The alarming rise of unqualified medical practitioners in Pakistan poses a serious threat to public health, and it’s a reality that many are unaware of. Picture this: rusty nails hold used infusion tubes on the walls of a clinic run by one of the countless unlicensed doctors practicing across the country.
In southern Sindh province, a small roadside establishment welcomes dozens of patients daily, with a few chairs arranged around wooden tables that serve as makeshift examination areas for those seeking care. "These patients trust me. They believe I can provide them with effective treatment," stated Abdul Waheed, who opened his clinic just a few months ago near Hyderabad city.
During the daytime, the 48-year-old works at a private hospital in Hyderabad, but he dedicates his evenings to seeing patients in Tando Saeed Khan, charging a mere 300 rupees (approximately $1) per consultation. Waheed, who boasts a diploma in homeopathy alongside a four-year nursing course, speaks confidently about his abilities. "I’ve invested significant time in this field, working alongside various doctors. Thankfully, I feel confident in my capacity to diagnose and treat patients," he told AFP.
Despite his self-assurance, there is no sign of legal authorization or registration for him to practice medicine. After assessing two young children, he emphasized that patients willingly seek his help and place their faith in his skills. "No one has questioned my qualifications yet. If someone does, I'll handle it then," Waheed remarked, revealing how easily unqualified individuals can operate as medical providers in Pakistan.
These unregistered clinics often serve as the primary—and sometimes sole—source of medical care for impoverished communities.
Abdul Ghafoor Shoro, the Secretary General of the Pakistan Medical Association, estimates that over 600,000 fraudulent doctors are practicing nationwide. This startling statistic is corroborated by the Sindh Healthcare Commission (SHCC), which based its findings on data from the Pakistan Medical and Dental Council.
Shoro describes this situation as a public health crisis, explaining that many of these unqualified practitioners learn basic medical procedures while working alongside actual doctors before launching their own clinics. "Unqualified doctors lack knowledge about medication side effects and the correct dosages. Misdiagnosis can lead to perilous consequences," he cautioned.
Furthermore, the medical instruments they use often remain unsterilized; they may wash them with water but do not properly disinfect them. The reuse of syringes, in particular, heightens the risk of spreading diseases such as hepatitis and AIDS.
During a visit to Tando Saeed Khan, the presence of another unqualified practitioner was evident; upon noticing the journalists, he promptly closed his clinic and vanished. Villager Ali Ahmed pointed out that multiple similar clinics exist in the vicinity, all lacking qualified medical personnel. "People here are not educated enough to identify qualified doctors," the 31-year-old shared.
The ramifications of this unchecked practice are dire, especially for Pakistan's already overburdened healthcare system. Medical experts warn that tertiary hospitals frequently find themselves inundated with patients whose conditions have deteriorated due to inadequate treatment from unqualified providers. Khalid Bukhari, head of Civil Hospital Karachi, noted that his facility routinely receives cases from across the nation that have been mishandled by unqualified practitioners. "They frequently misdiagnose and mistreat patients, leading to an overload in our hospital. Most of the cases we encounter are those ruined by them," Bukhari explained. "These individuals are jeopardizing the lives of vulnerable citizens. If patients sought care from licensed doctors and received accurate diagnoses, they would not need to come to us."
Regulatory bodies are aware of their inability to mitigate this crisis. "Our resources are limited. Eradicating this issue is not straightforward. For every 25 clinics we shut down, 25 new ones pop up almost immediately," remarked Ahson Qavi Siddiqi, head of the SHCC. Recently, the commission closed an unregistered bungalow in Karachi masquerading as a hospital complete with intensive care units for both children and adults.
Siddiqi lamented the weakness of existing laws, stating, "We pursue legal action, but because these offenses are bailable, the accused often secure bail the very next day." He also highlighted the considerable security risks faced by inspection teams. "Many of these practitioners wield considerable influence in their communities. In numerous instances, our teams have been taken hostage or shot at. I lack the manpower to enforce stringent measures," he disclosed.
Shoro further emphasized that families often suffer financially when something goes wrong due to unqualified care, facing exorbitant medical bills for necessary treatment. "Many individuals die or are left permanently disabled, and their families are left to bear the consequences for the rest of their lives."
