R E F L E C T I O N S F R O M O U R G R A N T E E S I N P A K I S T A N:
“Emergency rooms have existed in Pakistan since the mid 1950s. However, emergency medicine is just now beginning to get recognition as a specialized branch of internal medicine. At present time, all emergency rooms are completely staffed and run by Senior Medical Officer (SMOs), i.e. medical residency graduates from surgery, internal medicine or pediatrics who are waiting to take their specialty licensing exams.
In terms of the patient disease pathology the one major difference is the percentage of infectious disease patients – almost 40% of critical care cases are serious tropical infections such as malaria, dengue and the like. A very significant number of patients are trauma patients however trauma codes are not run by emergency physicians, rather general surgery residents direct these codes. Trauma is very much a new and practically non-existent field in Pakistan and definitely needs direction for development. To date there is only one official emergency medicine training residency in Pakistan, the one at Agha Khan University Hospital (AKU). It has sixteen residents at present.
The ambulances are arranged according to several ambulance stations all across Karachi and calls are directed to the closest station from a central station at Tower road, where the dispatch service is located. At the present time there is no formal unified coordination between the various services, especially in response to disasters. They keep in communication informally via telephones and personal contacts. There is also a lack of formal ambulance to hospital communication so typically very critical patients such as mass casualty victims are often brought in without any prior notifications. There is a very palpable competition for patients between the various non-profit organizations since all these organizations benefit from donations from the patients as well as families.”
-DR. NUR-AIN NADIR