Asia-Pacific, Development & Aid, Economy & Trade, Gender, Headlines, Health, Human Rights, Labour, Population, Women's Health

PAKISTAN: When the Doors Are Open, But Women Choose to Stay Away

Zofeen Ebrahim* - IPS/TerraViva

KARACHI, Pakistan, Sep 21 2010 (IPS) - For five years, Sana Yasir toiled through medical school and then was awarded at the end with a diploma and a bright future. After completing the required year-long clinical practice, however, Yasir got married and quit the workplace.

That was six years ago. Today Yasir, a 28-year-old mother of a year-old son, wants another child before she considers restarting her medical career.

“My husband didn’t stop me from work,” she says, “but I decided it would be easier (to quit) and instead prepare for my post-graduate studies (while) starting a family.”

Medical professionals here say Yasir’s case is hardly rare in Pakistan. In fact, far too many female medical graduates are choosing not to practise their profession that some medical insiders say the country may run out of practicing doctors soon.

According to Dr Omar Farooq, pro-vice chancellor of the Dow University of Health Sciences and principal of the Sindh Medical College, Pakistan’s current doctor-patient ratio is about 1:100. In rural areas, he says, the figure can be as high as 1:600-900.

For every one specialist, says Farooq, there are 14,000 patients.

“If female students, who form a majority of graduates every year, decide not to continue with studies, and the cream of male students leave for greener pastures, in less than 10 years there will be a severe shortage of doctors,” he says.

There are no available statistics that would show that many, if not most, of Pakistan’s female doctors are choosing to stay home and look after their families instead of trying to balance home and career.

Farooq, however, estimates that “50 percent of the female medical students don’t practise after graduating, especially if they get married”.

“Of the 50 percent who do,” he says, “25 percent often quit once they have kids. Only 12 to 13 percent of the women go for specialisation.”

The situation has apparently become quite serious enough for some medical professionals to suggest that the Supreme Court reconsider its 1999 recommendation for medical schools to adopt an “open merit” admissions system.

This was in response to a petition filed by a female medical school applicant who was unable to gain admission because of the then quota system that limited the number of female students per batch.

Since medical schools began implementing open-merit admissions, more women have been able to pursue medical degrees. Today women make up about 75 percent to 80 percent of Pakistan’s medical graduates.

“It’s not easy to keep a balance between family and kids and work,” says Dr Faryal Khan, explaining why Pakistani female doctors often quit their jobs.

Khan, 32, has tried to look for a part-time job that would allow her some hours with her two young children at home. But she says, “Either the hours are not good or the pay isn’t attractive enough for me.”

“It’s either the husband who frowns upon night shifts or discourages his wife from keeping long hours that results in young (medical) graduates resigning,” says Dr Mariam Waqas. Waqas herself is still working even though she is married. But then she has yet to have children. She also works in a non-government organisation where she can keep regular hours, unlike in a hospital.

According to Waqas, “a vast majority” of the women who graduated with her seven years ago from medical school are currently unemployed by choice. “These were really promising, bright young women,” she comments.

“We did it, so why can’t these girls do, too?” asks an exasperated Samrina Hashmi, who began her practicum just a month after giving birth to twins in 1990. “I worked 108 hours a week!”

Hashmi, though, was in Britain at the time – far from the clucking tongues of conservative-minded relatives and neighbours. Her workplace was also near a daycare centre, enabling her to go and nurse her two babies during her breaks.

Asked if it helps to have a doctor for a husband, Hashmi retorts, “It helps to have an understanding husband.”

“For a woman doctor,” remarks Dr Azra Ahsan, “a supportive family network is paramount for her to pursue a career path laden with one exam or the other.”

Meanwhile, Nashrah Abdul Haq, a final-year student at Dow Medical College, says that it is unfair that all female medical students are expected to work after they finish their studies. “It should be (their) choice,” she says. “Many girls from other professional colleges opt not to work, too. Why single out female doctors?”

Haq, 24, also does not think ending the open-merit system would help give male students a better chance of admission to medical school and eventually lead to a better doctor- patient ratio in Pakistan.

“Few boys are opting for medical studies,” she says. “And those who do want to go abroad in any case.”

Hashmi, for her part, says that making the workplace more conducive to mothers may encourage female doctors to continue practising. “There can be crèches for the babies,” she says. “It will take off a lot of (the mothers’) anxiety of not being able to see their babies for long hours.”

She suggests having a safe pick-and-drop facility for those on night shifts as well. Part-time training facilities for medical graduates who still need to do their clinical practice wouldn’t hurt, too, says Hashmi. “Instead of finishing a course in two years,” she says, “(they) can do it in four.”

(*This story was originally published by IPS TerraViva with the support of UNIFEM and the Dutch MDG3 Fund.)