Pakistan : Infant mortality — a case of medical negligence

By Sehrish Wasif

The family of two was ready to welcome their little bundle of joy. Invitations were sent to relatives back home. Pink decorations awaited the baby girl’s arrival before everything came to a crashing end.

“Over a year ago we lost our first baby due to negligence of the doctor. She [the doctor] deliberately postponed delivering the baby long after my wife was due to give birth,” said Jehangir Shah, adding that the delay led to development of infections in the child who could not survive and died two months after being born.

Following one unfortunate incident, Shah was extra careful the next time. He took his wife to the District Headquarter Hospital (DHQ) Rawalpindi a day before she was due. However, doctors turned the couple away asking them to return later.

The return did not hold good news for the two as the wait took away their second child, this time a boy. “The doctors told us that feces of the child were stuck in his lungs,” Shah explained.

Much like this couple, many parents lose their newborns owing to medical negligence every year in the country.

According to the United Nations Children’s Fund (Unicef) report titled, ‘The State of The World’s Children 2014’, Pakistan has been ranked at 26 in the list of countries with the highest infant mortality rates across the globe.

Highlighting a similar issue, another survey carried out by Save the Children— Ending Newborn Deaths— states that with a sorry state of affairs regarding maternal and child health, Pakistan records the highest number of stillbirths globally making it the most dangerous place to be a mother or a child. The issue, however, remains ignored by the policymakers and stakeholders alike.

Such neglect has led to tragic outcomes which are either often not focused on or investigated from a health system’s perspective.

Commenting on the issue, senior gynecologist in the maternal newborn and child health department at Pakistan Institute of Medical Sciences, on condition of anonymity, told The Express Tribune that a high number of expectant mothers are turned away by doctors everyday without any valid reason.

These couples have no platform and are left with no other option but to go back.

She added that most of these pregnant women come from far-flung areas and seldom come back after being returned once. The couples usually cannot either bear to travel so far once more or are unable to bear the costs of travelling.

“This is one of the main but self-created causes of child and maternal deaths in the country. All it requires is behavioural change, not any other paradigm shift in policy,” she insisted.

Accepting that there was a need for change of perceptions, Agha Khan University Community Health Sciences and Family Medicine Associate Professor Dr Omrana Pasha was of the view that there is a need to teach professional ethics at medical colleges.

Pasha said it is the prime responsibility of a healthcare professional to attend to his or her patient at any cost, especially when a pregnant mother comes to them for medical help.

“Such rude or ignorant attitudes of professional healthcare workers force these expecting mothers to get their babies delivered with the help of unskilled midwives at home or small clinics which usually results in death of both the mother and the child” she said. A medical officer (MO) at one of the Basic Health Units in Rawalpindi District revealed that after being turned away by doctors, couples approach him for deliveries. “I too have to turn them away as the delay already causes complication risking the lives of both the mother and the child,” the MO said, on the condition of anonymity.