Aga Khan University Hospital

  • Karachi
  • Kashang Afzal

The field site I have chosen to study is Aga Khan University Hospital. Due to the hospital’s extensive size and divisions, this paper will be focusing on just the hospital division of the Aga Khan Institution, specifically the private ward. The paper will feature a comparison between the situation of the private ward versus the general ward, as well as an overall description of the hospital. The duration of my study and observation of Aga Khan has been of about three weeks. During these three weeks, I have been to different parts of the hospital, sat through interviews between three different doctors and visited the private ward several times.

The first thing an individual notices about Aga Khan is simply the expansiveness of the hospital. The hospital has been built in a very skillful manner, with the buildings appearing on your left as you drive through the hospital. There are different buildings for different divisions of the hospital, for example, the emergency section, clinical section, pharmacy section, private ward section as well as the university section of Aga Khan. There are two gates, which are on opposite sides of the hospital. One of the gates is close to the private ward whilst the other is close to the emergency division of the hospital. Despite the beauty of the hospital, there is construction being done on one side, where a new private ward is being built.

Upon, entering the private ward of the hospital, the first thing that grabs an individual’s attention is the strong, overpowering smell of detergent. The entire corridor smells and looks extremely clean. During the day, starting from 8 am to about 11 am, cleaners in their brown uniforms and white joggers roam the corridors, going from room to room. Two cleaners enter a room together and hence, work fast and exit within a period of three minutes, leaving the room to smell just like the corridor. One would expect the smell of detergent, to make an individual feel comforted, yet it leaves their senses on high alert, making them feel uneasy rather than comfortable. The smell of detergent simply seems to remind patients and their families that they are being tended to at a hospital and not at home. It ends with patients and their attendants feeling alienated of some sort. Apart from the smell, the corridor and rooms are air-conditioned and get quite chilly. Similar to many other hospitals, all the walls of the hospitals are white. The bed sheets in the rooms are white, towels are white as well as pillow covers and the gowns of the patients, so there is an overwhelming sense of the color white, which only adds to the depressing nature of the hospital.

At about 9 am, all the patients in all the wards are given their breakfast. They are assigned either a strong or soft diet. A strong diet consists of more protein than a soft diet. The patient is given a combination of different foods to help boost energy and sugar levels. At 11 am, various doctors begin to take rounds, dealing with their own patients individually. Physiotherapists, along with their teams, arrive to help their patients perform daily exercises. You often see patients walking around with the help of two nurses: one helps them to walk, whilst the other wheels an oxygen tank near the patient. It is important to note, that the ratio of male nurses is quite high compared to female nurses, in the private ward. These nurses seem to have a good rapport with each other and you can often find them chatting and smiling within groups, during their breaks despite the depressing environment of the hospital. The shifts of the nurses end at 6 pm everyday and so at 6 pm, there is a change of hospital staff for every patient. None of the nurses in the private ward disturb the patients from 12 am to 4 am, unless the patient summons them, themselves. After 4 am, the nurses begin to go in and out of the rooms to replace IV drip bags and give the patients their medication. The process of giving a patient a painkiller is as such that after the doctor prescribes it, it takes about thirty minutes before the patient is given the painkiller. This is because the doctor’s prescription goes down to the pharmacy, where they confirm that the drug is available. This request then goes to the account’s office where the financial assistants confirm that the patient has paid enough money in advance to be able to afford the drug. The request for the painkiller or any type of medication then goes back to the pharmacy, which sends it to the ward that requires it, after which the patient is finally given the drug or medicine. The hospital staff, in the private ward as per my experience has been cooperative and friendly.

In comparison, to the private ward, the general ward is not air-conditioned. The rooms are air-conditioned but the corridors are not and instead of a strong sense of detergent, there is an overwhelming smell of chlorine in the air, since the corridors don’t have windows and are open. The smell of chlorine comes from the fountains below the corridors of the general ward. The environment of the general ward is more depressing than that of the private ward, since families here sit on benches, huddled up together waiting for their relatives or friends to recover or come out of the operation theatre. You see many people praying, whilst others are crying or remain passive with expressions of worry and anxiety. The visiting hours of the hospital are from five thirty to eight thirty, so this is when the hospital gets extremely crowded. The cafeterias are always full of people with the attendants of patient’s rushing in to get something to eat before they have to return back to their families. At Eight Thirty pm, there is a loud announcement in all parts of the hospital, that asks visitors to leave but many linger behind not wanting to leave their loved ones in this eerie alienated environment, that is a hospital. In comparison to the private ward, the general ward is much more crowded, with families sitting huddled on one side and patients being wheeled out from operation theatres and rooms from the other side. Standing in the general ward, observing patients and their families, I experienced an extremely sinking feeling: one of depression, anxiety and worry. Apart from that, I experienced a strong sense of fear as I saw the painful conditions that so many patients were in. To be able to really empathize with these patients and these families, I wanted to speak to them and comfort them, so I went and spoke to this middle-aged woman who was crying a lot. She told me that her two-year-old son had been in the operation theatre because he had a hole in his heart and this was the first night that he had ever slept away from her because he was in the I.C.U. The pain that this mother was going through was so heartbreaking to listen to and understand because she was not able to see her son. She was also extremely worried about paying her son’s medical bills as she was a single, working mother who was not completely financially stable. She spoke of how comparatively Aga Khan charged much more than other hospitals, but because they had compatible doctors she brought her son here and was now struggling to pay the medical bills. The pain of this mother combined with the added stress of fulfilling medical bills made me realize that many people in the general ward must be facing this issue. Upon, talking to a few more people, I realized that many families had complaints that Aga Khan was an extremely expensive hospital and only brought their family members here because they felt Aga Khan had doctors with good rapports and wanted to give their loved ones the best treatment that they could possibly receive. Therefore, it is possible to suggest that the environment of the general ward is quite different to that of the private ward. Whilst interviewing these families, many had complaints that when they went for consultations to doctors at Aga Khan, most doctors were in a rush to leave the room. Each doctor is given two to four rooms for consultations and clinical time. Most are in a rush to leave the room without answering the patient’s questions or satisfying the patient’s and their family’s questions properly. This is something; I experienced and observed myself in the consultations I sat through. Most doctors were either rude or not patient friendly at all or were in a rush to leave. Out of the three doctors whose consultations, I attended, was the only doctor who patiently listened to the concerns of my family specifically and responded to each question without rushing out, which resulted in my family picking him as the doctor we wanted to treat the concerned patient.

In conclusion, in the three weeks and several hours that I have spent at the hospital, this is what I have observed about the Aga Khan University Hospital.