Vulnerable medical doctors

Medical doctors have been identified as soft targets for violence and terrorism since quite some time. In early 2000, there was a huge wake of 'doctor killings' that took so many lives. An ethnic angle was given to such killings but it did not work. A number of doctors running their general practice clinics were killed in broad day light.
According to Pakistan Medical Association with which I was associated as a Vice President from years 2000 to 2004, a record of more than forty doctors was prepared. A number of specialists were also targeted. A practising psychiatrist was warned by police that he was on target hit list and that something should be done by him to avert this looming danger. That psychiatrist left the country and settled in the US. A dedicated ear, nose and throat specialist, associated with a private university, was killed outside his clinic. Two doctors, who happened to be brothers, were asked by four people, including a woman, to accompany them in order to treat an ailing patient, then were asked to get down from the car near a private hospital in Nazimabad and were shot point blank. None of the culprits was apprehended by the police to-date.
There are a number of horrifying tales about the violent murders of these doctors and the tragic life events of their families. Once the PMA asked the law-enforcement agencies to help doctors. The chief of police at that time offered licensed ammunition to doctors so they can protect themselves. A training package was also offered. That reminded us of Western cowboy movies and era where reign of terror was contained by people themselves. The general explanation for such killings was that doctors were an elite group who were respected in the community and were easily accessible and hence became soft targets. There was a pause for few years after many doctors were killed until it re-surfaced again this year. Few other doctors were recently killed outside their clinic.
A number of doctors were kidnapped for ransom and threatened for extortion of money. Under these circumstances, a number of doctors had left the country, changed their profession and stopped pursuing medical career. This is a huge blow to our already fragile healthcare system.
Of late, there is a big discussion countrywide about the misuse of 'blasphemy act'. The recent example of a doctor, being blamed for blasphemy by a medical representative, is an eye-opener. Here the perpetrator is a 'medical representative' belonging to a renowned pharmaceutical company. Often these medical representatives are not appropriately screened before appointments; their training is inadequate, especially in terms of communication skills and personality sensitivities. In many instances, their career path is not clearly defined. There is a huge pressure upon them to meet their sale targets as their performance gets evaluated on how effective sale agents are they. Many such representatives lure doctors for desired prescriptions in exchange of gifts, trips and a number of other things. Sometimes they even beg the doctors to do the needful for the sake of their job security.
Unfortunately, with ever growing frustration, intolerance and hopelessness among people in the country, the human emotion of 'rage' has been commonly witnessed everywhere. Probably, because of the 'fit of rage' this representative adopted a devious path in order to avenge the alleged misbehaviour of this doctor and framed him for blasphemy. This has become a high profile case as the Pakistan Medical Association and a large number of Pakistani-origin doctors settled abroad took a very serious notice.
The press release by the PMA warned the concerned pharmaceutical company for a wider action and resolved to mobilise the government for effective intervention in this matter. It is important that the medical body should stand up in solidarity with the vulnerable doctors and do everything to protect them from this vulnerability. There is a lesson to learn for the pharmaceutical companies to review their selection procedures, policy guidelines, ethics and training of staff.
The Chief Justice of Pakistan should take notice of such laws that are abused, misinterpreted and malformed. The scenario is that of a general feeling of resentment, insecurity and helplessness among medical doctors. Pakistan has already become a lawless jungle where practically no one is safe. With existing precarious state of the country's economy and security, people are getting berserk and turning into monsters. It is high time when at least the civil society should stand up and forcefully eliminate all wrong people with their wrong deeds once and for all. This is important in order to preserve the psychological well being of the nation.
(The writer is a Professor of Psychiatry at Memorial University of Newfoundland, Canada.)