Establishing a Poison Information Centre in Pakistan: Challenges and Achievements

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Pakistan's commitment to global chemical safety and public health efforts is reflected in its participation in international agreements and projects. However, the absence of a centralized Poison Information Centre (PIC) undermined these efforts. A PIC is crucial for providing immediate information and assistance in poisoning cases, which can prevent fatalities and reduce the burden on healthcare systems.

Under the EU CBRN PRECA Project 87, Pakistan received support to enhance chemical safety through four key areas: command and control systems, food safety, water safety, and chemical safety in mass gatherings. One of the project's mandates was to establish a PIC in Pakistan, a task that fell to the chemical safety group led by me. This responsibility came with significant challenges, compounded by my position as a woman in a traditionally male-dominated field.

As a woman, I faced additional scrutiny and resistance. Societal expectations often dictate that women prioritize domestic responsibilities over professional ambitions, leading to skepticism about their ability to lead such critical projects. Additionally, institutional resistance, particularly in male-dominated leadership hinders the progress.

Despite these challenges, support from some senior colleagues allowed me to overcome initial hurdles. Their cooperation and mentorship played a crucial role in navigating the complex landscape and securing the necessary approvals and resources.

Logistical and Resource Constraints

The initial challenge faced was selecting an appropriate location for the PIC at the institute. I, alongside Pakistan’s National Focal Point (NFP) for the EU CBRN CoE, aimed to find a location that could operate within Pakistan's limited resources. However, the most significant barrier was convincing the relevant head, who was engaged in testing various chemicals and drugs. This task proved exceptionally difficult for me due to both my junior rank and my gender. Despite the primary goal of establishing a comprehensive PIC which would prove immensely useful as poisons could be tested and information could be conveyed to the medics and public, I faced rejection. Even intervention from the CEO was unable to persuade the head.

Professional isolation is another critical issue. Women in Pakistan often have fewer opportunities to network and build professional relationships, which are crucial for the success of such initiatives.  Following this setback, I approached various donors for assistance. The donors, however, were unwilling to help citing mistrust for country and its use of resources and capital and was further hindered by my lack of connections with high value donors.

During this period, I experienced significant anxiety but remained committed to achieving the KPIs set for the country's chemical safety group. Through discussions with the NFP and supportive colleagues, I decided to narrow the scope to just a PIC. 

Once again, the issue of location arose. Fortunately, with the CEO's support, I was able to secure a room for the PIC in a central location. After resolving the issue of location, I encountered another significant obstacle: staffing the PIC. This challenge was particularly daunting as a woman trying to establish myself in a male-dominated field. However, after great effort, the issue was resolved, and a competent medical doctor was assigned the task of handling the advisory portion in the PIC.

Despite this progress, I still had a substantial workload. I had to prepare all the necessary documentation for the PIC myself, including Standard Operating Procedures, call log forms, list of locally available antidotes, pamphlets, etc. Despite the backing of a UK-based database “ToxBase” through the PRECA project, the task required meticulous attention to detail and a deep understanding of the subject matter. As a woman in this field, I had to demonstrate exceptional competence and dedication to ensure the success of the PIC, overcoming numerous challenges to achieve set goals.

Achievements and Ongoing Challenges

Despite formidable obstacles, my team and I successfully established a PIC at the National Institute of Health (NIH), marking a significant milestone in Pakistan's efforts to enhance chemical safety and public health. The PIC now provides essential services, addressing poisoning incidents promptly and effectively.

However, maintaining the PIC presents ongoing challenges. Ensuring continuous funding, updating equipment, and providing ongoing staff training are critical for the center's sustainability. 

Dr. Shazia Adeel and her team successfully established a PIC at the National Institute of Health, marking a significant milestone in Pakistan's efforts to enhance chemical safety and public health.

Conclusion

The journey to establish a Poison Information Center at NIH in Pakistan, led by a woman, highlights the broader challenges faced by women in the professional and healthcare sectors. Societal expectations, institutional resistance, logistical hurdles, and general systemic flaws all contributing to a complex and often discouraging environment. Despite these challenges, the successful establishment of the PIC represents a significant achievement in public health and women's empowerment in Pakistan. Addressing these issues requires a multifaceted approach, including policy changes, societal support, and increased funding and resources for healthcare initiatives led by women.