A boy holds an intravenous bottle for his injured friend at Jinnah Postgraduate Medical Centre in Karachi, Pakistan. (Photographer: Warrick Page/Bloomberg News)

Derelict Pakistan Hospital Signals Imran Khan's Health Challenge

(Bloomberg) -- In a red-brick hospital in the southern Pakistani town of Nindo, plastic transparent sheets cover unused equipment, and dusty halls and rooms are empty for a lack of staff and patients.

Since its construction five years ago, the facility still isn’t functioning. The government hasn’t released funding to the 20-bed hospital after it was built with Iranian aid.

“People have a lot of expectations when they come here with serious injuries -- we can only give them first aid,” said Abdul Rehman, one of four doctors still manning the hospital. “Any woman that comes here to deliver a baby is sent to the next closest one after a checkup, but they often don’t reach there. They die on the way.”

The abandoned hospital is a window into the problems that plague Pakistan’s neglected healthcare system in a country where public expenditure in the sector is less than three percent of gross domestic product. One in 22 babies die in Pakistan, the highest mortality rate in the world and the nation is ranked 150 of 189 countries in the United Nations’ human development index. Pakistan is one of three nations where polio still exists and about 44 percent of all children are stunted.

Derelict Pakistan Hospital Signals Imran Khan's Health Challenge

It’s an area close to Prime Minister Imran Khan’s heart. After rising to fame by captaining Pakistan’s first cricket world cup win in 1992, he spent many years trying to raise funds for a large cancer hospital in remembrance of his late mother. In campaigning before Khan’s election victory in July, his Movement for Justice party railed against Pakistan’s poor heath statistics and lack of affordable care.

“It is so hard for the poor to get their quality treatment done,” Khan said last month. “The whole budget of the family gets disturbed when someone falls sick.”

As part of Khan’s plans to create an “Islamic welfare state,” his government wants to expand a health insurance program to provide cover for about 14 million poor families by 2020 in Punjab, the most populous province, and the Afghan border areas. Khan this month requested officials to identify administrative and legislative bottlenecks that may hold back reforms in the health sector.

Yet those aspirations have so-far taken a back seat as the government struggles with its latest in a long line of balance-of-payments crisis and tries to raise external funding from friendly nations and a potential International Monetary Fund bailout.

Derelict Pakistan Hospital Signals Imran Khan's Health Challenge

For now, Pakistan’s public hospitals remain overcrowded and unsanitary. Beds are in short supply with patients and their families spilling into corridors, floors and other waiting areas. There are less than a dozen large hospitals that provide all services and Pakistan doesn’t have a single nationwide pharmacy chain in a country that is rife with counterfeit and expired drugs.

Government bureaucracy makes sure funding and decisions are delayed or never taken, according to Mitha Ram, who recently retired as a government medical officer and took a job in the private sector.

“Government hospitals have a lot of load,” he said. “There is no cleanliness, there is a lot of rush.”

Ram works at a clinic in the Thar desert, one of Pakistan’s poorest regions. He, along with two other doctors, diagnose 100 patients a day with some traveling more than 75 miles. At the facility funded by Indus Hospitals and Karachi-based conglomerate Engro Corp., which is mining coal in the area, dozens of men and women wait patiently to be seen.

Derelict Pakistan Hospital Signals Imran Khan's Health Challenge

“A city with 200,000 to 250,000 population has two hospitals of 500 beds” in the U.S., said Manzoor Qazi, the chief executive officer at Shifa International Hospitals Ltd., which is building private facilities in Pakistan. “In ours of tens of millions of people, we don’t have one decent hospital.”

Qazi moved back from the U.S. with about half a dozen doctors two decades ago to open a 25-bed hospital in Pakistan’s capital, Islamabad. That facility has expanded to 450 beds to become the largest hospital in the city treating more than 2,000 patients a day. It still can’t keep up with demand and Qazi plans to expand capacity by four times mainly through joint ventures across Pakistan.

Those investing in Pakistan’s health sector point to rising middle-class consumption. Pakistani households spend about a third of their income on food and only three percent on healthcare, so there is room for growth, said Farrukh Ansari, the chief executive officer at Karachi-based private equity firm Ijara Capital Partners Ltd, which runs a $100 million fund that makes healthcare investments.

They plan to open about 250 pharmacies across Pakistan next year with U.K.-based Kingsman Pharmacies Ltd. They are also looking to acquire a diagnostics company in Pakistan that does tests on patients.

“It’s a matter of awareness and low cost and a genuine healthcare system that needs to be introduced in Pakistan,” said Ansari. “The government is not catering or taking advantage of these facts.”

©2019 Bloomberg L.P.