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The Sham Doctors Who Prey On Pakistan's Poor

Street scene near Rawalpindi, Pakistan
Street scene near Rawalpindi, Pakistan
Malik Ayub Sumbal

RAWALPINDI — When 40-year-old government employee Danial Ahmed has problems with his teeth, he goes to a quack on the streets of Rawalpindi, Pakistan. “The price of dental treatment is expensive,” he says. “I cannot afford it. These quacks offer cheap treatment. For just a few hundred rupees, we can get relief from toothache and other oral infections.”

These cheap alternatives to real doctors can easily be found on virtually any roadside in Pakistan. They sit along the streets or in a small kiosks, where patients are treated on the spot.

According to the government, there are more than 600,000 of such sham doctors practising across Pakistan. They claim they can treat anything from minor dental problems to deadly diseases, and they’re obviously offering their services without authorized medical degrees.

Many poor people prefer going to them than to real doctors, as private medical practices and legitimate clinics charge what for them is too hefty a sum.

Ahmed Khan, 50, is sitting on the pavement in Rawalpindi’s busiest square. He has been treating patients here for the last two decades. He’s well known among his clients — two to three dozen visit him every day — for treating everything from headaches to dental problems.

“I’m experienced in doing this job,” he says. “I have treated hundreds of patients each day. The majority of them get relief after my treatment. Otherwise, why would they visit me?”

Most of his patients are from poor families and cannot afford anything else. Khan and others like him charge as little as $1 dollar and provide cheap medicine.

Dr. Muhammad Nawaz Khokar is among those who are concerned about the practice. “They’re playing with the lives of innocent people,” he says. “And they have no expertise in diseases. They use unsterilized equipment, which is a major reason for the spread of diseases from one patient to another. This is how the majority of diseases are being transmitted in Pakistan.”

In 2009, the Supreme Court ordered health secretaries to take action against quackery, but so far nothing has happened. A year later, the government passed the Health Care Commission Act and asked all local authorities to end quackery in their districts. But many of them operate in rural areas that have limited medical facilities.

“We have started to crack down against them, but they have strong backing,” says Dr. A.K. Niazi, head of the Rawalpindi District Health Office. “There’s a law against quacks, but it’s not implemented. According to the law, quacks should be put behind bars and are not eligible for bail.”

In fact, dozens of illegal clinics have been closed down. But examples of these fake doctors going to jail because of what they’re doing are still very rare.

Muhammad Qasim Khan, 45, still regrets his decision to visit one of these unqualified people for his illness. “I went to a quack near my house for medication for my fever,” he recalls. “But he injected me with something, and now I’ve been infected with hepatitis. I’m now undergoing treatment for this fatal disease. It’s been a lesson for me — never ever go to a quack. They can be deadly.”

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In Northern Kenya, Where Climate Change Is Measured In Starving Children

The worst drought in 40 years, which has deepened from the effects of climate change, is hitting the young the hardest around the Horn of Africa. A close-up look at the victims, and attempts to save lives and limit lasting effects on an already fragile region in Kenya.

Photo of five mothers holding their malnourished children

At feeding time, nurses and aides encourage mothers to socialize their children and stimulate them to eat.

Georgina Gustin

KAKUMA — The words "Stabilization Ward" are painted in uneven black letters above the entrance, but everyone in this massive refugee camp in Kakuma, Kenya, calls it ya maziwa: The place of milk.

Rescue workers and doctors, mothers and fathers, have carried hundreds of starving children through the doors of this one-room hospital wing, which is sometimes so crowded that babies and toddlers have to share beds. A pediatric unit is only a few steps away, but malnourished children don’t go there. They need special care, and even that doesn’t always save them.

In an office of the International Rescue Committee nearby, Vincent Opinya sits behind a desk with figures on dry-erase boards and a map of the camp on the walls around him. “We’ve lost 45 children this year due to malnutrition,” he says, juggling emergencies, phone calls, and texts. “We’re seeing a significant increase in malnutrition cases as a result of the drought — the worst we’ve faced in 40 years.”

From January to June, the ward experienced an 800 percent rise in admissions of children under 5 who needed treatment for malnourishment — a surge that aid groups blame mostly on a climate change-fueled drought that has turned the region into a parched barren.

Opinya, the nutrition manager for the IRC here, has had to rattle off these statistics many times, but the reality of the numbers is starting to crack his professional armor. “It’s a very sad situation,” he says, wearily. And he believes it will only get worse. A third year of drought is likely on the way.

More children may die. But millions will survive malnutrition and hunger only to live through a compromised future, researchers say. The longer-term health effects of this drought — weakened immune systems, developmental problems — will persist for a generation or more, with consequences that will cascade into communities and societies for decades.

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