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Monday Jun 29 2020

How doctors overseas can help Pakistan during a pandemic

Several COVID-19 cases also go unreported, as patients have limited or poor access to healthcare facilities. Photo: Reuters

In March, the World Health Organisation (WHO) declared COVID-19 a pandemic. Since then, 10 million coronavirus cases have been reported worldwide with over 500,000 deaths, as of June 29.

The emergency has challenged healthcare systems around the world, particularly those of developing countries like Pakistan. Today, Pakistan’s healthcare system is overwhelmed, even though the peak of the pandemic is expected by August.

Several COVID-19 cases also go unreported, as patients have limited or poor access to healthcare facilities.

Earlier this month, a team of over 25 consultants based in the United Kingdom, piloted a “Patient Advice Line” to help patients in Pakistan via remote consultation.

The project aims to extend a helping hand to the COVID-19 infected in Pakistan, as well as to gather learning points for healthcare professionals working in the country.

The team observed that no support platform was available to patients in Pakistan from a primary care perspective. Lack of guidelines, anxiety, conspiracy theories and false claims create more concern and confusion among the masses. Patients were learning from WhatsApp groups/messages, and social media platforms, instead of doctors.

Then, there was also a lack of understanding as the information available was not based on evidence, proving to be potentially harmful. It was noted that seriously ill patients were getting treated at home without any safety checks and guidance on how much oxygen to administer an infected person.

Moreover, mental health was been neglected in Pakistan. Patients were anxious, depressed and suffering from panic attacks. No counselling service or support lines were available for both patients and the clinical staff. Also, the use of herbal treatments like sanna makki was troublingly high.

Given these observations, UK clinicians felt that a multifaceted approach is needed to handle the current pandemic and long-term health management. The approach involved changing both patients’ and doctors’ behaviour, and with the right use of the medium to change the population’s health behaviour as well.

Doctors in Pakistan should be encouraged to practice evidence-based medicine only.

Prescriptions should be monitored by local authorities and there should be an educational portal for all medics. Polypharmacy and prescribing multiple medications without evidence can lead to more harm rather good. It is also against good medical practice guidelines. Local pharmacies should not be allowed to dispense medication without valid prescriptions from a qualified doctor.

There should also be health promotion services at local drug stores and should be promoted to the general public including hygiene, self-isolation and use of masks etc.

Mental health support teams and counselling services must be digitally available to both patients and clinical staff. There should be a dedicated COVID-19 support service for pregnant women to protect both mother and child, with local paediatricians and gynaecologists onboard.

The government of Pakistan must realise the importance of primary care and should invest in terms of infrastructure and workforce to revolutionize the system. Also, the ministry of health must work in conjunction with the ministry of information and technology to take appropriate steps towards transforming the model of healthcare.

Technology-driven healthcare models can enable patients to have wider access to doctors and nurses at the ease of their home.

Primary care consultations can be delivered through online digital portals. Increasing access to the Internet and smartphones to masses has created an environment in Pakistan where health-care entrepreneurs can come forward and help in developing digital health platforms.

Pakistani doctors overseas are willing to come forward and help in developing a model by utilising available resources for a bigger and better impact on our healthcare economy. Let’s make the best of this advice.

Dr Salman Shahid is a consultant family physician in England