Men and women should have equal opportunity. This seems like a pretty basic (although not necessary implemented) idea. But gender equality can sometimes breed unexpected complications due to different cultures, constraints or customs. This does not mean that we should abandon it, but rather work with it to understand how to simplify those complications.
It may seem strange that gender equality and equal opportunity could create problems when these are oftentimes key solutions, however, one such problem is the current shortage of doctors in Pakistan.
In 1991, the Supreme Court dismantled a quota, which dictated that 80 percent of places in medical schools were reserved for men and a mere 20% went to women. Lifting this quota was an awesome step in the right direction, and the admissions process became one that was based on merit instead of favouring male admittance to medical schools.
Gradually, women began to take up more and more seats in medical schools. Although Pakistan is a country known for gender inequality, especially with regard to girl’s education, in 2015 more than 70% of medical students are women (compared to 47% in the US) according to the governmental regulatory body known as the Pakistan Medical and Dental Council (PMDC). However, only 23% of registered doctors are women.
According to dawn.com “50 percent of female doctors never work after graduation”. This is probably because of a relatively patriarchal society, where women are pressured to get married and cease working.
Perhaps a more serious issue is highlighted by a BBC correspondent in Islamabad who explains that “a medical degree is an extremely hot ticket in the marriage market”. In terms of societal perceptions, “it's very prestigious to introduce your daughter-in-law or wife as a doctor”.
I think that it is ridiculous to insist on having a wife/ daughter-in-law with a medical degree and then pressure her not to use it, but my personal opinions aside, the healthcare system of Pakistan is being adversely affected by this version of the “trophy wife”. As it is, only $9.3 per Pakistani citizen is spent on healthcare compared to an international standard of $60.
To make this worse, there are at most 60,000 medical practitioners in the country, when the demand is at 600,000 (around 10 percent of the demand is being met). Given that, only 23 percent of these are women, female patients who prefer to be examined by female doctors suffer from this shortage in particular.
Ikram Junaidi states that the Pakistani government spends 2.4 million Pakistani rupees on each admitted medical student. When these medical students turn into doctors and don’t practice, they contribute much less to society than they were budgeted to and thus have taken up "already meagre resources". The government has thus spent on healthcare, but the benefits of that are never reaped by the public.
As a response to this issue, in 2014 PMDC decided to set quotas at 50 percent each for men and women, as opposed to based on merit. This was a solution that perhaps took proportional representation too seriously and equality quite literally. As such, the Lahore High Court subsequently annulled this decision. Given that the decision was consciously made to lessen women in colleges, I argue that this quota may have been exactly equal, but still pretty unfair.
I believe that a better solution is not to regulate who can go to medical school, but to regulate what students need to do after they graduate. As columnist Fasi Zaka puts it: “Doctors are leaving, but the restrictions should be at the point of exit rather than entry”. Thus with regard to both brain drain and the so-called “doctor brides”, I think an obligatory service term for each graduate in Pakistan could be a beneficial solution.
Although the inability to choose marriage over career is not feminist, as Rafia Zakaria says, “while post-feminist interpretations of women’s choice may insist that Pakistan’s female medical students should have the option of saying “no” to a medical career if they wish to, such arguments are simply not valid in a country with such limited resources and a society always looking for excuses to keep women out of the workplace”.
Although a service term is a longer-term solution that could take months to take effect, there is another solution happening now: an organization named doctHERs that “connects female doctors to millions of underserved patients in real-time while leveraging online technology”. Thus, female doctors who may be confined to their homes are able to serve female patients who are also confined to their homes.
Thus when addressing gender inequality, it is important to remember that one cannot adopt a “one-size-fits-all” approach. However, if implementing gender equality brings about additional difficulties in certain cultures, we should not give up on it but be mindful that gender equality might even look different or have different norms in different places.