Health care in Pakistan is mostly private where the government provides a small amount of the total health expenditures, with the remainder being entirely private, out-of-pocket expenses. Health care delivery in Pakistan on the other hand, is the worst of both worlds; not only the health care delivery is predominantly private there are no watchdog bodies, agencies or audit commissions to monitor quality. The result is a thriving private practice; which is unregulated and unmonitored. The majority of clinicians in the city of Karachi are practising without any accountability and are not answerable to any higher authority. More than often complex procedures are undertaken in clinics and smaller hospitals, which are unequipped to deal with complications. Health and safety regulations simply do not exist.[5]