On August 8, a suicide bombing ripped through Quetta’s Sandeman Provincial Hospital, leaving over 70 dead. According to eyewitnesses, after the blast only one doctor came forward to treat the wounded: Dr. Shehla Sami Kakar.
Dr. Shehla is a well-known Associate Professor of Obstetrics and Gynecology in Bolan Medical College (BMC), based in Quetta. She is a consultant obstetrician and gynecologist. She was posted to Sandeman Provincial Hospital (SPH) in 2008 as an Assistant Professor, and got promoted to Associate Professor in 2015. As of now, she is the only doctor who has the honor of being a medical educationist and gynecologist of this caliber in Balochistan province. She also has seven publications to her name, with an eighth on the way.
Dr. Shehla recently spoke with The Diplomat’s Najeeb Kakar about the Quetta hospital bombing and her experiences treating the wounded. The following interview has been edited for grammar and clarity.
Where were you when the blast occurred, and what was the atmosphere when you reached at the site of that horrific explosion?
That day we had our gynecology operation list. When I came to my operation theater, it was around 9:15. We have four operation theaters that we shifted our patients inside, and then decided which case was to be operated by whom and which faculty member. At the time we were deciding this and doing priority management of the stable elective cases, that was when the heart-wrenching and most shocking blast took place. The entire window of our operating theater C, which overlooks the casualty ward, was broken.
The blast was really horrifying and exploded with a very loud, almost ear-piercing and shocking sound. That was the moment when I realized that the direction came from the casualty ward of our hospital; that means the blast has taken place here. In split second I decided that I was not going to proceed [to operate] on the elective cases. They were stable patients, who planned to be operated on the same day or the next day.
I rushed to help the injured victims immediately. But frankly it was very difficult approaching the casualty ward at that point, because the entire crowd of the hospital was running away from the blast site. Unfortunately, automatic rifle fire started in such an indiscreet manner after the blast. However, the immediate thought was that may be they [the ones firing guns] are the terrorists, who are accompanying the one who exploded himself so that the injured lawyers who are on the ground don’t survive. So I continued rushing toward the blast site with the thoughts that I should not be afraid of this terrifying situation. If there is something I can do for humanity, I should continue to serve them in this crisis situation. When I reached near the casualty ward, most of the lawyers were shrieking and yelling with pain.
Moreover, people were lying dead; their bodies were scattered around the hospital premises. At the site, there was still dust; smoke and a toxic strong smell had encircled the atmosphere. I saw the lawyers — the one who was lying close to me was bleeding heavily from his left leg. I immediately sat down next to him, took off the neck tie of his dress coat and tied it over his bleeding leg in a tourniquet, so that the bleeding stopped. All the lawyers who had survived the blast were standing there dazed and shocked, not moving, not speaking, looking only in one direction as if they had been frozen. I started shouting and howling at them to please come and help me. Thank God that sense prevailed, and four of them came to help.
In this manner I started moving forward from one injured to the next. On all those who had injuries to their limbs, to their arms and their legs, I kept tying tourniquets. While I was tying tourniquet over the limbs of the patients and the injured lawyers, I did one more thing – to make sure that their airways weren’t blocked. Those victims who were bleeding from their noses, mouths, and ears, I turned their position sideways and I requested the other lawyers to lift them into a sideways position, so that they don’t inhale and aspirate their own blood and they don’t die before reaching the operating theater.
For those who had injuries to the chest and abdomen, I took the coats of the injured and normal lawyers and the people standing nearby and applied pressure with their coats close to the bleeding point over their chest and abdomen. Unfortunately, no stretchers were available and no ambulances were available for 10 to 15 minutes so that the injured people could have been shifted to other hospitals.
That was the minimum I could do, that was my responsibility as a doctor and human being.
Being a woman in male-dominated Pakistan, was there any question about you treating the victims of the August 8 blast?
First, for a woman to help the injured in the hospital, I think there is no gender discrimination, and there should be no gender discrimination. Once we decide to become a doctor, it is our responsibility to come to the fore and help the people regardless of their faith, religion, cast, creed, color, and gender, whether they are male or female, Muslim or non-Muslim. As a doctor it was my responsibility and that should be the responsibility of an entire generation of doctors, medics and paramedics regardless of their gender.
Second, it is only a perception that it is male-dominated society. If ladies take the opportunity to study — they must work hard both at home and outside the home — then it will not be a question of [male] domination.
As far as rights are concerned, Sura-an-Nisa [a chapter of the Quran] states very clearly that males and females have equal rights. So it is not a question of domination; it is part of how we perceive what Islam says. So practically I don’t believe that it is domination.
There were other doctors on the hospital premises, but you were the only icon who helped the victims. How did you get the motivation and courage to help in that deadly situation?
I think it was something of a second time for me. On April 12, 2010 an Hazara leader by the name of Hussain Yousufi was gunned down. When his dead body was brought to Sandeman Provincial Hospital (SPH), all the Hazaras were gathered [to protest] against his grisly killing. So that time a second main attack took place — that was the bomb blast. I was doing rounds in the gynecology department; all the windows were broken. I left my ward abruptly and rushed toward the casualty ward to help and rescue the victims there in 2010.
For me, fortunately, no media people saw that. No media people took my photograph. Although I equally helped those people as well [as the Quetta victims], but people then didn’t know how many people I had helped. And very sadly, very ironically after six years, the scenario is the same. Nobody was there to help me then, and nobody was here to help me this year.
In 2010 there was the same lack of medical facilities with no bandages, no emergency stretchers, and no ambulances available. And exactly the same status quo persisted even after six years. So the motivation was this: that if I can save human lives, I should rush in; this a God-given opportunity and I should not lose that.
But I do hope that through your interview and what you journalists are doing, other doctors do get motivated. And I hope the next time such an unfortunate incident does take place. I do hope the doctors would come forward.
How many doctors are there in the hospital?
We have 45 departments in our hospital, and 45 departments is a huge hospital. And in each department there are 30 to 40 doctors. If only two doctors, two nurses, and two paramedics from each department could have come forward, you can imagine that: 45 multiplied by two of each category of health care provider. We could have had a huge crowed helping the people and providing first aid response.
So yes, we do have a lot of doctors. We do not have a shortage of doctors. And I hope the next time such something happens close to hospital or anywhere else close to doctors, I hope the doctors come forward to help.
You mentioned the lack of medical facilities. If there were more medical facilities available at the moment, could the death toll have been decreased?
As a doctor I believe that, yes, human lives could have been saved if we had first aid respondents. Now the question is how many human lives could have been saved? It is difficult to speak in retrospect. In hindsight, when you look back, people can always say that this could have been done differently.
But yes I do agree with you that lives could have been saved if we had first aid respondents to provide first aid forthwith. It was in the center of the hospital, not anywhere else in Quetta.
Whose responsibility is it to provide psychological care to the victim’s families, those who were injured but survived, or those who saw the traumatic unfortunate incident?
Essentially the society and the medical community should be providing psychological care, but in Pakistan we don’t have such a setup. In the entire world, the psychological counselling for Post-Traumatic Stress Disorder (PTSD) is provided by psychologists. In Balochistan we don’t have psychologists. As a result there is nobody to provide that psychological care.
For myself, what I did and what I saw, I take solace and peace in reciting the name of Allah Almighty. And I hope till we have a proper system of psychological counselling, I hope the victim’s families can take the refuge, solace, and peace in Islam, faith, and through Allah Almighty.
You are a role model not only for the civil hospital’s staff but also for an entire generation of Pakistanis. Do you have any message for them?
Thank you very much for making me a role model. But I think what I did was something that everybody could have done. And everybody should do it. It could have done by everybody, and it should have done it by everybody — all people, regardless of whether they are doctors, nurses, and paramedics.
I believe that if we are in such a society where a blast or such a huge disaster or crisis can take place, then all students, teachers, journalists, police, law enforcement agencies, and doctors in particular should come forward for training. If we can provide a first aid response, we should always be brave enough and courageous enough to reach out in time. We should not be afraid of death. The time of our death is fixed; it can’t be moved a split second forward or backward. So we must not be afraid of the injuries or a fatality that may be awaiting us. We should be brave enough to set an example as a doctor. If I don’t come forward and other medics don’t come forward, the question is: who will? If we don’t come forward, who is going to help the injured people?
People who are not trained should be trained but that takes some time. We need doctors, nurses and paramedics. We need to be available at all time and at all places. Everybody can do that. To be courageous and to come forward at such a time is something that differentiates us from the normal society and that also differentiates us from the normal person. We have been provided so much education, so much experience to help people at a time of crisis. If we don’t do that, we are going to be answerable to Allah Almighty in this world and the life here after.