By serving themselves all the same unhealthy foods, patients with nutrition-sensitive diseases
Patient attendants from out of town camp in an open space at the Civil Hospital due to lack of free shelters. Photo: Jalal Qureshi/Express
KARACHI:
In many branches of alternative medicine, food is considered a natural medicine. Certain foods have been shown to support specific health conditions, while others are known to contribute to common lifestyle diseases. However, in Karachi’s district hospitals, where patients are served generic meals, food has become a source of harm rather than healing.
While hospital meals around the world are adapted under the guidance of experts, in public hospitals in Sindh patients often complain that the food is nutritionally inadequate. Many hospitals offer only one meal a day, and over the past decade, hospital administrations have closed in-house kitchens and outsourced food preparation to private contractors. Previously, hospitals hired kitchen staff to prepare meals, but now 90 percent rely on contractors who are unaware of patients’ individual nutritional needs.
Food budgets in public hospitals are tied to the number of beds, and administrators often try to limit patient admissions to reduce expenses on food and medicine. The Department of Health publishes tenders for meals, including set menus, after which hospitals award contracts to companies offering the lowest price. Contractors typically prepare food in their own kitchens, although some use hospital kitchens with their staff. There is no system to check the quality of meals and food is provided without the guidance of nutrition experts.
Although the contractors claim to provide mutton twice a week, fish once and vegetables and lentils on other days, patients complain that the hospital food looks ordinary, lacks nutrients and is served in a humiliating manner. Meals are delivered on steel trolleys, curries in open buckets and hygiene rules are ignored, leading many patients to bring food from home. Even though hundreds of millions of rupees are spent annually on patient meals, complaints remain common.
At Saudabad Hospital, a patient, Muhammad Aslam, confirmed that the meals were the same for everyone and were sometimes too spicy, making them unsuitable for his blood pressure. Another patient, Shafiq Ahmed, added that there was no system in place to monitor the quality of food or ensure that it meets patients’ needs. Similarly, at Lyari General Hospital, Akhtar Baloch described receiving only lentils and vegetables for four consecutive days, regardless of his medical conditions.
Lyari General Hospital has more than 300 beds, a food budget of Rs 45 million, a partially outsourced kitchen, no dietician and a patient occupancy of more than 50 per cent. The 200-bedded Liaquatabad Hospital allocates Rs 27 million for meals and outsources food through the lowest bid tender, that too without a dietician. The New Karachi Hospital, also with 200 beds and a food budget of Rs 10 million, and Korangi Hospital, with 200 beds and a budget of Rs 40 million, follow the same model and both report patient occupancy of 50 to 60 per cent.
In contrast, some larger hospitals maintain more structured food services. The Civil Hospital, with a budget of Rs 200 crore and more than 90 per cent patient income, prepares meals in-house under the supervision of a nutritionist and offers mutton, fish, vegetables, lentils, boiled eggs and bread. Jinnah Hospital, with 2,000 beds and a budget of Rs 200 million, runs a scientifically managed kitchen where private dietitians supervise the preparation of meals, keeping in mind high and low protein needs. Although the government dietitian position remains vacant due to legal issues, private experts ensure proper nutrition for patients, with fill rates of around 95 percent.
Despite significant funding, most public hospitals in Karachi struggle to provide adequate, hygienic and medically appropriate meals. Patients continue to face uniform, low-quality food, often supplied by contractors who are unfamiliar with individual dietary needs. While a few large hospitals follow professional guidelines under the supervision of dieticians, the prevailing system in most district hospitals leaves patients dissatisfied, highlighting the urgent need for trained nutritionists, proper kitchens and quality control to ensure that hospital meals meet health and hygiene standards.
