to their private clinics, acted as strike breakers supporting the right-wing conservative government. The reality is that health education and other basic necessities are not a preference of the present rulers and the political elite. Almost all mainstream political parties had a contemptuous attitude towards the doctors’ strike. Even if the rulers wanted to impart universal health to all the citizens there is no room for this in the present economic system. In a crisis-ridden capitalism the lust for more profits is accentuated even further and every sector of society is targeted to fulfil this insatiable lust. The doctors have to learn the lessons that they are also part of the working class. They will have to shed all the prejudices of profession and institution. If other sectors of the proletariat had joined in the strike the outcome would have been different. The whole of society is suffering from the calamities produced by this rotten system. It will; be the working classes who will have to rise in a united class struggle to overthrow this system and end misery, poverty, deprivation and exploitation.