LUMHS- Problems and Solutions

Dear Dr Mazhar Lakho,

I have gone through the glimpses of LMUH taken by you during your recent visit of Liaquat Medical University and interpretations on the glimpses by colleagues since last couple of weeks. Most of the colleagues have incorporated the valuable comments and suggestions which shows their eager interest to rectify the problems and solutions of the LMUH. I appreciate their concerns.

Dear Sir I always encourage and requested you to keep on sending the beautiful messages on Health issues once again I appreciate your sincere efforts.

In the light of the pictures

Let us analyze the situation of the Liaquat Medical University of Health sciences Jamshoro regarding the gradually deterioration of the Institution.

In my mind following are the related questions.

Who is responsible to improve the situation?

Vice Chancellor/ Medical Superintendent of the Hospital OR Professors In charge of the concerned wards?

What are the hindrances to authority to improve the situation?

Which MAFIA or IRRITANTS are working against the Institutions?

What are the reasons that Administration is compromising with the MAFIA/CULPRITS?

To find out the solutions of the above questions, we have to look Past of the student affairs and to discuss for the future planning. Only to recall the memory of the senior colleagues and show the actual picture of the Institution to the junior colleagues. What lesson we learned for the future from Past?

In my mind I have different scenarios of the Institution (Exclusively based on my personal opinion and observations).

SCENARIO: I.

During 1969, we students were facing the same situations of law and order for instance, 02 young students of Tando Jam Agriculture University were killed on the railway station of Tando Jam and Mr. Abdul; Razzaque Soomro Lecturer was killed in the Technical college at old wahdat colony Hyderabad by one of the Ethnic group. Masroor Hassan Commissioner ordered to open the fire on the Sindhi student’s rally on 4^th March at Al-Manzar bridge Jamshoro and several students were killed, Hundreds of students from Sindh were put in Jail because of the slogan “SINDHI ME LISTOON CHAPIO”. In this procession all Sindhi students of the Province were at one plate form irrespective to their separate student’s parties. In this rally the prominent Student leaders took part like Masaud Noorani, Lala Qadir, Iqbal Tarin, Yousuf Talpur, Mehmood Daheri, Abdul Wahid Areesar, Yousuf Laghari, Moula Bux Laghari etc.

During 70s at Torri Phattak on the Indus high way near Khanote Students were proceeding to anniversary of Sain JM Sayed at SANN, were killed by army. Shaheed Zulfiqar Ali Bhutto was hanged in Rawalpindi . In this connection I will quote many examples of worst law and order situations in the Sindh Province .

We faced the law and order situation, that is why we lost our 02 academic years, means we were the medical batch of 1978 and passed MBBS in 1980.

But during the worst law and order situations in 70s, 80s, our worthy teachers and administration did not closed college and not stopped the studies in the colleges and continued their teachings honestly with hook and crook and were adhering with the Ethics’ of the Medical profession. I will quote here that our respective teachers were always present in OPD, Ward, and they never missed the morning and evening round in the wards. They never missed any single lecture during the college hours. Professors along with senior registrars and auxiliary staff were available round the clock in the wards. Medical Superintendent had eye of vigilance on the wards/ OPD, no body dare to be absent from duty right from sweeper to prof: in charge of the ward. The regularity /punctuality and the cleanliness of the wards were excellent

I love and salute my professors of LMCH, Prof: M A Almani, Prof: Shafi Qureshi, Prof: A Ghani Siddiqui, Prof: Aqil Bin Abdul Qadir, Prof: Muneer, Prof: Aftab Muneer, Prof; Ibrahim Memon, Prof; Madam Nasira, Prof: Karim Abbassi, Prof: Ikhlaq-U-Nabi,Prof: Azhar, Prof: Raja, Prof: Azeem Mirza, Prof: Irshad Moriani, M S Dr; K Y Ansari, Prof:G M Bhatti, prof: Jameel Siddiqui , and Senior registrars of the concern wards and staff. (Please apologies me if I forget the name of any Proff).

This was the bunch of flowers; their top priority was, to deliver daily Lectures to the students, demonstration on the patients in the OPD/ward, and daily morning/evening complete round of the indoor wards. (May Almighty ALLAH bless them and their families?).

One day we found Prof: Ibrahim Memon Child Specialist was very much worried because he came one hour late in the ward and Dr K Y Ansari Medical Superintendent of the LMUH gave him explanation for coming late.

It is worth to mention here that, Professors used to get admission of their children in the LMUH. Every student felt proud of that he is student of Liaquat Medical College Jamshoro.

On the other hand;

The academic studies were continued under the supervision of the above noble professors of the Institution .The prominent Student leaders were very famous in student healthy and progressive Politics like Dr A R. Bughio, Dr Feroze Ursani, Dr Mazhar Lakho, Dr Khadim Hussain Lakhiar, Dr Moula Bux Junejo, Dr Shah Beg Chandio ,Dr Abdullah Rajput, Dr Amanullah Talpur, Dr khalil Qazi, Dr Zulifqar Mirza, Dr Shaqat Abbassi and so many student leaders . All were in different student’s parties but we could not found any conflict between them. They all were united with the excellent study atmosphere, every student enjoyed during his student life. There was no any MAFIA in the students, in administration, no clash, no killings; none of the student was armed with weapons. Every thing was smoothly running. There was peaceful atmosphere.

But at this stage there was no any MAFIA/IRRITANTS/BYCOTS of the class. Every thing was running fine and smooth. Medical students were publishing the notes on various medical subjects of the course, some of the colleagues issued the Magazines, quarterly magazines on the politics like Dr Khadim Hussain Lakhiar was issuing the Magazine named “ PAGHAM “.

We used to listen the poetry from our medical students like Bulbul Khorwahi (Dr Khan Mohammed Jat) Soomro Sindhi ( Dr Siddique Soomro) in the hostels and college. There was no interference of the political leaders in the college /Hospital.

On Hospital Side every thing was running excellent, professors were visiting the OPD and taking indoor morning/evening rounds even every professor was running his private clinic. Hospital cleanliness was excellent; there was no difference in the General and Specialist cadre.

SCENARIO: II.

After that, the old professors gradually got retirement and the new regime of the teachers replaced the ancestors along with the new student leaders, the situation became reverse, and unfortunately the standards of the college were not maintained or sustained and were compromised at the cost of personal benefits. We all son of the soil are responsible because we could not followed the footprints of our noble senior teachers neither the previous student leaders.

In the mean time the Liaquat Medical College was upgraded to the Medical University . Instead of the maintaining the standard of the University the situation became deteriorated day by day.

Some of the Professors started to give more time to their private clinics, instead of the morning, and evening rounds in the wards, they used to come at the OPD off and on and only spent few time not more than 02 or 03 hours in the OPD or in the ward. Some of the Professors came in the ward after 2-3 weeks and left the ward without taking round. The senior registrars started to quit from the ward after 2pm and only fix the duty of the PG student and one or two medical officers in the ward and registrars run their private clinics in the evening and turn back to the ward on the next morning.

The entire in door patients were kept at the mercy of ALLAH. Most of the serious patients were not getting admitted in the ward unless he/she visit the concerned professor at the cost of his examination fee. Most of the registrars were strictly asked by Professors to not admit the patients in the ward till he/she visits professor first at his private clinic.

No body bothers to check the regularity /punctuality, of the staff right from the University side or from the Administration side of the hospital. Every thing was out of control. The academic administration and Hospital administration compromises with the MAFIA/ CULPRITS for their personal benefits and to save their chair. Both administrations were working without coordination. No body from academic side complaints regarding the issues of the wards through in charge professors neither Hospital administration complaints against Professors and ghost MAFIA of the hospital with the result the patients were severally affected regarding the health care.

The Hospital budget was misused, there were no planning. Indoor patients were buying every medicine from out side in spite of the presence of sufficient budget. Public sector hospital looks like private hospital. The University administration was working as a ship without navigation. Both of the administrations (Academic/ Hospital) were working on the slogan

“UTHRE TUM -------- ITHER HUM”.

On the other hand student’s leader ship was unable to organize the medical students and the by cot of the classes/students clash/firing in the institution was the daily routine in the University. But University administration shows cool response/apathy in this connection. .

In terms of the job responsibilities of the Academic and Hospital Administration, we can superficially discuss their performance individually.

1. ACADEMIC ADMINISTRSATION:

University has the strong administration working under the direct control of the Vice Chancellor of the university.

1. Registrar
2. Controller of the examinations.
3. Director Student Affairs.
4. Syndicate/Senate.
5. Dean of various faculties.
6. Professors/ Associate Professors/Assistant professors/ Demonstrators of various departments.

A part from the other academic responsibilities of the University, the above officers are also responsible for the hospital side administration in terms of the availability of the Professors in the ward. The responsibility of the administration is to maintain the regularity/ punctuality of the teaching staff including in charge professors, Associates, Assistant and the staff of the wards. Admin: ensures that all the teaching staff is regular, delivering the lecture to the medical students in the college as well as in the OPDs and having morning/ evening rounds in the wards. Administration is also responsible to check the wear and tear of the wards, cleanliness and to report any issue pertaining to the ward for the benefit of the indoor patients to the hospital administration for action.

Secondly with the concurrence of the Academic and Hospital administration the monthly meeting should be arranged with the in charge professors of the ward to sort out the problems of the ward and the minutes should be recorded and handed over to Hospital administration for compliance. There fore the academic administration is responsible to maintain the standards of the institution like;

1. Regularity/Punctuality of the professors in the University/ ward and OPD.
2. Regular morning and evening rounds of the professors in the ward.
3. Professors should keep vigilance on the nursing staff of the ward and ensure that Registrars are visiting the patients in the evening or available during the night duty.
4. Cleanliness, wear and tear of the ward.

2. HOSPITAL ADMINISTRSATION:

Medical Superintendent of the Hospital is well equipped with army of the admin officers under his control like,

1. Deputy Medical superintendent. (01)
2. RMOs (04)
3. Additional Medical Superintendent (12)

AMS (General) AMS (Paramedics), AMS (C& W), AMS (Medical Students) AMS (OPD) AMS (OTs), AMS (General evening), AMS (Hostils), AMS (Medico legal), AMS (Indoor) AMS (Private wards), AMS (Medical Stores).

4. Chief CMOs(02) and CMOs.
5. Registrars in each ward of the hospital.

The above officers are responsible to maintain the discipline and standards of the hospital to visit the hospital regularly on the daily basis and report to Medical superintendent to take action. If there is a problem regarding the non availability of the professors, Associates, Assistant, Registrars and staff in the wards, OPDs, COD, OTs it should be discussed in the monthly meeting with academic administration on monthly basis to resolve the issues.

Hospital administration is responsible to take action on the issues raised by the Professors in charge of the ward.

Hospital administration ensures the quality care to the patients with the appropriate supply of the drugs/ medicines to the patients.

Hospital administration is wholly solely responsible to made available all the OT/emergency facilities in the hospital.

SCENARIO: III.

Possible Solutions;

ACADMIC SIDE:

1 To solve the problems of the students, and to take action against the MAFIA, IRRITANTS, those creating the bad atmosphere of the university. (For example: Dr Khadim Hussain Lakhiar was appointed as Director Students Affairs. During his appointment he took serious action against IRRITANTS and till his stay there was no any by cots and blackmailing to the University administration. He registered the cases against the irritants at Jamshoro police station till now he is facing the evidences of the courts at his own. University administration shows apathy on the GOOD job done by Director Student affairs.

2 Secret Branch of the University means SECRET BRANCH; the administration should discourage the political/Elite class to interfere in the branch so that the transparency of the results of the poor medical students ensured. Due to that the restlessness in the hard working students is natural.

3 To reduce the copy culture through awareness to the Medical students by seminars, debates, lectures and exchange inter provincial visits should be arranged to the various prominent and reputable institutions of the country.

4 Brilliant students should be awarded foreign scholarships for higher studies.

5 Regular visits of the administration to the Hospital wards to ensure the presence of the teaching staff including in charge Professors and his ward staff.

6 The regularity / punctuality of the teaching staff should be strictly followed.

HOSPITAL SIDE:

1. Vice Chancellor of the University is the head of the institution and chairman of the hospital committee. He should conduct the monthly meeting along with Medical superintendent of the hospital; Professors of the ward also attend the meeting with the issues of the concerned ward.
2. All the professors of the wards should be strictly directed to visit their wards on daily basis and ensure the regularity /punctuality of the all ward staff .( At present some of the Professors are coming in the wards after 2 to 3 weeks , sitting in the office and left ward without round).
3. Medical Superintendent should submit report of the concerned Professors/ staff of the ward in the monthly meetings.
4. All the indoor patients should be provided free medicines as prescribed by the Professors and the pathological investigations of the indoor patients should be carried out free of charge.
5. All the registrars of the ward should not refer the patients to the professors for the sake of examination fees. (Most of the Professors do admits the patients after examining at their private clinic.).
6. Medical Superintendent should ensure the cleanliness of the hospital and depute Dy: MS/ AMS/RMOs to do the complete round of the hospital on daily basis and report to MS for action.
7. The attendance of the sweepers and other care taker staff of the wards should strictly be monitored on daily basis..
8. Similarly one officer from VC office should be nominated to make daily visits to the wards/ college for the cleanliness, in this connection the responsibility should be given to the Director students affairs. The issues regarding the cleanliness should be discussed in the daily/ monthly meetings.

MEETING OF THE POLITICAL LEADERS/PARENTS:

The meeting of the political leaders of different parties should be arranged and the University / Hospital Administration and the parents of the students should be called in the meeting to debate the issues of the students for the smooth running of the University and the Hospital. In this connection Vice Chancellor/ Medical Superintendent take initiatives and prominent Student leaders should take part to facilitate the higher authorities of the University.

FORMATION OF THINK TANK FOR LMUH:

There is a great need of think tank for University; the idea is floated for discussion to incorporate your views and suggestions.

DRAFT:

THINK TANK:

A BODY OF EXPERTS PROVIDING ADVISES AND IDEAS ON SPECIFIC ISSUES/PROBLEMS OF UNIVERSTY/HOSPITAL AND THE MEDICAL STUDENTS.

Aims/ Objectives:

1. Cleanliness of the Hospital wards/Institution.

2. 100% Provision of Medicines to all indoor patients

3. 100% pathological tests free of cost to the indoor patients.

4. Security/ Safety of the Hospital Employee and patients. (AMS/RMOS/SHO/SPO committee should be formed).

5. Visiting hours should be monitored (AMS/Hawaldar).

6. 100% attendance of Professors/other staff of the Hospital/students academic lectures should be ensured (All Deans of the faculty, Director Student’s affair / Top 05 students should be selected for this committee).

7. Student’s politics should be discouraged during the college hours, so that no body dares to by cot the classes.

8. Transparency of the student results should be strictly maintained. No political/ Elite class influence accepted.( VC/Controller/ Registrar Director Student Affairs/05 Top most students form the committee).

Name (Title) ( Suggested).

1…!!!!!!!!!!!!!

2……………………………………………………………………………………….

Areas of Work ( Issues):

1: MEDICAL EDUCATION.

2. HOSPITAL ISSUES

3 STUDENTS AFFAIRS.

3. PATIENTS WELFARE.

4. MEDICAL STAFF PROBLEMS.

5. BULLETIN ON THE PERFORMANCE OF THE UNIVERSITY/HOSPITAL.

6…………………………..

.

ANCHORS (Identification /Nomination)

1. VICE CHANCELLOR OF THE UNIVERSITY.
2. PROFESSORS./MS of the Hospital.
3. PARENTS.
4. POLITICAL LEADERS OF DIFFERENT PARTIES/ INTELLECTUALS.
5. PARENTS.
6. NOTABLE STUDENTS.
7. Writers/Poets/Teachers.
8. Media (Print and Electronic).
9. ………

TORs( Terms of references):

• Non Profit Organization.
• Policy Institute.
• Organization.
• Corporation.
• Group of Intellectuals.
• ……………………….
• …………………………
• ……………………….
• ……………………………

IDENTIFICATION OF OFFICE SPACE:

Arrangements of the first Meeting:

OTHERS:

Suggestions will be appreciated

SCENARIO: IV.

Regarding the poor Patients of Sindh:

Why any patient reaches at the last stage of diseases in Tertiary care level Hospital?

The Health seeking Behavior of the patients (HSB) in our province is very different, especially in the rural areas. During any Health Problem first of all patient use home remedy, then he seeks treatment from Traditional Healers like Hakeem and also get help from spiritual healers like Taveez from Molvi or Bhopo or stay at Shrines. Then he proceeds to near by quack, he treats him on the lump sum contract basis (Now a days like our most of Surgeons treat their patient on Package basis displayed out of their clinics). If the patient did not get relief then he tried to visit any physician at Town. If the lab facilities are not available in the town, after trying few days physician refer the patient to Tertiary care level Hospital like LMUH etc. Now patient is received at the end stage of the disease. If the patient is admitted in the Hospital he/she needs complete attention other wise you may imagine the results.

In this connection I want to discuss why the patients are misguided by the Traditional/spiritual Healers and our qualified Doctors. This is our sole responsibility that when we pass our MBBS or post graduate degree and we are posted at any where in the Sindh Province or establish private clinic we try to guide and treat the patients on Humanitarian ground so that they could not reach at the last stage of the disease.

Now days what is happening in the LMUH every body knows? I don’t want to debate further more. I had been working as Additional MS of the LMUH in 2006 (after house job done in cardiology ward in 1981) and when I compared the time of 70s and onwards. I found the deteriorating of the institution. THIS IS ONLY MANAGEMENT PROBLEM OF THE UNIVERSITY AND HOSPITAL ADMINISTRATION:.

May almighty ALLAH keep us under his blessings.

I apologize for the lengthy description of my views. If any body is hurt by my views please forgive me.

I will finish here with the following two sentences.

WE LOVE OUR SELVESES EVEN AFTER MAKING SO MANY MISTAKES.

THEN HOW CAN WE HATE OTHERS FOR THEIR SMALL MISTAKES?

With respect and Regards

Dr Mohammed Bux Bhurgri

LMC (1980).

13/02/10