(formerly IRIN News) Journalism from the heart of crises

Millions unable to afford health care

Diagnostic tests or hospital care are out of reach for many poor people in Pakistan
Kamila Hyat/IRIN

“I suffer from hepatitis C. Please help me live by giving your charity to help me buy medicine. I have five children who depend on me.”



Thus reads a placard next to Shahida Bibi, who has taken to begging on the streets of Lahore in her spare time in a bid to afford the medicines which could save her life.



As a cleaner she earns about US$40 a month. On this income and about $53 handed over each year by her brother, she must support her children - the eldest of whom is 15. Her husband, a drug addict, abandoned the family two years ago.



“I don’t know how I contracted hepatitis C. It could have been when my youngest daughter was born about 18 months ago. A ‘dai’ [traditional, untrained midwife] delivered her. But now doctors say I need injections that cost at least Rs 50,000 [$666] for a six-month treatment plan if I am to live,” she told IRIN. “I beg, even though I hate doing it, because somehow, for my children, I must live,” she said.



Shahida is one of millions unable to afford medical care. According to official data, there are 127,859 doctors and 12,804 health facilities in the country to cater for over 160 million people.



More and more people are being denied health care simply because they cannot afford it.



“Fewer and fewer people consult doctors. Fees have not gone up, but the cost of medicines is high, and even when they see a doctor they often cannot follow up on care, as medicines are beyond their budget,” said Waheed Sharif, a general practitioner in Lahore. As an example, he cited the case of a patient with high blood pressure who took the pills she is supposed to take each day only once a week “because that’s all she can afford”.



Inflation



Consumer prices have risen by over 20 percent in the last year, according to the Federal Bureau of Statistics, placing enormous stresses on most households.



“My wife suffers diabetes. Her feet are now swollen and she often feels tired. Apart from medicines, the doctors have suggested a special diet - but how can we afford to give her fruit and meat when I earn only Rs 8,000 [about $106] a month and must educate my children as well,” said Qaiser Hussain, 35, a father of two.



Hussain suffers from a shortage of breath, but says: “If I go to a doctor they will prescribe expensive tests and medicines and I cannot afford them. Therefore I simply do not go”.



Amir Omair, an associate professor in the community health sciences department at Lahore’s Fatima Memorial Hospital College of Medicine and Dentistry, told Herald, the local monthly magazine, that people were now consulting doctors only when disease became acute, because of the financial burdens they faced.



“Health has become a luxury”



The Network for Consumer Protection, an Islamabad-based NGO, which conducted a detailed survey in 2004 on the pricing of drugs and access to them, found “public health facilities had extremely low availability of essential medicines” while “medicines for common treatments were unaffordable and out of reach to the poor when purchased in the private sector.”



“Basically health has become a luxury. The rich can get the best treatment. But people like me cannot afford to be sick,” said Qaiser Hussain. He fears that, like his father, who died of cardiac arrest in his 50s, he has a heart disease. “I suspect this, but what can I do? I must just wait and see,” he said.



kh/at/cb

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