When I was a medical student, we formed a ‘Health Education Society’ to share preventive health strategies. One of our earliest interventions was that we printed a small pamphlet on breast cancer. It was a copy of a US printed pamphlet and had a geometric circle with arrows marking the direction for women to palpate their breasts to identify any tumors earlier. I shared a few printed copies with some of my female classmates and some later got offended.
This was surprising for me as our own medical books have much more explicit pictures of the human body but probably it was not the content but who shared it. They thought that it was inappropriate for a male to give them these pamphlets. We decided not to distribute those pamphlets anymore. This was an important lesson in public health for me. No matter how well intended you may be, but you still need to consult the stakeholders. I still have those undistributed pamphlets lying with me reminding me of a costly mistake of thinking that “I know best for the public”.
Recently in Lahore, I came to know about our barber’s young son who died in a traffic accident on a nearby flyover bridge (college road/ PECCO road). When I was talking to him, he told me that his son’s bike fell from the bridge. I failed to understand how a bike could fall from the bridge. Then I thought that maybe the young boy was driving recklessly. The very next day as we were driving there, I saw a lot of commotion and my driver told me that there had been an accident and a dead body was lying there.
As soon as I returned home and turned on the TV, there was news of a couple falling off the very same bridge and both had died. Next time I was driving on the bridge I realised that instead of good railings, regular road dividers were placed. Probably that is the reason for people falling off this bridge as they are not tall enough and have a small incline at the ground level.
Recently in Islamabad, there was news that after a decade some intersections were being brought back instead of signal-free corridors. Nearly a decade ago some traffic planners realised that if we scrap intersections and introduce signal-free roads it smoothes vehicle traffic. This became a trend and the intersections where cars were waiting for a long time and giving pedestrians an opportunity to cross the road were gone. But planners did not even consider the majority of the population who were not driving and needed to cross those streets on foot. Now poor pedestrians risk their lives darting across speeding traffic. Pedestrian bridges are few and far between and difficult for old and sick to climb.
This is a perfect example of how the exchequer’s resources went to provide facilitation to one segment of society but creating more problems for other segments. Reason is that when these decisions are made, in these rooms everyone drives a car. No pedestrian is ever part of these consultations. Contrary to this in the west even for scientific study approval we need to present our work to the committees composed of not only the general public but representatives of marginalised populations.
It’s a daunting task as I failed the first time when I was explaining my Stanford University study for the state of California. It was difficult for me to answer their apprehensions as I was thinking about academic excellence and maybe not about their welfare. On the next attempt we were successful in addressing their concerns and I learned a lesson in humility.
Flyover bridges and signal-free corridors are very important, and my life has become easier while using them. But we need to ascertain how other stakeholders are affected after this. Is the construction safe or not for different vehicles? Even though I know of three deaths, it does not prove unsafety, but it gives a strong impetus to students of public health and government to analyse the situation and come up with a corrective strategy. Public health is not about doing fancy theoretical studies and getting published, but our job is about trying to serve our populations. But you also need to talk to them first before you start serving them.
