A woman’s medical nightmare exposes crisis of unqualified doctors in Pakistan’s KP

Saima Khan, a 28-year-old schoolteacher from Peshawar district in Pakistan’s Khyber Pakhtunkhwa (KP) province, is battling for her health after a fake doctor’s dangerous mistake left her with a life-threatening blood clot in her hand. Now, she must undergo a second surgery—all because she sought treatment for a simple fever.

Khan’s ordeal began when she visited a local quack—an unlicensed medical practitioner—who administered an injection that went horribly wrong. Instead of curing her fever, the shot caused severe swelling and a stubborn clot, forcing her into surgery. When the first operation failed to fully resolve the issue, doctors confirmed she needed another procedure.

“I only wanted relief from the fever—I never imagined it would come to this,” she told Nukta. “I’m unable to work now, and the pain is constant. Doctors say I need another surgery.”

Quackery replaces care

Her case highlights a troubling reality across many parts of KP, where unqualified "doctors" continue to operate unchecked and remain a persistent threat despite periodic crackdowns, placing countless lives in danger.

According to a study on healthcare-seeking behavior by Shaista Naz, Assistant Professor at the Department of Rural Development, University of Agriculture Peshawar, "44% of the population in KP turns to unlicensed practitioners for treatment, while 56% consult qualified doctors. However, the study reveals that even among those seeking care from certified professionals, 68% prefer private clinics—mainly to avoid long queues and due to a lack of trust in public hospital staff,” the research reveals.

Why quacks?

A former practitioner at Mardan Medical Complex (MMC), currently practicing in the UK, Dr. Zain ul Abideen, told Nukta that poverty, lack of awareness, easy access, and the promise of quick relief drive many patients to unqualified practitioners. “High inflation makes private clinics unaffordable, while long waits at public hospitals force daily wage earners to avoid them,” he said.

He noted that some qualified doctors steer patients toward their private clinics, charging between PKR 1,000 and PKR 5,000, and frequently prescribe costly diagnostic tests. In contrast, quacks offer immediate, though often unsafe, relief for as little as PKR 200 through injectable treatments.

Speaking to Nukta, Dr Tahir Khan — currently serving at the National University Hospital in Singapore and formerly associated with Lady Reading Hospital in Peshawar — said Pakistan’s healthcare crisis is rooted in a shortage of doctors and a fragile system.

“Job opportunities are limited, salaries are low, and contract-based MTI policies offer no job security,” he said, adding that such conditions are prompting many doctors to leave the country.

According to data from the Bureau of Emigration and Overseas Employment, at least 39,975 doctors have left Pakistan for employment abroad since 1971.

WHO’s recommendation

According to the 2023 national census, Khyber Pakhtunkhwa’s population stands at 40.85 million. However, data from the provincial health department shows that only 10,749 medical and dental practitioners are available, of whom over 1,000 are either on leave or no longer in active practice.

This puts the doctor-to-population ratio at approximately 1:4,200 - far below the World Health Organization’s recommended standard of one doctor per 1,000 people. Based on this guideline, KP requires at least 40,856 qualified doctors to adequately meet public health needs.

The situation is similarly dire for nursing staff, with just 4,270 nurses across the province, resulting in a nurse-to-population ratio of 1:9,566 - also significantly below acceptable benchmarks.

Speaking to Nukta, Attaullah Khan, spokesperson for the KP Health Department, stated that the government is taking steps to address the shortage of doctors across the province. “Medical Teaching Institutes (MTIs) have advertised posts for medical staff and consultants as part of ongoing recruitment efforts,” he said.

Khan added that more than 600 medical officers and consultants will be appointed in peripheral hospitals, while over 500 positions have been advertised for the merged districts to bridge the existing gap.

Global comparison

According to the Organization for Economic Cooperation and Development (OECD), Austria and Norway maintain a doctor-to-population ratio of 5:1,000. At the same time, Iceland and Ireland stand close behind with around four doctors per 1,000 people. The United States and the United Kingdom each report a ratio of approximately 3:1,000. In East Asia, China, Japan, and South Korea have over two doctors per 1,000 individuals.

In contrast, South Asian countries such as Pakistan, Bangladesh, Afghanistan, and India fall below the World Health Organization’s benchmark of one doctor per 1,000 people. India’s Ministry of Health claims it achieved this target in 2018, reporting one doctor for every 834 citizens. However, the figure is disputed, as it includes practitioners from traditional medicine systems under AYUSH—Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy—raising questions about the validity of the claim.

Role of KPHCC

According to the Khyber Pakhtunkhwa Healthcare Commission (KPHCC), 1,491 clinics were sealed over the past year, while 1,455 were issued show-cause notices for failing to meet regulatory standards or violating healthcare protocols.

Azm Rehman, Public Relations Officer of the KPHCC, said the commission is committed to ensuring the provision of standard healthcare services. “All clinics and healthcare establishments must be registered with the commission; otherwise, action is taken,” he said.

Rehman added that enforcement against unqualified and unregistered practitioners is ongoing, with special anti-quackery drives also launched in collaboration with district administrations.

“Quackery is not limited to those without medical or dental degrees—it also includes practitioners who cross professional boundaries, such as a dentist running a psychology clinic. Such cases are also dealt with strictly,” he explained.