Tag Archives: doctors

Aftermath of Doctors’ strike

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By Farkhanda Qaiser

“Baji aap ko tu mehanga kapra dunga main…!” The shopkeeper said maliciously.

“Hain Bhai sahib? Magar kyun?” The lady was bewildered.

“Kyunki aap doctor hain…!” came the reply.

This incident occurred recently with a friend’s aunt who happens to be a dentist-turned-housewife. And I fear more such incidents as an aftermath to the young doctors’ strike and the successful negative propaganda by Punjab Government. (I call it successful because it achieved its desired result – turning majority of the civil society against doctors).

However the matter is not so simple. It will have long-term effects. This defaming media hype has created a trust deficit between the physician and the patient. The patients have been made to believe that doctors of today are purely greedy souls who would go to any limit for their pay hikes. When in fact, the truth is quite different. The issue is not about increasing salaries rather it’s about job security via a proper service structure. It’s about diminishing bureaucratic and political influence from the induction, promotion and transfers of doctors. This measure would ensure the promotion of merit as opposed to a ‘sifarish culture’ which is prevalent in our society at present. Hence, the opposition from the Punjab Government can be explained by this simple fact.

Nevertheless the sacred trust that exists between a physician and his patient must be preserved at all costs. So now it is our responsibility to bring back that lost faith. Or else we could suffer a similar fate as that of Indian doctors.

Yes, our Indian counterparts have also resorted to strikes countless times. Theirs had been an old story spreading over the course of almost 10 years. The demands were – pay hike and time-bound promotions. The response of their government was very similar to that of Punjab Government but minus the brutal crackdown i.e. appointment of ad-hoc doctors and adoption of delaying tactics to sabotage the just demands of doctors. However the public reaction was very alarming. There were innumerable cases of assaults on doctors along with token-protests by social organizations like Gujars and trade associations of Rajasthan.

Let’s hope the situation doesn’t get this bad in Pakistan.

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The Doctors’ strike: Sifting the myth from the facts

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By Farkhanda Qaiser

When I heard a common man cursing the doctors and endorsing the brutal acts of the Punjab police against these saviors of life, I skipped a beat. I’m not a member of YDA neither am I yet a doctor. I’m simply a medical student who was at first intrigued by the entire issue and then alarmed when the Punjab government started the crackdown of doctors as if they were criminals.

I turned to the media channels to get the true story but was highly disappointed at the sensationalized and politicized version that greatly masked the true demands of the doctors. In the meanwhile, I kept getting text messages from my seniors that were diametrically opposite to the news updates on media. If media said that doctors are bowing down to the pressure of the government and returning to the hospitals, the text messages immediately denied these false claims. I was highly perturbed by the situation so I switched on my ‘Shahbaz Sharif’ laptop and logged onto facebook. And VIOLA…! The young doctors and their supporters had spammed every group and page condemning the actions of the Punjab government and reporting about the critical condition of the doctors who had been tortured in the police crackdown. And this is what made me turn my head. Ever since the crackdown, I had been dogging the news channels and listening to the rowdy talk shows but never once had I heard about the doctors being brutally beaten up. Why were the facts being manipulated by the media? Could I no longer trust the ‘Azad Media’ of Pakistan to deliver me the news as it really is rather than presenting a partial picture? Thus I began my own search for the truth. And there were astounding revelations along the way. I’d like to share them with my readers.

Another new demand?!

I realized that the prime allegation against YDA is that ever since its inception in 2008, it has come out on the streets multiple times and used pressure tactics to get its demands accepted. People believed that similarly this time the YDA again had a new demand for which it was making the poor patients suffer. However this was no new demand and neither were there any casualties due to the strike.

Last year when the doctors ended their 37-day OPD strike, the Punjab government assured them that not only will their salaries be increased but a comprehensive service structure will also be devised. A special committee was then constituted consisting of all stakeholders for revising the service structure of doctors and paramedics of the health department. Then followed 23 meetings of this committee over the span of a year, in which YDA scaled down the financial impact of its demands from Rs. 423 billion a year to just Rs. 4 billion; all the incentives were to be given in phases during the next five years.

Moreover in February 2012, during suo moto proceedings of the Punjab Institute of Cardiology medicine scandal, a Supreme Court bench headed by Justice Tassaduq Hussain Jilani and Justice Mian Saqib Nisar also directed the Punjab government to give a career-oriented service structure to doctors.  But throughout all this time, the Punjab government has stubbornly refused to keep its promises on the grounds of financial constraints. This is the feeblest excuse on earth because we all know how this same government spends billions of rupees on foreign tours and perks and benefits for its MPAs. Can’t these greedy politicians spare a mere Rs. 4 billion for a better healthcare system?

I suppose not.

OPD strike and casualties?

After having failed in all their attempts to get their rightful demands accepted, the YDA was left with no other choice but to resort to a lock-out in OPDs. This strike started on 18th June 2012; that’s when the media’s malicious campaign started. Images of patients crying were shown and doctors were dubbed as killers without even investigating into the facts. As anyone with the minimal knowledge about the healthcare system would know that closing OPDs cannot result into any deaths because patients coming to OPD, i.e., out-patient department are not critical. Moreover these patients were being treated in emergencies and indoors which were fully functional even during the strike. So in fact the workload of doctors had increased in the days of the strike. To understand further we must look into the duties of a House Officer (a doctor doing house job). He does a 30-hour ward day once a week, 12-hour emergency once or twice a week and the rest of the days are spent doing a 6-hour indoors duty. On the other hand, OPD duty hours are very less. Hence, while the media was crying itself hoarse saying that doctors are neglecting their duty, those same young doctors were sacrificing their day and night serving their patients!

Is the doctors’ strike justified?

Yet another question has arisen time and again in media regarding the ethical value of a strike by doctors and its precedents in other countries of the world. In the past 20 years there have been strikes by medical doctors in Australia, Belgium, Canada, Chile, Finland, France, Germany, Ghana, India, Ireland, Israel, Italy, Korea, Malta, New Zealand, Peru, Serbia, Spain, Sri Lanka, Romania, USA, UK, Zambia, and Zimbabwe to name but a few. The usual causes have been pay and working conditions of doctors. Some of these strikes have led to improvements in healthcare systems, whereas others have caused lasting damage due to delayed action by the respective governments.

On the face of it, it sounds very cruel that patients are being denied treatment for their ailments albeit minor. It reminds me that not long ago, lawyers of our country carried out similar protests and closed down courts adding to the sufferings of the poor clients. However the entire civil society and media supported the lawyers in their cause of supremacy of law and independence of judiciary because they believed that a short-term inconvenience such as a strike would be balanced against a long-term improvement of the system. Now drawing an analogy between the doctors and the lawyers’ situation, we see that the doctors are also trying to achieve a better healthcare system. This brings us directly to the demand of the YDA: the service structure.

What is a service structure?

What the demand of a better service structure mean is that there should be a proper code of conduct for the induction, promotions and transfer of doctors. In its absence and without the right connections, many doctors who start their service as BPS-17 officers also retire in the same grade. Some of them are transferred to district health facilities at the whims of a grade 16 section officer. In April this year, when 691 doctors were transferred to primary and secondary healthcare centers, YDA opposed the move saying that it is not against the transfer but it believes there must be some rules and regulations governing these transfers. Moreover YDA also campaigned for the appointment of Medical Officer directly in Grade 18; for the stipend of post graduate to be made equal to that of a Medical Officer and for bringing health professional allowance equal to basic pay.

The long-term benefits:

All these measures would eventually stop the massive brain drain that is occurring at present. Medical students who study from public sector colleges see no future in staying in Pakistan unless they have a strong ‘sifarish’ to back them for promotions year after year. Thus they opt for higher studies and subsequent jobs in US, UK, Australia, Canada and even Middle East. It’s not just a matter of higher pay rather it’s about job security. If even after studying assiduously all your life and completing your graduation with flying colors, you are still dependent on a BPS-16 section officer or a fake-degree holder politician for the continuity of your job, then you’re bound to spend sleepless nights fearing for the future of your family.

And if somehow a doctor cannot manage to go abroad then he turns to the private sector, which obviously is out-of-reach for the general public. Thus improving the service structure would also serve to retain the trained staff in public sector ensuring quality healthcare for all and sundry. Here I would like to clarify a point regarding private practice. Many common people seem to believe that YDA is being very greedy by asking the poor government for financial favours when in fact these young doctors earn thousands in their private practice. Well that is clearly not the case; because it takes decades and graying-hair experience to reach that Rs. 1000 per walk-in-patient-at-private-clinics state. And of course the young doctors haven’t yet reached that state. So they’re entirely dependent on the government to cater to them.

Therefore the government should stop its high-handed behavior with the most educated cream of the nation and focus instead on solving the problems at hand.

Also YDA should not be seen as a greedy insatiable body forever protesting only for its rights but rather as a body that envisions a Pakistan with better healthcare system. In the past, YDA has also given valuable suggestions to the government of Punjab, which if implemented could radically improve the public healthcare sector. One of these suggestions is a refer system between primary healthcare (found in rural areas), secondary healthcare (found at district level) and tertiary care hospitals in cities. This means that a patient with appendicitis doesn’t have to come all the way to Jinnah hospital for his treatment. Rather he can get himself checked at DHQ Gujrat or any other primary or secondary healthcare.

For improving medical facilities in far flung areas, YDA proposed that private medical colleges owned by MNAs of political parties could be directed to supervise district hospitals, which are in abysmal condition at present.

Support us Please!

In the end I would appeal to the civil society to please support the doctors in their cause and stop cursing the noble souls who spend their lifetimes serving the poor and ill; who have continued to serve them through thick and thin whether it be bomb blasts or earthquakes or floods; who have sacrificed their countless nights to answer the call of duty; who treat their patients without caring for their own health. Please reject the negative propaganda of the Punjab government that is spending millions on doing character assassination of doctors rather than fulfilling their demands.

I would also request the media to please stop sensationalizing this issue and present an unbiased view to the public. We have high hopes from the ‘Azad media’ some fractions of which are finally realizing who the real killer is. In the 3rd July show of ‘Aaj Kamran Khan k sath’ the anchorperson admitted that not a single death had occurred during the peaceful OPD strike of doctors in the first 12 days until the use of force by the Punjab police against the doctors on the eve of 1st July after which the doctors were threatened with arrests if they returned to hospitals and some of the doctors were brutally beaten up and arrested. Since then dozens of people have died due to lack of medical staff in hospitals and only the Punjab government is to be blamed for these deaths…! Moreover city42 unveiled how false FIRs had been lodged against a couple of doctors to attain judicial orders for their remand. Similarly many anchorpersons and column writers are also presenting impartial views. However there are still many who continue to shout at doctors and showcasing them as gluttonous and callous.

Over 20 years ago, a detailed ethical justification for doctors’ strike was published in the New Zealand Medical Journal. According to this article, “what is right should result in the greatest good for the greatest number of people.” If a strike would enable doctors to have better work conditions resulting in them being better rested and thus being able to do their job better then it is fully justified. Doctors sometimes must have the courage to do unpopular and difficult things for the greater good of the public.

And this is exactly what the YDA is doing and paying heavily for.

 

The Bird’s Eye View of Laptop Distribution in KEMU

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This blog was published in KemUnited on 9th April 2012.

By Farkhanda Qaiser

Getting those DELL Inspiron N4050 laptops wasn’t as easy as it may sound. Here’s an in-depth analysis of what conspired both on-screen and backstage. There’ll be many an interesting tale never made public before. So read on and enjoy…!

In KEMU, it all started in the first week of March with a top-notch meeting of the Vice Chancellor Prof. Dr. Asad Aslam Khan with the Presidents

and Executive Members of all societies. And a whirl of activity followed soon afterwards. There was alot to be done and little time at hand because the laptop distribution ceremony had been scheduled right after the Sports Week. Majority of workload fell on the frail shoulders of KAPS – managing the decor of the entire event as well as training the kemcolian choir. Whereas KEDS provided the speakers for hosting and speeches. All the organizers worked day and night to make this event a success. Yet they couldn’t bear to miss the Clash of Titans i.e. the Pakistan-India Cricket match. (VC hadn’t spared the organizers even on a sunday) so they decided to live-stream the entire match by using KEMCANNA wifi and watching the action on a projector set up in the library hall. However all their planning came to naught as the wifi failed them on a crucial moment. Even the VC was disappointed at this mishap. He seemed to avid supporter of the Pakistani team. (well who’s not when it comes to a match against arch-rivals!).

During the last days before the big event, the organizers often stayed back in university till 12 or 1 at night. Once VC even took them for a dinner to Salt n’ Pepper to reward them for all their hard work. (wow…!) And ofcourse how can we forget the furtive renovation of buildings of KEMU with a hastily put up “Shahbaz Research Centre” being the highlight. and finally some much-needed separate washrooms for girls and boys were also built (at the back of Exam branch or so I’ve heard).

Then came along the notorious ‘Undertaking forms’ and the various official documents that had to be attested. For 2 days before the ceremony, KEMU patiala block was flooded with scores of people hovering around the ‘dreaded’ notice boards while the boys adorned the benches in the tented ground. All waiting for an announcement about the registration numbers and the beginning of dispatch of forms. They were to be disappointed time and again. The first day the buses left at 6 pm and still the undertaking forms were nowhere in sight. However the next day brought some good news with the first onset of ‘shoving-you-out-of-your-ribcage’ phenomena. Trust me, the crowd’s reaction was worse than it is during the announcement of the result of PROFS (on the same notice board). Then there were the Street Art people roaming around in their “World record holder” shirts. They had just finished painting the world’s largest painting in the National Hockey Stadium and now expected to be treated likewise by being given an easier excess to the front of the queue. But not to be…!

There was also the racket of the girl organizers having to wear white shalwar kameez with maroon dupattas and the boys to don the maroon coats with white shirts. While the dress may have been easily accessible to the boys (as many happen to be ravians) but the girls were much perturbed. Some hastily got them stitched at double prices. Others were seen borrowing them from their younger sisters or the younger sisters of the cousins of their friends. While still others were seen hovering around the Nursing hostel pleading with the nurses to lend them their dresses for a day…!

After much ado, finally the big day arrived. The VC being the cheif organizer was often seen shuffling around the ground where the arrangements were being made. Some KAPS girls actually hammered in nails onto the trees to fix the ‘WELCOME TO KEMU’ banners. Whereas the KAPS boys were given the job of blowing the green and white ballons (which sadly deflated before the evening could even kick off). At around 6 pm, the flag party gathered to welcome the Cheif Minister of Punjab, Mian Shahbaz Sharif. However they were much disappointed to see that his son Hamza Shahbaz had come instead.

“Kemcolians are always let down by the CM.”

Many were seen opining as even on the 150th celebrations of KEMU, Hamza had come instead of his illustrious father. Is KE not good enough for the CM or what? Anyhow disgruntled

as they were, yet the flag party still escorted the chief guest to the stage. After which the ceremony was officially inaugurated by the hosts Rabia Zia and Usama Talib. Then the recitation of Holy Quran and Naat took place. Among the highlights of the event were the address by the VC and Khawaja Saad Rafique; speech by Sidrah Latif and the national songs sung by the choir. The crowd seemed to love the songs and were seen singing along with them on the tunes of “Is parcham k saaye tale hum ek hain, hum ek hain” and many others. The most amazing sight was that of Dr. Awais of physiology waving the Pakistani flags and dancing to the songs in the middle of the ground. He greatly energized everyone. Some guys stood up on their seats to sing and dance. It was definitely a wonderful sight and one of the rare displays of our love for our motherland. For me, this was the most precious moment of the day…! We may complain about the Punjab Government squandering the public money for political purposes but this same government brought the 6000 crowd together on a single platform..he objective may have been to get laptops however the KEMU organizing committee must be commended for putting together such a wholesome event. We were jubiliant. We were exhilarated. Not just to get laptops but also to be kemcolians…and most importantly to be Pakistanis…!

Some enthusiastic political minded students didn’t let this opportunity go out of hand. They were seen wearing the Shahbaz Sharif shirs and caps while others wore teh Imran Khan ones. At times they even broke out into slogans in support of PTI. However this was an unnecessary gesture that could’ve been done without. Rumor has it that strict action was taken against these students.

Then there were also those unlucky students who were denied their rightful share of laptops because they’d had supply in their Final exams. VC and Prof.Dr Farid were seen pleading their case in front of the CM team emphasizing that a supply in medical is not the same as elsewhere. It’s much more common and less stereotypical in nature. Even a seemingly brilliant student can get a supply on account of bad luck or nerves. Eventually their demands were met and the Punjab Gov agreed to also present laptops to these unfortunate people.

Moving on to the highest respect which was bestowed upon the brilliant students of KE…yes I’m talking about the profound guard of honor that was given to them. This was another amazing experience. People stood on their seats to get a good view as the myriad of media people and their cameras hid much from view. Our joy knew no bounds at being given so much respect for all our hard work. If only, doctors were as respected at other times too.

Then came the big moment that all had been waiting for. The time for the distribution of the laptops. The top 5 students of every class were to be called to stage and given away the laptops by the chief guest Hamza Shahbaz. Whereas 5 booths had been set up for the remaining students. The PA of Hamza Shahbaz asked the host to make this announcement. And once the word was out, the audience rushed to their respective booths in patiala without waiting for the chief guest to leave first or make a speech if there was any. The organizers kept trying to woo back everyone but to no avail. This may have been the biggest mishap of the event yet the CM team had an equal hand in it. They shouldv’e been more clear about their intentions in the first place.

While the toppers received their laptops on stage, the crowd rushed to their respective booths to be the first ones to get the laptops. Many lines were made outside the booth. Infact one too many. So much so that they didn’t appear to be queues any longer. However the boys proved to be more disciplined as they are less in number (in KEMU atleast. For every boy, there are 3 girls). At booth 3, a serious fight broke out which led to the booth being closed until decorum was maintained. Actually there were around 400 people at each booth which was too much to handle. Some students received their laptops as late as 11 pm. The KE buses left really late that night. When the media asked these students to record their protest, surprisingly they refused (usually we happen to be a nation content at complaining but not that day). Instead the girls started singing “hum zinda quom hain, hum painda quom hain.” and that literally shut the media up…!

Now we know that CM Shahbaz Sharif was giving out 110,000 laptops worth Rs. 4 billion. but we didn’t know was that the laptops would be in 2 colors -black for boys and red for girls. However the kemcolian guys proved to be an exception to the rule. Some of them wanted the red ones. Considering the fact that the female population at KE is far more, the corresponding number of red laptops was really less. So that saw most of the girls begging boys to exchange laptops with them. However many were not granted their wish. So they learnt to be happy with their black ones instead…!

And so a much happening day came to an end…!

Being Patch Adams…!

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This blog was published in KemUnited (the official blog of King Edward Medical University) on 9th March 2012.
 
By Farkhanda Qaiser
 
Thinking it to be just another lecture on ‘communication skills’ by some senior teacher, I headed towards the Mini Anatomy Lecture Theatre (which I later found out to be the demonstration room in DH). This workshop was being conducted under the auspices of “Kemcolian Akhuwat Club” which had found an ingenuous way of filling up the seats. Namely, asking all society presidents to send 3 of their active members. And since I happen to be QUITE an active member in A LOT of societies so I was representing many of them. But still I wasn’t really happy about this sudden interruption in my plans.
However my thoughts changed drastically after the 1 hour which was the duration of this workshop. Mr. Pervaiz Bashir – advisor to President of CPSP – was the convener. As is the style of motivational speakers (I dub him that), he started off by asking a simple question from the 40+ audience of medical students:
 
Why did you join this profession?
Almost one-half cited parental pressure as the cause while the other half passionately dubbed it as their own choice to serve humanity.
Then there was a chain of questions which were duly answered by the audience as whole. Some of them were:

Who comes to a doctor?

Ans: Patients.
 
Why do they come to a doctor?
Ans: To seek the solution to some physical or psychological problem that they’re facing. (I had the burning desire to say that patients come with their presenting complaint…! You see I’m an enthusiastic 3rd Year student who takes her wards quite seriously=p)
 
What does a doctor do?
Ans: He solves their problems. (Or in ward language, he painstakingly takes a careful history, performs the complete examination, suggests investigations and plans a proper course of treatment)
 
Thus it was established that a doctor is a problem solver. Yes you better be good in solving issues. Whether it be at home, among siblings or among friends. Like it’s said in that famous movie, Patch Adams: Talk to strangers, talk to wrong numbers. Talk to everyone. Develop your communication skills because they will serve you best in this profession. P.S. There’s no need to take this so literally. If you know what I mean =)
 
At this point you might be weighing the importance of medical knowledge versus this art of communication. Undoubtedly, you cannot be a successful doctor unless you know your Last, Guyton, Robbins or the dreaded Katzung. However the need of the hour is to ask yourself, is that enough? Is that bookish knowledge enough to satisfy your patients? Would the books teach you how to deal with a beleaguered parent whose only son has become paralyzed waist down due to an RTA? (Sorry, wards talk again, it means road traffic accident) Would they inculcate in you the passion to become a doctor just to serve humanity? Many a times, it’s difficult to hold onto that passion when you’re passing through a hard phase. You’ve failed 5 pharmacology tests, missed half of the lectures, got repeaters in major wards and are cursing the moment you chose to do MBBS. You curse Munir the attendant for having picked your proxies or shut the door of the lecture theatre when you were just half a minute late. You curse your class fellows for being the ultimate thetas that they are (Yes, everybody experiences this during the Prof Season). You curse the supply in Anatomy that took away half of your year. In short, you’re passing through the worst experiences anyone could imagine. In this scenario, you’d probably slap someone who even dares to say that medicine is a noble profession and should be dealt as such. Because for you, it’s a nightmare in so many words.
 
From where would you get the motivation to continue? The answer to this question was one that literally shook me for a moment. I’ll be coming to that shortly.
 
So have you ever thought who decided that you’ll become a doctor one day?
You? Your parents? Your excellent grades in Matric/FSc or Olevels/Alevels? Your good luck?
 
No, none of these! It was the ultimate authority in this universe who decided your fate! Allah Subhanawata’ala…! He says in the Holy Quran that He provides shifa to the people. Doctors are merely his vicegerents doing as He wills. Infact there are only two branches of knowledge that are discussed in the Holy Quran: Ilm-e-deen (knowledge of the religion) and ilm-e-ibdaan (knowledge of the body). Thus it’s such a noble profession that it found a place in the holiest books of all times. We ought to feel privileged at being given the opportunity to study the human body – the creator of which is Allah Himself.
So firstly, the science of medicine itself is a wonderful science or as I say (Magic with Medicine) and secondly, the doctor who practices that science is doing a great service and will be rewarded as such. This can be explained as follows: As Islam tells us, Allah loves us more than 70 mothers which in Arabic is a way of saying, unlimited. Just imagine how much our one mother loves us. She cries at our pain; sacrifices her sleep when we are ill; fulfils our needs without being asked to and loves us without any strings attached. Now multiply this love and care by 70 or unlimited…! We cannot even begin to imagine how MUCH our creator loves each one of us. And when one such creation of Almighty Allah falls ill, he comes to us – the doctors. If we deal that patient with the due respect and care he deserves, he’d definitely remember us in good words and give us duas. Moreover, Allah would be happy with us too because we alleviated the pain of His loved one whether by medicine or simply by good behavior. So if we just think about the rewards that our profession bestows on us, we would never need any other motivation to carry on through thick and thin. After all, with rewards comes great responsibility…! (Well yeah, the doctors’ version of Spiderman’s punch line).
 
However, we’re not fulfilling half of our responsibility, if we don’t pursue the ART of medicine as well. The communication skills involved in dealing well with the patients; listening to their problems; providing them a shoulder to cry on and being their friends is what completes a doctor. This brings us to a pyramid about the grades of a doctor:
Doc
Good
Best
Excellent
Outstanding
Extraordinary
 

We can be good doctors only if we try to be extraordinary. If we try to appease all our patients, we might be successful in satisfying a handful. But in the end, it’s the effort which matters and not the result. So our ultimate goal should be to become a complete doctor who practices both the science and art of medicine and treats his patients with the due respect that they deserve. This is the call and need of the hour and it is time enough we realized that.

2011 in review

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The WordPress.com stats helper monkeys prepared a 2011 annual report for this blog.

Here’s an excerpt:

A San Francisco cable car holds 60 people. This blog was viewed about 1,500 times in 2011. If it were a cable car, it would take about 25 trips to carry that many people.

Click here to see the complete report.