IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861. Volume 13, Issue 1 Ver. IV (Jan. 2014), PP 43-52 www.iosrjournals.org www.iosrjournals.org 43 | Page Pattern of Diffiulties Faced By the Attendants of Admitted Patients in Tertiary Care Unit Coming From Outside The Karachi City Dr.Fahmida Khatoon 1 , Dr.Zulfiqar Sheikh Prof. Ibrahim Hassan Alzahrani 2 , Dr.Abd-Elnaser Badawy 4 Assistent Professor United Medical And Dental College,Pakistan 1 Associate Professor ,Dow University Health Science Pakistan. 2 Professor and Chairman of Pathology, College of Medicine, King Abdulaziz University, Jedah 3 Medical biochemistry department,Faculty of medicine,Mansoura university 4 Abstract: OBJECTIVES: To identify and assess the problems faced by the attendants of patients admitted in Karachi‘s tertiary care unit who have come for treatment from outside the city area. METHODS: It was a computer based study on 502 attendants in with the help of a questionnaire. It was conducted in Jinnah Postgraduate Medical Centre, Karachi. CONCLUSION: The attendants faced numerous difficulties at every step. While getting their loved ones treated the attendants themselves are very likely to contract some illness because of these problems. The root of all problems is lack of faculties and resources in their own area. Now the challenge ahead lies in moving beyond documenting the pattern of difficulties to addressing them and putting forward long term solutions. I. Introduction Alleviating the difficulties faced by attendants of patients from outside the Karachi city area admitted in tertiary care unit requires an understanding of causes & consequence of their problems. They have to face these difficulties mainly due to lack of facilities in their own area, like in India where 73.7% of all cases received no prenatal care & went to hospital after crossing the safety margin & have to travel difficult terrain in unfavorable climate in doing so 1,2 . This pattern of difficulties faced by attendants jeopardizes their mental & physical health & personal hygiene. They make do with whatever food & drinking water is available which may be unhygienic & may contain hazardous additives. Asthmatics & patients of chronic lung or heart disease are particularly vulnerable to outdoor air pollutants to which they are exposed by traveling long distances and inappropriate / lack of shelters. Overcrowding, inability to maintain personal hygiene from lack, unavailability and deplorable sanitation of washrooms 3 , sharing or using sub standard instruments of personal use e.g. razors, combs, etc. greatly increases their risk of developing a serious infection, life threatening disease (e.g. AIDS, Hepatitis-C), nutritional deficiencies & naturally compromised immune system 4 . Disturbance is felt not only in their own professional & social routine but also in their families’ back home. This only adds to the mental stress of the attendant, which predisposes them towards psychiatric & psychological problems 5 . Financial support by NGOs is given on individual basis to those from outside the Karachi city area seeking treatment in a tertiary care unit. If this finance is spent on development & true functioning of a three tier health care delivery system, large scale & long term benefits can be reaped 6 . Also public – private partnerships should be facilitated for this purpose 7,24 . Most important solution is reducing the unnecessary burden of rural attendants on tertiary care units. Then a smaller crowd can be easily managed and provided for. This is achieved in other countries and in Punjab by treating the disease in minor & sub clinical stage & preventing them from becoming complicated enough to require the care of a tertiary care unit 6 . This research primarily addresses the medical sector & gives a complementary perspective on issues of health care access to vulnerable rural populations. It points towards the challenges faced by & the support extended to the rural attendants in a tertiary care unit.