Sami Ullah
PAKISTAN’S health sector is under immense pressure. A deeply troubling incident occurred at a major public hospital in Karachi. A woman in labour gave birth in a washroom. For any healthcare system, this is deeply disturbing. A woman in one of the most vulnerable moments of her life should be surrounded by trained staff, proper monitoring and immediate medical attention—not left to deliver her baby in a place never meant for childbirth. A video of the incident spread rapidly on social media, turning public attention toward what happened inside the hospital. But the real issue goes beyond one shocking incident. It raises a much bigger question: what happens when people enter Pakistan’s healthcare system expecting care, but instead face delays, overcrowding and neglect?
An inquiry into the incident reportedly found serious shortcomings in the care provided to the woman. One of the reported concerns was that she was told to “walk around” even though she was already in labour. Eventually, she gave birth in a washroom. These details raise serious questions about whether she was properly assessed and whether basic maternity-care procedures were followed. Childbirth is not a situation where there is much room for delay or confusion. Labour can progress quickly, and a mother or baby can suddenly require medical intervention. A simple assessment at the right time can make a major difference. This is why maternity wards need properly trained staff, clear procedures and constant monitoring.
The JPMC incident also shows the difference between having a hospital and having a healthcare system that actually works. A large hospital may have specialist doctors, modern equipment and thousands of trained workers, but these things mean little if a patient in distress is not recognised and treated properly. Pakistan’s public hospitals face enormous pressure. Large numbers of patients arrive every day, often because they cannot afford private treatment or because good medical facilities are unavailable in their own areas. Doctors, nurses and paramedics work under difficult conditions, while overcrowding and staff shortages can make their jobs even harder. But difficult working conditions cannot explain everything. Hospitals also need strong management, proper supervision and accountability. Patients should not have to depend on luck to receive basic medical attention.
The problem is even greater outside major cities. In many rural areas, people have limited access to qualified doctors, diagnostic facilities and specialist care. When serious illness or pregnancy complications arise, families may have to travel long distances to larger cities. By the time they reach a tertiary hospital, their condition may already be more complicated. Financial pressure makes the situation worse. More than half of Pakistan’s total health expenditure comes from people paying directly from their own pockets. Families may have to spend money on medicines, tests, consultations and other medical expenses. For poorer households, even a relatively small medical bill can become a serious burden.
This can also cause people to delay seeking treatment. A family may ignore early symptoms because they cannot afford a doctor. Later, when the condition becomes serious, they may have no choice but to visit an already overcrowded public hospital. In this way, weak financial protection can contribute to pressure on the entire healthcare system. Pakistan’s health problems are not limited to maternity care. Hospitals and health centres also struggle with medicine shortages, limited diagnostic services, infection-control challenges, workforce shortages and weak oversight. At the same time, the country faces both infectious diseases and a growing burden of diabetes, heart disease and cancer.
This makes strong primary healthcare especially important. Not every health problem should end up in a major tertiary hospital. If people can receive reliable treatment and monitoring at local health centres, pressure on large hospitals can be reduced. The World Health Organisation has repeatedly highlighted the importance of strengthening primary healthcare, improving the health workforce and reducing financial barriers to treatment. The JPMC incident should therefore not be viewed simply as an embarrassing moment captured on a mobile phone. It is a reminder of the human consequences of weaknesses within the healthcare system.
Behind every statistic is a real person. For a woman in labour, timely care can mean the difference between a safe delivery and a dangerous situation. For a poor family, the cost of treatment can determine whether they seek help at all. And for a patient arriving at a public hospital, being treated with dignity should never depend on their income, location or social influence. Pakistan does not only need more hospitals and expensive medical equipment. It needs a healthcare system that works at the basic level: patients should be listened to, assessed promptly, treated safely and referred when necessary.
The washroom delivery at JPMC is disturbing precisely because it represents a failure at this most basic level. The lesson is simple: a healthcare system should not be judged only by its buildings, machines or number of doctors. It should be judged by how it treats a frightened patient when she needs help the most. That is where healthcare becomes more than infrastructure—it becomes care.
—The writer occasionally contributes to the national daily.
