May 2011, Volume 61, Issue 5

Editorial

Disaster management never part of the medical curriculum in Pakistan

Kiran Ejaz  ( Department of Emergency Medicine, Aga Khan University Hospital, Karachi. )

An oil pipeline bursts in a cosmopolitan city. A sewerage line is mistakenly hit while working on the water system in the main city center of Karachi, resulting in a sewerage spill involving three blocks of the city\\\'s business area on a given day.1 Some nations worry that such events are health hazards and public health personnel are immediately mobilized. In Pakistan, disasters are only addressed if the rich are affected by its consequences.
As part of the Disaster Management Cell of Pakistan Medical Association, I observed steps being taken from the relief phase of disaster management. We also established a surveillance cycle through our already established network across the country.2 We continue doing as many other Non-Governmental Organizations and Aid agenesis are doing and should have been previously thought of and done by the government officials. The Pakistan Forces helped in the disaster impact, rescue and field care phases. Had it not been their pre-disaster preparedness our fellow men would not have survived this topological disaster, the recent floods.
The question I ask myself is why were we not prepared for it. National Disaster Management Authority (NDMA) is responsible to establish, plan and conduct capacity building through the National Institute of Disaster Management (NIDM) under National Disaster Management Ordinance 2009.4 Trying to find an answer within my own learning curve and career path, I have noticed a genuine flaw in our medical curriculum design. The earthquake of 2005 taught us lessons but our administrators and curriculum designers seldom make realistic decisions to polish the cream of Pakistan. Not even a single medical college teaches Disaster Management to their undergraduates. Post graduate teaching of Pakistan is already under critique in numerous circles. Having Public Health and more precisely Disaster Management mentioned on the yearly teaching plan is enough for the authorities. Majority of the medical students are not aware of Public Health being a necessity of the healthcare system of any nation. Pakistan Medical and Dental Council know exactly how to spoil the cream of Pakistan but making them slaves of a system of mere memorization. Merely inspecting for number of staff and materials present at the departments does not mean that the curriculum topics are being taught as the need of the time.5 Those who dare to use their brain power are at losing ends in majority of the cases.
As a medical student, my Community Medicine teacher did mention having a chapter in our text book. However as it was not important for passing the exams we really did not learn much of it at undergraduate level. As a student of Diploma in Public Health, the programme taught us about Disease Early Warning Signs and other measures that we seldom saw before in our surroundings. One is surprised to see all the reports being published online without getting to meet their representative in the fields. As a postgraduate Masters student, we were taught three hours of Disaster Management as part of our Public Health curriculum. The very book used at the undergraduate level gave us a half picture and a bookish approach to a disaster that we should be prepared for to deal within Pakistan. We were asked to make presentations regarding various disasters and that so was actively participated by a handful of my classmates. Most of my colleagues and juniors never took my career path and only did clinical rotations, they are handicapped if the word Disaster Management is used and are ready to prove their clinical skills at all time to disaster hit areas.
A regular medical student who is brilliant enough to work through self-learning at majority of the country\\\'s medical colleges and has power to serve the fellow nation men can deal with disasters of any level and any time. I ask the medical curriculum designers to wake up and not waste yet another five years in thinking that these minds can work wonders. NDMA would benefit through collaborative efforts with PMDC in preparation of future disasters in Pakistan.

References

1.The Daily Times : MA Jinnah Rd Sewage Problem Continues. (Online) (Cited 2010 Sep 25) Available from URL: http://www.dailytimes.com.pk/ default.asp?page=2010\\\\07\\\\06\\\\story_6-7-2010_pg12_7.
2.Young Doctors Continue Duty At Relief Camps. (Online) (Cited 2010 Sep 25).  Available from URL: http://www.daily.pk/young-doctors-continue-duty-at-relief-camps-21926/.
3.Pakistan Education News:  Impart Training In Disaster Management University Of Peshawar. (Online) (Cited 2010 Sep 25). Available from URL: http://pakedu.net/pakistani-education-news/impart-training-in-disaster-management-university-of-peshawar/.
4.National Institute of Disaster Management. (Online) (Cited 2010 Sep 25). Available from URL: http://ndma.gov.pk/nidm.html.
5.Pakistan Medical And Dental Council, Inspection Report, Department of Community Medicine. (Online) (Cited 2010 Sep 25). Available from URL: http://www.pmdc.org.pk/LinkClick.aspx?fileticket=48ROAYDjJLQ%3d&tabid=102&mid=649.

Journal of the Pakistan Medical Association has agreed to receive and publish manuscripts in accordance with the principles of the following committees: