Nurse giving care in a general ward at St Elizabeth Hospital - Photo: Fr Robert McCulloch
The official Pakistan Economic Survey 2020-2021 says that “the Covid pandemic has tested Pakistan’s health infrastructure” and even more so because the total Pakistan federal and provincial government healthcare expenditure in 2019-20 for a population of 220 million was just 1.2% of GDP.
St Elizabeth Hospital responds to this healthcare crisis in Hyderabad and in the surrounding rural areas. At the same time, it helps Pakistan to achieve the United Nations Sustainable Development Goal No.3 relating to health.
St Elizabeth Hospital is owned by the Catholic diocese of Hyderabad and has its own Board, Administration and Management. It is an 80-bed general hospital with a specialization in Mother and Child Care. It has three operating theatres, outpatients’ department, emergency room, and digitalized Xray equipment. Pakistan has excellent healthcare legislation but enforcement is loaded again the private sector. Government healthcare bodies struggle to comply due to financial constraints. The strategy of the very young but highly qualified and professionally competent Administrator (36 years old Eric Siraj is administrator) and Management Team (average age is 33) has been to anticipate governmental legislation by putting into practice obvious health requirements relating to infection control, medical waste, a central sterile supply department, pharmaceuticals and environmental issues. This has created a positive working relationship with government bodies.
St Elizabeth’s Home-Based Palliative Care (HBPC) and Mobile Medical Outreach Programme (MMOP) are two ways that we respond to obvious healthcare needs. Through HBPC and MMOP, St Elizabeth implements the call made on World Health Day, 7th April 2021, from the Vatican by Cardinal Peter Turkson, head of the Secretariat for Promoting Human Integral Development, that “health inequalities are preventable through strategies that aim to ensure equal access to healthcare especially for those who are vulnerable and marginalized.”
Staff member in the hospital clinical laboratory at St Elizabeth hospital - Photo: Fr Robert McCulloch
Since 2005, St. Elizabeth Hospital, through its Home-Based Palliative Care, has provided breakthrough healthcare in Hyderabad to terminally-ill cancer patients in a way not found elsewhere in Pakistan. St Elizabeth is the only hospital in Pakistan that provides home-based palliative care. A very few other hospitals in the major cities have in-hospital palliative care. Palliative care nursing given by St Elizabeth is free. It is a 24-hour on-call emergency service as well as regularly scheduled visits. In January 2022, 20 cancer patients were receiving palliative care nursing, of whom 17 were in 4th stage. The four nurses and two doctors made 174 home visits. We urgently need financial assistance to provide another motorcycle for the nurses to get through the very narrow unmade streets to patients’ houses, and for one of our HBPC male nurses to do a specialized Diploma in Oncology Nursing in Karachi.
Through its MMOP, St. Elizabeth Hospital has been the sole medical provider since 2008 to over 50,000 impoverished people every year. The problem is that the doctors are concentrated in cities. Access to primary health care in rural Pakistan is limited; poverty makes it almost impossible. As the Pakistan Economic Survey says: “health care delivery suffers from some key issues like the high population growth, uneven distribution of health professionals, deficient workforce, insufficient funding and limited quality health care services.”
The MMOP overcomes these issues by providing regular, effective, professional, compassionate and free health care to many impoverished semi-nomadic tribal people who are bonded agricultural workers in Sindh province in south-east Pakistan. MMOP is their sole medical provider. The majority are Hindu although many are marginalized Muslims and Christians.
Care being given to an infant in the Emergency Room at St Elizabeth Hospital - Photo: Fr Robert McCulloch
Due to Covid restrictions, MMOP has had to be somewhat reduced in its outreach However, from January 13th-22nd, 2022, 1,564 patients were seen and provided primary health care. Common healthcare issues are those related to mother and child, malnutrition, malaria, typhoid, gastroenteritis, respiratory tract infections, anaemia, jaundice, viral infections, dehydration, urinary tract infections, skin diseases, and TB prevention and control. Responding to the need is a huge strain on St. Elizabeth’s limited financial resources.
In addition to providing free immediate primary healthcare, the Mobile Medical Outreach refers patients for further levels of care to Hyderabad and Karachi for which St. Elizabeth accepts financial responsibility and which it monitors through its nursing staff.
The neo-natal mortality rate and the maternal mortality rate in Pakistan are the worst among the four Asian countries given for comparison by the Pakistan Economic Survey 2020-2021. Attached to St Elizabeth Hospital is St Elizabeth School of Midwifery which aims at addressing this crisis situation. Young Christian women from situations of marginalization and religion-based discrimination come to train at the School of Midwifery. They advance their socio-economic position by becoming skilled professional and qualified midwives for maternal, neo-natal and infant care. Twenty young women will graduate from the School of Midwifery in 2022. Funding the School of Midwifery is a continual financial challenge for the Board and Administration of St Elizabeth Hospital.
Much needs to be done to expand the services and healthcare given at and through St Elizabeth Hospital. Locally generated income is sufficient only for salaries and basic running costs. For everything else, we depend totally on the generosity of donors and benefactors.
Columban Fr. Robert McCulloch worked in Pakistan for 34 years.
Related links
