Town Talk
*Exhibition: 'The work that will probably never end' by multidisciplinary artist Saira Ansari at Grey Noise, 26 A, KB Colony, Street 4, Airport Road, Lahore Cantt.
*Exhibition of landscapes at Hamail Art Gallery.

The citizens of Lahore were struck with remorse earlier this month when they heard about the closure of Janki Devi Maternity Hospital, known for offering outclass medical services to people since before partition. Located off Abbott Road and right next to the passport office in Qila Gujjar Singh area, the hospital had been catering to the needs of patients coming from different parts of the city and beyond, at nominal costs.

The Evacuee Trust Property Board (ETPB), which manages the hospital, claims the facility has been shut down for renovation work and will be opened once it's over. However, the banner placed on the main gate of the hospital reads it has been closed due to non-release of funds from the federal government. Both these excuses have been termed contradictory by the hospital staff and patients who say how can the hospital management think of renovation work in the absence of funds.

On a visit to the hospital premises and during conversation with some members of the hospital staff, it was revealed to TNS that the real causes behind the closure were the inability of ETPB to manage its affairs and strike a truce among the warring groups of its staff members. Minor financial problems are there but can be managed easily, they believe. They also doubt the hospital might be closed for good though the board had announced its closure for a specific period.

The ultimate sufferers no doubt have been the patients and their families who would come here without fear of being fleeced or maltreated during childbirths, says Mrs Najaf Malik, mother of two daughters, Khadija Ali and Fatima Ali, born at Janki Devi Hospital in 1997 and 2004 respectively. She tells TNS that the level of medical care and treatment at the hospital was extraordinary and not even heard of at expensive private hospitals of the city.

She says a lot of staff members, especially the nurses and other paramedics, had been working there for over 20 years and associated with each other just like family members. Similarly, generations after generations, had benefited from the hospital and naturally developed a loyalty with it, she says. She tells TNS she knows many girls whose mothers and grandmothers were also born here.

Mrs Malik says the hospital closure has hurt her directly as she was planning to bring her pregnant niece here for her first delivery. She shares it with TNS that the hospital charges Rs 15,000 for a Caesarian section, inclusive of medicines and bedding, and Rs 5,000 for a normal delivery, also inclusive of medicine and bedding. No doubt this hospital has been a blessing for the poor and the low-earning population of the city and must not cease to exist, she adds.

The 15-kanal Janki Devi Hospital was established by Dr Jamiat Singh who was professor of pathology in King Edward Medical College Lahore. He lost his wife Janki Devi during delivery, in whose memory he planned to build a quality maternity hospital Dr Jamiat Singh made a trust hospital by collecting donations in 1930 where all the patients, irrespective of religion, cast and creed, were provided treatment free of cost. After partition the hospital came under the administrative control of Punjab Government and later on June 7, 1993, hospital affairs came under the administrative control of ETPB.

Everything was smooth at the hospital till the former ETPB Chairman Lt Gen (retd) Zulfiqar Ali Khan gave it under the control of an NGO Pakistan Model Educational Foundation (PMEIF)-run by his close relative Lt Col (retd) Izhar-ul-Haq, says a medical officer at the hospital on condition of withholding her name.

She tells TNS that Izhar recruited around 40 people which were not needed at all, taking the strength of the hospital staff from 60 to 100. This additional burden has created financial problems for the hospital as most of these new employees are appointed somewhere else but draw salary under the head of the hospital, she adds.

The medical officer tells TNS that the then Medical Superintendent (MS) Dr Fauzia Asif was forced to resign by Izhar. The removed MS was reinstated by the federal government later on and the hospital was taken back from the NGO but the ETPB has not yet allowed Dr Fauzia to resume charge, she says. Even the sitting ETPB Chairman Pir Asif Hashmi did not restore the former MS and appointed his deputy secretary Fauzia Aziz administrator to look into the matter, she says adding: "This led to quarrels among different groups of doctors and finally the closure of the hospital."

The ETPB Chairman Pir Asif Hashmi has confirmed in his talk with media that the hospital was not only facing financial hardships, but quarrels were the order of the day because of grouping and lobbying among staff members.

The closure of Janki Devi Hospital has not only surprised the general public but baffled the ETPB members as well. ETPB member Dr S. M. Yaqoob tells TNS that he did not know about the closure of the hospital and came to know about it from media. He says he was part of the committee formed to propose measures to improve its affairs. He tells TNS there were several issues including quarrels among the staff and the committee was working on a report which could not be submitted before the closure of the hospital.

A copy of an FIR available with TNS hints at the intensity of quarrels going on among staff members at Janki Devi Hospital. The report numbered 1017/2010 registered at Qila Gujjar Singh on August 5, 2010 says Dr Samina Khan, a pregnant staffer of the hospital, was beaten up by another staffer Dr Sabeeka Naz so severely that it led to an abortion. The charge if established can lead to 10 years' imprisonment for the attacker.

However, it has been learnt that the family of Dr Samina, the aggrieved, is not publicising the issue on request of some PPP high-ups, closely associated to the sitting ETPB chief. Hospital staffer Dr Farah Hafeez, administrative officer Fauzia Aziz and former administrator Col (retd) Izharul Haq are also nominated in the FIR under charges of abetment.

Another ETPB member Ezra Shujaat also tells TNS that he was not aware of any developments on the hospital closure issue. He says he cannot confirm when the hospital will re-open as the board had not even met for the last six months. This is something which proves ETPB affairs are not being run with consensus and only a couple of people are calling the shots.

Pakistan Medical Association (PMA) Punjab Chapter has termed the closure of the hospital an attempt to sell out its 15-kanal prime land and has offered to run it if ETPB and Punjab government cannot do that.

trend

The 18th of last month Ahmad Hassan, 44, was going home from his office in Gulberg on canal road when suddenly he felt sharp white light being flashed from a speedy car following him to overtake his car. Hassan's eyes could not tolerate the rays of the high intensity light on his rear view mirror. His car went out of control, shockingly moving towards the footpath along the canal and stopped short of falling into the canal.

Like Hassan, many other people who regularly drive on the main and busy roads of the city feel that the 'bad' trend of using high intensity flash lights in cars and surprisingly now in motorbikes too, is spreading very fast.

"It is becoming a fashion," says Owais Ahmed, a businessman in late 30s, who also luckily escaped an accident due to the High Intensity Discharge (HID) light in the cars while driving on the Allama Iqbal Town main boulevard in 2005. "It was just the HID light in a car that blinded me," he recalls.

"Five years back few cars were using such flashlights but now there is an alarmingly rise in the trend," he says, adding that anybody who stops along The Mall at night can observe that every third or fourth car has white or beam lights which hurt the eyes of drivers. "You feel great discomfort but sadly nobody bothers," he laments.

According to the Excise and Taxation Department figures, the number of registered vehicles in the city is around 1.8 million. "On average, around 10,000 vehicles, including up to 6,000 motorbikes, are registered in the provincial metropolis every month," says Akram Ashraf Gondal, Additional Director General of the provincial Excise and Taxation Department.

A traffic warden at The Mall says, requesting anonymity, "We act when we receive a complaint. By law nobody can use sharp lights. They are supposed to be low. Also, nobody is allowed to fabricate lights. Other than company fittings, lights are strictly forbidden."

An inspector in the traffic police says that many people are using HID lights, which is not allowed and we have fined them many a time. "These are beam lights, laser lights, xenon lights, which are not allowed. However, some luxurious cars like BMW and Lexus etc. have in-built white lights, but that is not HID light," he explains.

Some of the HID lamps are mercury vapor lamps; sodium vapor lamps; and Ultra-High Performance (UHP) and xenon light.

The motor vehicle law of the provincial government covers the subject to some extent, but does not specifically mention the use of any particular light, says one inspector serving in the helpline of Lahore Traffic Police.

"The law is not revised since 1965, though some amendments were made to the law a few years later," says a legal officer serving in the traffic department of the city. The rules amended did not ban use of HID lights in vehicles.

Only Section 112-A of the Provincial Motor Vehicles Ordinance 1965 covers the issue of lights. The section titled "unauthorised use of emergency light or a distinctive sign," reads that "A person who displays a revolving or an emergency light, fabricates or counterfeits a distinctive sign or mark on a motor vehicle in violation of the provisions of this Ordinance, the rules or a notification issued by the government, shall be punished with imprisonment which may extend to six months or with fine which may extend to one thousand rupees or with both."

"We know that the use of HID lights is on the rise and we challan the violators. So far, there are not many complaints against these lights," says Chief Traffic Officer Captain (retd) Ahmad Mobeen, while talking to TNS. He says a meeting would be convened soon to take up the issue. "Last week, according to the figures, 53 people were fined for using beam and HID lights," he points out.

However, the authorities seem unaware of the damage to the eyes because of the HID lights. There are vigilance and complaint cells in the traffic police section but these are more about the monitoring of performance of the traffic wardens and not about the issues of the drivers and the public.

"Such lights are damaging for retina and can lead to even serious diseases like eye cancer," Prof Dr Asad Aslam, a leading ophthalmologist of the city who is serving at King Edward Medical University, tells TNS. "These are ultraviolet rays that create discomfort," he says, suggesting strict ban on them. "HID or xenon lights badly affect the vision," says another ophthalmologist Dr Hameed Awan. "It naturally affects eyes and can lead to accidents," he mentions, calling for strict implementation of the law to stop this trend.

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A whooping sum of Rs 595 million public money spent on producing doctors in Punjab goes down the drain every year. Now that sounds strange and shocking.

"The government spends Rs 500,000-600,000 on each medical student every year," says Muhammad Atif, Director Media and Publications, University of Health Sciences (UHS), Lahore. However, "this money is wasted when almost 50 per cent of the girl students abandon their education halfway: either in the third or the fourth year of their studies or after passing their MBBS final exams," he adds.

"75-79 per cent girls are on the list when admissions to various medical universities and colleges are closed. However, when the medical graduates get themselves registered with the Pakistan Medical and Dental Council (PMDC) to practise medicine, their ratio drops to as low as 41 per cent," the UHS official says. The Council is the only statutory, regulatory and registration authority for medical and dental education in Pakistan.

According to the University of Health Sciences official documents, the total number of students admitted to medical colleges and universities in Punjab this year stood at 3,175. Its 75 per cent makes 2,381 female students. PMDC data confirms almost 50per cent female medical students will drop out when this batch graduates. So, the number of female students who would most probably continue with their profession would be reduced to 1190. And the money spent to train remaining 50 per cent students would be wasted.

According to the PMDC statistics, given at its website http://www.pmdc.org.pk/, there were total 112,183 qualified doctors in the country till December 2009 66,083 male and 46,100 female doctors. These general practitioners included 58 per cent male and 41 per cent female doctors.

Majority of female doctors did not register themselves with the PMDC for specialisation. According to the official statistics, the ratio of specialist female doctors in the country is only 23 per cent, compared with 77 per cent male specialist doctors. The total number of specialist doctors in the country till Dec 2009 was 21,629, and 16,808 among them are males.

However, Fatima Jinnah Medical College (FJMC) Principal Prof. Dr. Rakhshanda Tayyab does not believe that such a large number of female students drop out during their medical education.

"What I know through my experience at the Fatima Jinnah Medical College (FJMC) is that only a few female students opt out of medical education before completion of their four-year programme," she says. "Getting admission to a medical college or studying medicine is not an easy job. So, why will they (female students) leave it halfway?" asks the principal. "However," she admits, "a small number of female students abandon their medical education midway for biological functions; they get married and, sometimes, they have to leave their education, or profession, due to family pressures," explains Prof. Rakhshanda. "And this is not a Pakistan-specific phenomenon."

Ayesha Aslam, a final-year student at the FJMC, agrees with her principal. "Only three out of total 250 students of my class left the college without completing their four-year medicine programme," says Ms. Aslam. However, she knows some girl students who left medical education in the first year after finding it a very tough programme.

For those who do not join the profession after completing their medical education, Ayesha Aslam says, "our society and cultural values should be held responsible."

Though Principal Prof. Rakhshanda terms large dropout rate mere speculations, she is interested in knowing the reality. "No official data is available on the dropout rate among female students. I feel a comprehensive study should be conducted to ascertain the number of female students, who leave their medicine education during their first, second, third or fourth years. Those who do not join profession after completing their MBBS education should also be part of the study," the FJMC principal suggests.

The University of Health Sciences Media and Publication Director says a good number of girl students resume their studies later on, as the law permits them to do so. They could resume their studies within five years of discontinuation. However, they have to reappear in all their exams they have already cleared if discontinuity spans over three years.

Relating reasons for high dropout rate, Muhammad Atif says: "Medicine student or a doctor means a good match for a girl in our society," he claims. Dropout rate among female students with rural backgrounds is especially high. "When they get married in feudal families, mostly they are not allowed to continue with their medical education or profession," adds the UHS official.

Dr Saeed Elahi, Chairman of the Chief Minister's Task Force for Control of Spurious Drugs and Health, says the government is aware of the gravity of the situation. The dropout rate among female medical students needs to be verified on scientific basis for effective planning. He says the number of doctors registered in Pakistan at present is about 113,000, while 25,000 of them are working abroad. It means only 88,000 doctors are available for a population of over 170 million, making a ratio of one doctor for about 2,000 persons. The doctor-population ratio, recommended for developing countries like Pakistan by the World Health Organisation (WHO), is one doctor for 1,000 people. That means we need at least 170,000 doctors in Pakistan for a population of 170 million, hence the need for another 57,000 doctors.

A high dropout rate among female medicine students in such a situation should be a serious cause for concern, adds Dr Saeed Elahi. He says health is a top priority of the provincial government and more medical and dental colleges are being set up in the province. In fact, 50 medical colleges and 23 dental colleges in public and private sector are not fulfilling the needs of the country -- "The medicine students are being imparted almost free education at the public sector medical colleges and universities. The government spends over three million rupees to train a doctor and charges a nominal tuition fee of about Rs 20,000 to 50,000 in five years," he says.

Dr Elahi says the authorities have planned special measures to curb dropout ratio among female medical students, especially in medical colleges of small cities. All students who would get admission to medical colleges against reserved seats of their respective districts would be bound to serve in their respective districts for five years. They would have to fill a surety bond worth Rs500,000 for admission to any medical college; and if they fail to serve in their districts after completion of their medical education, they, or their parents, would have to pay this money to the government as fine.

All students would also submit another affidavit at the time of admission to any medical or dental college, declaring that they would serve the province of Punjab for a period of five years, including two years in rural area, after graduation. In case of default, the medical graduate, or his/her parents, would have to pay Rs 500,000 fine to the Government of Punjab, the advisor on health explains.

"There was a suggestion to award the degree award once the candidate has joined the profession. However, the Punjab chief minister does not approve of the suggestion, as it would be a violation of the basic human rights. "All other possible measures would be taken to curb dropout trend among female students," he adds.

Commuters are faced with several problems due to the poor quality of the public transport service in the provincial capital. They have to wait at bus stops for a long time, thanks to a small number of public transport vehicles. Usually, it is seen that the commuters have to wait for about 30 minutes at the stops to board a bus to reach their destinations. The situation is worse on public holidays and on Sundays when a lot of transporters don't take out their vehicles assuming that there would be fewer travelers on the roads.

There are several transport companies which are plying buses in Lahore. Almost all the public buses are in poor condition, except one which is the only air conditioned bus service in the city. Majority of buses have either broken windows or they are without glasses. Moreover, their floors and roofs are damaged and their seats are broken. The lights inside the buses are either out of order or broken. Their problems have compounded by the suspension of van operation on certain routes.

There are motorcycle rickshaws in the city as well but they usually provide limited service. They are not allowed to ply on main roads, including The Mall, Ferozepur Road and Jail Road. However, after 10pm, the drivers are ready to go on main roads.

Public vans and buses are overloaded with passengers. The seating capacity of the vans is 15, and that includes the driver and conductor also. Most conductors take in four extra passengers without bothering about the fact that they will have to stand with their backs bent over.

The buses have 25 seats while their standing capacity is about 40 people in the male cabin. There are 12 seats in the female cabin and the standing capacity here is 15. The public transport vehicles are packed during the rush hours as more and more people try to board them. Many a bus is seen overloaded with people hanging at the doors, putting their lives in danger.

Some conductors also allow travelers, especially students, to sit on the roof tops irrespective of the dangers involved. This happens due to the shortage of buses and vans in the city. Traffic wardens are responsible also for overloading as they do not issue challan tickets to bus drivers.

The Lahore Transport Company, formed by the chief minister to provide trouble-free travel, has failed to deliver. It has so far taken no steps to check damaged and broken buses plying on the city roads.

Kashif, a student says that it is not fair to pay full fare and have to travel without a seat. Hannan, a shopkeeper says that drivers and conductors do not care for old people while boarding and getting off from buses and vans. "They treat all passengers alike. Sometimes, they force old men to board and get down from moving vehicles, which can be very dangerous for them."

He says that the buses of route No. 1 and No. 3 start a race with each other when they reach a stop.

Jawad, a factory employee, while standing at a bus stop on Ferozepur Road, says he has been waiting for about an hour. Hiring a taxi or a rickshaw, he says, is too expensive. "The Punjab government has closed the van service on many routes, causing an acute shortage of public transport in the city, while private companies lack required number of buses to transport public efficiently." He says that commuters, especially women and old men, have to face inconvenience when these buses break down on the road.

Several passengers say they have registered their complaints with the transport company's staff many times in the hope that the bus service will improve, but to no avail. The staff doesn't see any improvement in service for shortage of funds and non-provision of subsidy provided by the government.

The seats are hard and the drivers do not reduce speed on bumpy roads causing jerks. Commuters who travel daily complain of poor quality seats in buses which cause them backache. Buses with broken seats should not be allowed to ply as they can cause injury to commuters, besides damaging their clothes.

A manager of a transport company says the company is facing financial crunch due to regular increase in the prices of diesel. He says the company has demanded subsidy from the Lahore Transport Company for repair of buses.

A spokesman for the Lahore Transport Company admits that there is a shortage of buses in the city and to overcome this problem they are planning to ply 2,000 new buses in the next two years. He says the company gives subsidy to potential transport owners to buy new buses. He reveals that about 400 buses, most of them in poor condition, are running in the city for about nine million population, besides vans and rickshaws.