By Zubeida Mustafa
ONE major flaw in the education sector in Pakistan that hardly ever figures in popular discourse is the deeply rooted inequity which denies underprivileged children access to academic excellence. This is not a one-time phenomenon. It is a self-perpetuating one.
The offspring of middle-class parents face a formidable challenge when they seek admission to a public-sector medical university, let alone the elite private institutions which charge a forbidding fee. Even government institutions now impose heavy tuition charges that are unaffordable for the majority of the people. Denied education of good quality, can these children ever hope for upward mobility which comes with a good job?
In this context, it was a pleasure to see history being made at Pakistan’s first physician assistants’ convocation at the Sindh Institute of Urology and Transplantation’s SIMS (Sindh Institute of Medical Sciences). Last week, 252 young graduates (58pc women) received their four-year BS degree in various medical technology disciplines ranging from operation theatre science, to nuclear medicine and radiotherapy. Thirty-four nurses (including five men) also received their diplomas.
What makes SIMS different from other medical colleges and universities that have now followed suit and begun to train physician assistants? SIMS has proved that technical education can be made accessible to the underprivileged free of charge. In fact no one admitted there is required to pay any fees. As for other institutions, charging fees which run into lakhs of rupees, they are following the iniquitous pattern set in recent years.
The basis of this approach is the SIUT’s philosophy that has spawned SIMS. The objective is not to meet any market demands for commercialisation purposes.
Dr Adib Rizvi, director of the SIUT, has unwaveringly believed that healthcare is the birthright of every person and no one should be allowed to die because he or she cannot afford medical treatment. In line with this principle, the SIUT has treated ill people free of charge, all the while ensuring their dignity, for the last 40 years. In the market-driven world of profits and commercialism, the SIUT has strived to uphold its philosophy by developing a model which Dr Rizvi insists can be emulated.
The SIUT as a public-sector facility has entered into a triangular partnership with the community and doctors. The community donates generously to supplement the government’s funding while the doctors provide the best medical services possible to patients without charges — and round the clock. Since the institute keeps pace with the latest medical technology, it has expanded as and when the need arises. There is also the growing workload created by an increasing patient population to be taken care of.
SIMS was born in 2009 as a degree-awarding institution when an acute need for trained manpower began to be felt. The Zainul Abideen School of Medical Technology had already been set up in 2005 followed by the School of Nursing in 2006. Since the SIUT also deems education (including access to technical education) a fundamental right of the people, this parallel expansion made sense.
As is the SIUT’s culture, the constant struggle to raise the bar continues. While talking to some of the graduates who were awarded the four-year BS degree last Wednesday, I got an insight into the transformation SIMS had brought into their lives. Abdul Qadir, a graduate in operation theatre science and now working at the SIUT, went to a government school and a public-sector college. With the tough competition and high fees for admission to technical institutions, there were few prospects of his talents ever being allowed to bloom.
At SIMS he passed the entry test comfortably and the four-year course has groomed him for a successful career. He says what he found most useful was SIMS’ clinical-centred teaching along with lectures on theory.
Erum Ara, who studied at The Citizens Foundation School in North Karachi and a government college, got a BS in critical care sciences from SIMS. She had dreamed of becoming a doctor but couldn’t make it to the Dow University of Health Sciences. She doesn’t regret her failure one whit. At SIMS, where she cleared the entry test easily, she feels she has benefited immensely from the environment that promotes self-esteem, and the excellent faculty that is more effective by virtue of its clinical approach in teaching.
This is what equity in education means. It is not just opening doors for everyone, but also providing equal opportunities for high quality education for all. In fact, this must be introduced from the primary level to be effective.
Only conscientious government functionaries can do that. It is not generally remembered that the SIUT began as an eight-bed ward of the Civil Hospital that was nurtured into the exemplary institution it is today. It is not an NGO as Dr Rizvi did not use the Civil Hospital Karachi as a stepping stone to build a private charity hospital as others have done.