Posted by: Administrator | 4 September, 2006

President address at Health Expo 2006

1 December 2006

The Minister for Health Naseer Sahib, the Minister of State Shahnaz Sheikh the Federal Secretary for Health Anwar Mehmood Sahib, Director General Health Major General Shahida Malik, all the Ministers distinguish delegates, recipients of the awards, ladies and gentlemen, it is indeed my privilege to be part of this inauguration of Health Expo-2006. I would like to take this opportunity of welcoming all the delegates who are part of this expo, from various parts of Pakistan, but I would like to especially welcome all the foreign delegates who have come from abroad to be a part of this expo. And I am also told that this expo covers all sectors of health, and therefore there is a representation here today amongst us of professionals from the public sector as well as private sector. So therefore I would like to welcome them also.

Ladies and gentlemen, I was thinking what I need to talk to this audience who of course is an expert on health. So I would like to talk to you as a layman, as I understand as I have seen health and what we have seen and done. I am always a believer when you are tackling a sector, this happens to be a health sector today, you need to first of all see the environment in its complexity accurately, understand the environment of that sector and today I am talking of the health sector, the environment of Pakistan, and having analysis that environment, make a strategy of dealing with whatever short comings exist in that  nvironment and then having work out the strategy, go in the tactics of implementation of that strategy, that is the way forward of dealing with any subject and any sector.

 So therefore I would like to talk about what the environment existed and how we are going to implement the strategy? The basis of the problem of the Pakistan was economy, I am not going to talk of economy, but having revived the economy, now we are in the stage of transmitting the gains of the economic revival of the economic up surge to the people of Pakistan and within that I believe there is the element of poverty alleviation and job creation, there is the improvement in the quality of life of the people, which means giving electricity, gas and water to the  eople and then improving the quality of human resource, which we call human resource development and in that the key elements are education and health.

therefore today  I am going to talk only on health and leaving aside the others. We are now in

transmitting the economic gains to the health sector, may I further reinforce this

argument, you cannot do anything for any sector, unless your economy is right,

unless your economy is going up, I keep saying this over and over again. Because

there are many people who keep negating this argument by saying that I keep

talking of economy, macro economy. So what is the issue?

This is the core of everything. If it was not for the economy, we could not have done

anything for the health sector. In 1999-2000 when we analyzed what to do for the

health sector? What is the problem? We came to identifying four major problems.

There was no health care at the grass root level. Which means the primary and

secondary health care, which caters the 70% of your population, it was in pathetic

state because the basic health units, many constructed, when we are being in the

Army we used to go out for collective training in the field. The best place is to go out

and set up field hospitals in the fields and basic health units, whose windows used to

 

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be broken and they were used for anything for but for basic health units where

animals used to be died and we had to clean up the whole thing to establish our

centers. They were total in a state of mismanagement; not only mismanagement but

they were not existent, basic health units, rural health centers, field hospitals,

district hospitals were almost non existent. Then we realized that 60% of our disease

is from water. It is water born disease; therefore if we have to go for prevention, as

prevention is better than cure, we need to address the issue of water, safe and clean

drinking water to the common man. Richer people can have all the bottle of Nestle

bottle and everything. But for the common man the clean and safe drinking water.

The third issue was high mother mortality rate. Which we called are called MMR and

IMR, infant mortality rate, child mortality rate. MMR/IMR/CMR, this was our problem,

a high level of mortality which needed to be checked and controlled then rampant

diseases, requiring immunization, access to immunization, access to population for

immunizing them. That was the kind of all type of diseases within the population. We

identified these areas. Now going for implementation of the strategy and we first

wanted to address these issues of access to medial, health care to the people of

Pakistan. Which means DHU’s and rural health centers, RHC’s at the primary levels,

and the Tehsil/District hospital levels at the secondary level. Tehsil hospitals having

75 bedded hospitals. District hospitals are being 150 bedded hospitals. These needed

to be revamped. We went in for the addressable of this major issue. We are still

continuing, we haven’t reached home, lot has to be done, our rate of success varies

in certain provinces and I know that but we have to keep pursuing as I keep saying

that the glass is not full but the glass is not empty also. All provinces are devoting to

this issue. Primary health care and the secondary health care, I know that

computerized data is being maintained. I know the basic problem is that the doctors

do not go to the basic health units to serve there. No. 1 that there pays were dismal

and no 2 that there were no facilities to live in. Therefore we have addressed that.

Many of the provinces have done it. I know that in Punjab today employed in basic

health unit will get a pay of 25 thousand rupees which is not bad at all as compare to

the past days. And also a residence to stay in and now that the computerization has

been done, therefore his presence or her presence in the basic health unit being

supervised by Project Management Unit created in the CM’s office is effective way of

ensuring presence of doctors in basic health units, existence to the medical supplies

to them to the basic health units and rural health centers with facilities available.

Also ensuring that at the secondary level correct specialist and doctors and

equipment is available at the District/Tehsil level. For this purpose obviously funding

was required and I am very proud to say that if you combine the Federal budget and

the provincial budget to health. I think there is an increase of 2 to 3 hundred percent

to the allocation of the health centers again related to economy. In absolute terms if

we see it I don’t think it is enough, it is not enough. We have to allocate more. We

will keep doing it as the Pakistan’s economy is sustained and keep rising. We have to

allocate more funds to the health sector. And there is no doubt. It will be done. So

this is happening at the primary and secondary level, I don’t want to go into the

further details. There are many experiments that were done, plugging these there

units together and putting one doctor there but however this Is the latest and since

the funds are available, every available basic health unit will have a doctor and

medicines available and equipment available at the primary and secondary level to

look after the 70% population of Pakistan. And that is essential and we have to do

this.

But let me not ignore the importance of the tertiary level of health. And that are the

main hospitals in the cities. I think once we devote our attentions to the primary and

secondary levels, you will take the load off the tertiary level. Because today with the

absence of primary and secondary, every person from a village who can afford

comes into the man hospitals in Lahore and Karachi and bigger cities, putting extra

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load on those tertiary hospitals. Those who cannot afford it obviously have no access

to any medical attention so therefore the essential element of primary and secondary

health care. The ultimate of success is when there is a referral procedure. No body

should go to a district hospital directly unless refereed by the basic health unit of

doctor that is the ultimate of the medical service. Nobody should reach a main

hospital unless referred by the chain of doctors. Now that is the ideal way of finally

reaching a system where everyone is doing its job, right from RHU/BHU to Tehsil and

district hospitals and to the main hospitals. However in the tertiary side I would like

to say that we must improve our quality. I know that the main problem is not that

we don’t have good doctors; the main problem is post operative care which every

one talks of. We must improve the quality of our tertiary hospitals and post operative

health care so that we draw patients from outside into Pakistan. Because it is in

Pakistan it is much cheaper here than anywhere in the world. Therefore we must

improve the tertiary health care also. As I keep saying that the holistic approach of

primary, secondary and tertiary health care and qualitative improvement in all three

are essentials but our focus must remain primary and secondary health care to

deliver the services to the people.

The other issue is the prevention. We have to provide safe drinking water to the

people of Pakistan and we therefore have evolved a strategy of putting up filtration

plants down to a village having a population of 1000 people. For that purpose, 7

billion rupees have been allocated this year. I know this by December 2007, I am

trying to target 28000 villages, but at least down to every union council level there

must be a filtration plant. This needs a strategy. Because we need to judge the water

and then put a filtration plant in accordance whether only the chlorination is required

or a filtration plant is required, depends upon the quality of water. That the people

are drinking and therefore the Ministry of Science and Technology is involved to look

into the implementation of this programme and I monitor it myself, and I hold

conferences myself to ensure that this is done therefore InshAllah we will be moving

very fast on the delivery of this element because I think this is critical to improve the

health of the poorest. I would like to say here that NCHD (The National Commission

on Human Development) is playing an important role in educating the people at the

grass root level to improve specially contributing towards reduction in MMR/CMR, as

far as MMR/CMR are concerned I would be very proudly I would like to announce that

there is an allocation of rupees 20 billion for this purpose of addressing this issue of

child mortality and mother mortality. Then we have a programme of Lady Health

Visitors. I know that there used to be 64000 of them and today they are about

96000, these lady health visitors provide medical assistance and even medical care,

door to door medical care, this is how we would be able to impart education at the

lowest level and may be address the same issue of MMR/IMR. The immunization

campaign is proceeding quite well. The coverage of immunization has increased from

52% to 73%. I would like to urge the Minister that he must have access to 100%

population that is where the glass will be full. Because this is the safety of the

masses from disease. I must commend the Polio eradication plan, the Minster and all

the people involved in it. Our success is 99.9%. I know that this year we had only 33

cases of Polio and these are mainly in the refugee camps and we would like to cater

for all our brothers and sisters from Afghanistan as well as Pakistan and we must

make it sure that this is totally eradicated as soon as possible.

Ladies and gentlemen, I would be remiss if I did not mention about more about

NCHD, I must say that they are doing a great job, today they provide door to door

primary health care which ever district they have reached, they are trying to access

to the people at the grass root level. I know that they are training lot of women on

making ORS. They have already trained about almost 3 million females in the

making of ORS and since I have been to their one of the district activity they taught

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me how to make ORS and that is the root to avoiding and reducing child mortality.

That is the commendable job they are doing so overall they are trying to reduce

MMR/CMR reduction. And also assisting in the immunization programme. May I also

say that they are trying to develop the capacity of the District Government to

execute whatever has to be done in the health sector. Here I would like to say that

Nazim they have to play a critical role to play. The District Government that we have

introduced in Pakistan is the key to success in all sectors affecting the people at the

grass roots. It is they who need to participate actively to make sure that no doctor is

missing from the BHU or the RHC to make sure that all machines and equipment are

operative in their Tehsil and District hospitals. To make sure that medicines are

available for the masses. They can do that. The province or a centre can only make

polices. But the implementation of policy has to be through other agencies like the

NCHD who are at the grass root level or the District Governments who needs to do

that. So I would like to urge all the Nazims to understand that they are the main

contributors in assisting the primary and secondary health care. They must

contribute in ensuring of immunization of every individual in their districts. They

must also be aware of mother mortality and child mortality so their awareness is

essential for the success of overall success of the medical care of we are talking of.

Here I would also like to commend the effort of the medical side as far as our Earth

quake is concerned. There contribution of all doctors, nurses everyone involved in

the health care was tremendous. In that first of all treating of initial injuries, the

injured people, treating them effectively, ensuring minimum casualties and I am told

by the United Nations that if you compare it with other international disasters, our

injury ratios or death ratios to the injured was the minimum so therefore the

effectiveness of the medical support that we delivered for the earth quake to look

after the injured there. This of course involved all the hospitals and doctors of

Pakistan as well as all the volunteers who came form all over the country and abroad

and also the medical teams which came from abroad. I would like to commend all of

them. Not only that in the earth quake there were lot of dooms day agents who were

saying that there will be epidemics and people are going to die, there was no

epidemics that is the success of medical delivery and attention. May I also talk also

the crisis management in which we faced the issue of Bird Flu and Dengue fever

successfully. We contained that all very successfully. Credit goes to the medical

teams who assisted that all.

Two elements related to the medical industry is the Pharmaceutical industry which is

doing very well, there are multi nationals and there are out own people. I am very

glad that they are exporting and their export is on the rise but may I urge them first

of all to increase their exports to earn foreign exchange but also to reduce prices and

keep the prices in Pakistan within reach of the common man which means there by

reduction in prices. If they earning a lot and I know they are earning a lot, they must

share the benefit with the people specially the poor. On the surgical instrument

industry yes indeed we have a thriving surgical industry in Sialkot and they are

exporting. If you want to leap in millions to billions of export we need to move to

high technology. We cannot be in the lower edge of technology. We have to evaluate

to our products. And for that purpose expertise is required and for that purpose that

you would be glad to know that we are opening Pakistan Sweden University in

Sialkot. I will be inaugurating in a month or so, once that come up, it is going to deal

with subjects. It’s going to be teach subjects which will be relative to industry in

Sialkot. And a surgical instrument is one of them. And therefore I hope that in the

future we will have engineers and specialists who would understand high technology

in surgical instruments so that it can then translated then, knowledge then can

translated into economic benefits through production of high technology instruments

and exports of high technology instruments. Ladies and gentlemen, this is all that I

had to talk of.

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I would like to commend the effort of Ministry of Health and Minister, Secretary, DG

health and health Minister of State for organizing such a wonderful function. I am

grateful to you for inviting me and giving my views to everyone and I would like to

end by wishing the participants to this health Expo and specially those have come

from abroad I hope you find this interaction fruitful and I hope that you take back

very fond memories of your stay in Pakistan.

Thank you very much Ladies and gentlemen.

Pakistan Paindabad.

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