Mst. Saba (Petitioner) VS Fed. of Pakistan and Others (Respondent)

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HIGH COURT OF SINDH AT KARACHI

C.P. No.D-4819 of 2O18.

Date Order with signature of Judge

For hearing of main case.

Report of nistt. & sessions Judge umerkot filed in part file. F Report of Distt. & Sessions Judge Matiari liled in part file. Report of Distt. & Sessions Judge Jacobabad filed in part file. Report of Distt. & Sessions Judge Malir Karachi dated 08.05.2019 filed in part file.

iteport of Distt. & Sessions Judge Malir Karachi dated 28.05 -2OI9 liled in part file.

Report of Distt. & Sessions Judge Shahdadkot Kamber dated 06.05.2OI9 filed in Part file.

Report of Distt. & Sessions Judge Shahdadkot Kamber dated 16.05.2O19 filed in Part file.

Report of Distt, & Sessions Judge Shikarpur filed in part file. Report of Distt. & Sessions Judge Mirpur Khas dated O8.O5 .2019 filed in part file.

Report bf ni*tt. & Sessions Judge Mirpur Khas dated 16.05.2019 filed in part file.

Report of Distt. & Sessions Judge Kandhkot filed in part file. Report of Distt. & sessions Judge N/Feroz filed in part file. Report of bistt. & Sessions Judge Tharparkar filed in part file.

30.5.2q 19.

Ms. Saba, Advocate for the petitioner.

L Mr. Hakim Ali Shaikh, Additional Advocate General. Mr. Nad.eem Khan, Assistant Attorney General.

Mr. Hakim Ah Zardari, Focal Person Home Department. Mr. Asghar Ali Memon, Additional secretary (Health). Mr. Muhammad Ibrahim Memon, DS Health Department' Dr. Altaf Hussain Shaikh, OSD Health Department. Mr. Muhammad Younus, so (Litigation) Health Department. Dr. Khadim Hussain Qureshi, M.S. Civil Hospital, Karachi. Dr. Abdul saeed, DSM (Legal) Dr. Ruth K.M. Pfau, civil Hospital. Mr. Shakeel Ahmed, D.S. Finance Department' Mr. M. Saleem, S.O. Finance Department.

Dr. Sumair Noor Channa, SP Investigation-ll South. PI Iftikhar Hussain, SIO Eidgah

ORDER

Mohammad Karim Khan Agha-J:

Missing B4bv:

1.Investigation officer (lO) has submitted his report which is taken on record. I.O. of the case submits that he has issued letters to the Director Information Sindh for ad"vertisement of information of the missing child Noman aged about 03 years in the electronic and print

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3rf media. Investigation officer further submits that he had written letters to all Divisional DIGP's of Sindh to seek help for the recovery of missing chitd. It is ordered that all possible efforts shall be made by the investigation officer to trace out the missing child. Keeping in view the sensitivity of the matter, I.G. Police Sindh, Karachi is directed to look l- into the matter personally and ensure that a progress report is submitted on the next date of hearing.

With re to Civil H ital and other Government Hosuitals in Sindh:

Z. In response to our order dated 09.05.2019 report of Special Secretary (Admn) on behalf of Secretary Health is taken on record.

Pursuant to aforesaid order, the Secretary Health was directed to ensure that all deficiencies were rectified prior to today in respect of following equipment:-

(a)CT Scan is out of order,

(b)04 Ventilators require rePair, i (c) Both Cardio Cath labs are out of order, (41 nepair and maintenance to casualty department was needed which will be completed by June, 2019.

(e)A warehouse needs to be constructed, (0 Some encroachments not covered by Supreme Court Stay Orders sti1l need to be removed.

3.It appears from the report that none of the deficiencies have been fully rectified and that most of the equipment remains in a state of disrepair. Once again the Secretary Health is directed to ensure that all the above equipment is either replaced or repaired so that all such equipment are in good working order and that the warehouse is constructed and that all encroachments are removed prior to the next date of hearing.

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4.It also appears from the report that the Health Department, Government of Sindh has constituted a Committee with the following terms of reference (TOR's):-

TERMS OF TORs

. To study observations of learned District & Session Judges and recommend way forward for repair and maintenance/ procurement of new machinery and equipmentlplacement of HR/availability of medicine for disbursing free of cost to patients.

. To submit report on the enclosed proforma latest by 22"d May 2019.

5.A report on the implementation of the TORs was not submitted by 22nd May by the Committee. Be that as it ffiny, we find it difficult to understand the purpose of the Committee having such terms of reference. The reports received by the District & Sessions Judges, for each pubtic hospital in their respective district in the province of Sindh both clearly and adequately set out the maintenance and repair works needed. to be carried out at such hospital, what equipment and ^} machinery is required and what staff is required and what other actions are necessary to ensure that such public hospitals were in a position to adequately treat free of cost all members of the public. Prime-facie such TORs seem to be a delaying tactic in implementing the requirements of each public hospital as already set out by the District and Sessions Judges in their respective reports.

6.Just by way of one example to show the terrible conditions of the public Hospitals in Sindh which the general public including men, women and children have no choice but to endure if they fall sick we set out the salient features of the report of the District and Sessions Judge South in respect of Lyari General Hospital Karachi which in material part reads as undrrr, b

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..SUB; INSPECTION REPORT OF LYARI GENERI\L HOSPITAL

SITUATED //T DIS?R/CT SOUW

REF: (1) ORDER DATED 1 1, .2019.

In compliance of order passed in the aboue-mentioned petition, the urud.ersigned has called detail report from the Medical Superintendent of the concemed hospital and the team of judges haue also physicallg iruspected the hospital just to ascertain the position. The detail reports on the giuen points I. are as under:-

A. WHAT CONDITION THE HOSPITAL BUILDING 15 IN?

E.G, /S IN IT GOOD SIATE OF REPA/R AND IF NOT

WHAT IS REOUIRED:

The mo;ln building of Lgart Generql Hospttal fs not in good conditlon. It ho,s seePage Er, sanitatlon problemn there wols seepo,ge from water to,nk constrttcted on the roof of the butldtng &, utqter lotrs flowlng from eaery corners whlch needs immediate repalr & malntenance. The hospitat authoitg has giuen Qssurance regarding its repair ii short space of time. (Photo.s o/ building are attached hereusith & marked as Anneicure A, A'7 to A-4).

Silrrrlla;rlg, electrical sgstem instslled ln the buitdtng wols aPpeartng to be un-Just & un'safe o,nd there are chances of spreadlng fire (photographs are enclosed and marked as Annexure B, B'7 to B-2). There nre two eleaators, one is working whlle one ts out of order and one stalr ccse ho;uing no ra.mP whtch cettalnlg in' conaenlent and creqtes difftcultg to disabled patienfs. ,I There utars no proPer mecho;nism Ior shtfttng of pattents to upper fToors.

The Kitchen used fior the patients toas ln un' satlsfactory condition. The sewerage water urrrs o;ua;llcrble inslde the kitchen. Out of two one Refrtgerator wals functtonq.l which wo,s stuffed wtth poor qualttg mo;terto,l which needs immediate a.rrangements and action bg the competent authoritg (Photographs are enclosed and marked as Annexure C).

B. WHETHER THE HOSPITAL HAS SUFFICIENT DOCTORS

AND OTHER MEDICAL STAFF ON DUTY TO TREAT THE

PATIENTS F.OR ANY AILMENT WHICH THEY MAY BE

SUFEER//VG FROM,

There u)as shortage of doctors a;nd po,ra'medlco,l staff. As per hospital mo;r';a;gem;ent the dutg doctors hc;ae extra burden ornd dlscharglng extra duties ln a:ll .{ shifts, whtch affect thelr standard of seruices to the pcitlents. The health department has been requested to fillup the uacancies and the issue of the appointmerut is pending. There are o;pproxlmo:telg 375 ao,co,ncles., q

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(-. TO CONFIRM THAT THE HOSPITAL HAS SUFFICIENT

WORKING EOUIPMENT IN ORDER TO UATELY

TREAT /TS PATIE,NTS FOR AffY AILMENTS WHICH

THEY MAY BE SUFFERI/TG FROM.

There are four opero:tion theaters, out of whtch two were found dts-functional. 0. T. (1) ts ln worst conditlon, Whereas, the patients are being oPera,ted ln O,T. (2) without facilitg of air-conditlon. The dutg > doctors qnd staff of the operatlon thea:ter haae dlsclosed tho;t most of the medlcal-equipment used tn the Operation qre out af seraice qnd no anu instrument has been purchased in past gears. Theg also raised the issue of non-o;ao;ilo;bilitg of the electricttg ln loo;d' shedding 'hours o;nd alternate arrangement, The auailable one generator was reported to be out of order arud non-functional due to non-supplg of fuel. There was no bia- medical engineer in the hospital to ascertain the condition of auailable old medical-equipment. (Photographs of Ofs are enclosed and marked as Annexure D, D-1).

There wo,s no adequate staff to deql wtth large number of patients, The emergencq trollegs, ventllators marchines, Suctlon machines portable X'rags, dresslng sets were not aaalla,ble in the hospital.

D. WHETHER F EOUIPME I/[T /S REOUIRED AND

LSIT THA T EOUIPMENT,

As per ma,nagement a great deql of o,dditiona,l + equipment ls required for the hospital ln the follouttng Departments (as detqlled in the Report):-

1 DEPARTMENT OF RADIOLOGY.

2 DEPARTMENT O tr PATHOLOGY,

3 BLOOD BANK.

4 DEPARTMENT OF CAR D IOLOGY,

5 DEPARTMENT OF GYNAE AND OBS. O.T. AND

LABOR ROOM.

6. DEPARTMENT OF PAEDS/ NICU/ NURSERY

DEPARTMENT OF UROLOGY.

B. DEPARTMENT OF ENT.

9, DEPARTMENT OF EYE,

10. DEPARTMENT OF ORTHOPEDIC.

11. DEPARTMENT OF SURGERY.

12. DEPARTMENT OF SKIN/ DERMATOLOGY.

13. DBPARTMENT OF NEPHROLOGY.

14. ALL OT'S/ ANESTHESIA DEPARTMENT.

15. SURG/CAL ICU.

16. MEDICAL I & II.

17. LIVER CLINIC

.d 18, EMERGENCY.

19. OPD,

20. MISCELLANEOUS.

21. STERILIZATION UNIT.

22. LAUNDRY UNIT.

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E, TO PRO VIDE A LIST OF ALL EQUIPMENT IN GOOD REPAIR

AND EOUIPMENT WHICH /S OUT OF ORDER;

During ursft a grectt deal of equtpment utas found out o! order ln the fotlowing depafiments as detalled ln the report:'

1, DEPARTMENT OF RADIOLOGY,

2. DEPARTMENT OF PATHOLOGY.

> 3. DEPARTMENT OF GYITAE & OBS. O.T. & LABOR

ROOM,

4.DEPARTMENT OF PAEDS/ NICU/ ffURSERy.

5. DEPARTMENT OF DENTAL.

6. DEPARTMENT OF UROLOGY.

7. DEPARTMENT OF ENT.

8. DEPARTMENT OF EYE,

9. DEPARTMENT OF PAEDS/ NICU/ /VURSERY,

10, DEPARTMENT OF DENTAL.

11, DEPARTMENT Otr TJROLOGY.

12. DEPARTMENT OF E,YE.

13, DEPARTMENT Otr ORTHOPEDIC,

14. DEPARTMENT OF SURGERY.

15. DEPARTMENT NEPHROLOGY.

16. ALL O. T'S.

17, SURG/CAL ICU.

18.MEDICAL I &, il.

19, LIVER CLINIC.

20. EMERGENCY.

21, DEPARTMENT OF PHYSIOTHERAPY.

22, STER/I,IZATION UNIT.

23, LAUNDRY UNIT,

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F" TO REPORT OF THE HYGIENE AND SA]V/TH TION Otr THE

HOSPITAL.

Hggienic and Sanitatton Condltlon of the hospital artzs quite un-desired Sewerage water uras seen in the kitchen. Meat lging in the refrlgerator ta'as found un-hgglenic conditlon, wo,sh-room*s were un' cleqn, PorAable drlnking wqter urss not aaallable at the buttd.tng for the patients. Bed sheets, mattress o;nd plllows for patients uere dlrtg and un'clean No proper sterlllzation system of medlca,l equtpment wash sanltizers water coolers and a;lr condltlon system to lmproue sanitqtion of the hospital.

G, TO THAT THE HOSPITAL HA VE ADEOUATE

SECT]RITY ARRAN GEM ENTS :

"J The hospital ho,s neither CCTV Co,mera,s sgstem or police plcket has been established oaer there. The hospital management has raised the issue of secaritg arud demanded installation of the CCTV Cameras and so also proper police post far tlrc hosPital.

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H, TO CONFIRM THAT THE HOSPITAL /S PROVIDING

MEDICINE FREE OF CHARGE TO ALL THE PATIENTS:

Patieruts u)ere randomlg enquired regarding the supply of required medicine and there u)as no complaint, euen in some cases the fact of supply of the costly medicine u)o.s corufirmed up-to the leuel of end user. Howeaer, no software ructs a;uailable to monltor the o;aqllo,bllttg and dtstrlbutlon of the mediclnes etc. The hospltal authorltg wa;s dlrected to o;rro,nge the method of software as installed in the Ctull Hospltal. There wa,s cooltng issue in store. Electrical wires are aery faultg rrnd inaite snd mis-hape. The roof of store ls cntmbllng.

L TO CONFIRM THAT THERE ARE SUFF'/C/EIIT DOCTORS

AND OTHER S?IAF'F' HAVING UIRED SKILL

TO OPERATE ALL THE EQ UIPMENT AT THE HOSPITAL

There is acute shortage of qualtfied doctors q.s well qs trrzined medica,l staff to attend large ftumber of patlent comlng from a,ll oaer the country. The detail has already been pointed supra.

Report is submitted accordinglA.

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(TMDAD HUSSA IN KHOSOI

District & Sessfons Judge, Karachi South.

L 7 . Accordingly, the Secretary Health is directed to ensure that all the aspects pointed out in the reports of the District & Sessions Judges in respect of the public hospitals in their respective district are rectified/ acted upon including repair, maintenance, provision of equipment and staff etc. prior to the next date of hearing.

8.In this respect the Secretary Health shall file a report which shall clearly state what works lrepairs/maintenance the respective District & Sessions Judges in their reports required to be carried out/what equipment was needed, how many staff and at what level etc. were needed in respect of each public hospital and confirmation that all { such work has been undertaken, all such equipment and staff provided as set out in the reports of the District & Sessions Judges.

.i 3Ll g. We direct the Secretary Finance to ensure that sufficient budget is made available for the aforesaid purposes since citizen's right to adequate health care is a part of the right to life which is a fundamental right guaranteed under the constitution which the Government of Sindh is obliged to ensure

10.On the next date of hearing Secretary Health and Finance, MS Civil hospital and Director Anti Bncroachment GOS shall all be in attendance.

A copy of this order shall be sent by fax to them for compliance and also to the Chief Secretary Government of Sindh for information To come up on Wednesday August 7 , 2OL9.

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JUDGE

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