Organ transplantation technology was introduced in the West in 1904 when the first corneal graft operation was performed in a New York hospital. The first kidney was transplanted in Boston in 1954. Today, surgeons in the Third World have adopted the technology with a growing measure of confidence and success. Nearly 40,000 transplantations are being performed every year all over the world and this technology has come to stay.
As happens in the case of any scientific breakthrough, many related issues, especially of an ethical nature, are now being debated. The 1 Institute of Urology and Transplantation, Civil Hospital Karachi, which has kept up a constant exchange of views and expertise with transplantation surgeons in Western centres, recently played host to two eminent gentlemen from the Royal Free Hospital, London. Dr Oswald Fernando, a surgeon from Sri Lanka, and Dr Zac Verghese, a basic scientist from India, have worked in Britain since 1963. They are therefore well placed to understand the challenges transplantation technology faces in the socio-economic conditions of the Third World. Continue reading “Why not organs from cadavers?”
Population planning has been a highly contentious issue eversince men — as well as women — decided to intervene in the natural process of procreation to regulate demographic trends. The controversy has centred round the strategies adopted and the rationale advanced for slowing down population growth rates.
A new dimension was added to the debate when population became a North-South issue, as the industrialised states afraid of being swamped by Third World immigrants, refugees and asylum seekers began demanding that the developing countries take measures to check what has been termed as the population explosion. Continue reading “Population control: the ‘woman factor’”
There was a time when diabetes mellitus was regarded as the rich man’s disease. Not so any more. In fact, the data collected by epidemiologists indicate that today there is a higher incidence of this disorder in the developing countries.
Dr Peter Bennett, who is the head of the Epidemiology and Clinical Research Branch of the National Institute of Diabetes, Digestive and Kidney Diseases of the National Institute of Health, USA, has been investigating the prevalence of diabetes among the Pima Indians in America. His studies have extended.to other societies as well. “Surveys conducted over the last 15 to 20 years give very clear evidence that diabetes has been on the rise in the Third World,” Dr Bennett told me recently. He was in Karachi to attend the Regional Congress of the International Diabetes Federation. Continue reading “No longer the rich man’s disease”
Two hundred children in Britain who faced certain death from liver failure are alive today and leading a normal, healthy life. They owe their recovery to the miracle of transplantation: the technology that allows surgeons to graft wholesome organs from one person to another.
Behind every milestone in medical science there is invariably a human story of sustained commitment and caring effort. In the case of these 200 British children the man who has made liver transplantation possible is Sir Roy Calne, a pioneer in the field of transplantology. A professor of surgery in the Cambridge University and president of the. International Transplantation Society, Dr Calne has contributed to the science of transplantation by his research on the immuno-suppressive drugs, without which no organ graft can be successful.
The defence mechanism of the human body normally ensures that it rejects foreign objects, which include organs taken from another person. Hence the use of drugs to suppress the immune reactions but in such measured doses that infections do not kill the patient. Continue reading “Gift of Life”
In the early 1970s a magistrate from the interior of Sindh died of kidney failure in Civil Hospital, Karachi. This should normally not have merited a mention, especially twenty years later. Nearly 10,000 people in Pakistan come down with kidney failure every year.
But Mr Shaikh’s death, that was the magistrate’s name, proved to be an event of far-reaching consequences. In those days there were no facilities in Karachi for dialysis (let alone transplantation) — the only process by which the life of a patient of end-stage renal failure can be sustained. Mr Shaikh was sent to London where he was dialysed for a few weeks until his budget was exhausted. He was sent home with the false assurance that he was cured. He returned to Pakistan very pleased with himself looking forward to a new life. He brought as a token of his gratitude a small gift of handkerchiefs for the urologist who had attended to him in Karachi. Continue reading “Organ transplantation has come to stay -Dr Adib Rizvi”
NANHAY DOCTOR by Iftikhar Ahmad. Illustrated by Nigar Nazar. Published by UNICEF, Pakistan. 1992.
With the changing concepts of health care — there is now greater stress on health education and preventive medicine — the need to teach people the basic principles of hygiene, nutrition and immunisation can hardly be overemphasised. In fact the sooner this process of health education and information begins, the better it is.
GIVEN the public outcry against the government’s failure to invest adequately in the social development of the people, the authorities in Pakistan have become more wary about making loud pronouncements about their commitment to the social sectors. What better occasion would they have of speaking about this commitment and receiving media publicity than the time of the presentation of the budgets — federal and provincial. Hence, it was no surprise that in the budget season this year each and every finance minister spoke in exaggerated terms about the social sector being his government’s major priority.
But the problem with budget speeches is that they are accompanied by budget documents and preceded by the Economic Survey which do not always substantiate the official claims. This year too the provincial governments have attempted to focus on health and education, which are central to any programme of human resource development. Although there has been an overall increase in the budgets for these two sectors, one cannot but feel sceptical about the progress that will actually be made. Continue reading “Increased funding amid high scepticism over real progress”
Ten years ago there was not a single private university in Pakistan. Today there are three. The policy of inducting the private sector in education in a big way has begun to produce a visible impact.
The Aga Khan University in Karachi which was chartered in 1983 and the Lahore University of Management Sciences (founded two years later) today enjoy a prestige in the field of higher education in Pakistan that no other institution in the country has ever known.
The Hamdard University which received its charter in 1990 still has some time to go before it becomes functional. In characteristic Pakistani style, the university failed to respond to some basic queries to which the other private universities were prompt in providing information. Continue reading “The private sector in higher education”
Is the State responsible for educating its citizens and providing them health care? According to Adam Smith, who believed in the supremacy of the marketplace, education should be “self-sustaining and supported by those who use it”. Karl Marx displayed greater humanitarian concerns though today he stands discredited owing to the happenings in Eastern Europe. He advocated “free education for all children in public schools”.
Which of these principles should apply in Pakistan, a Third World country where 35 per cent of the people live below the poverty line (UNDP’s estimate)? The dictates of social justice should not permit a State to leave the responsibility of providing education and health care entirely to the vicissitudes of the marketplace.
And yet a glance at the federal and provincial budgets for the incoming year shows that the present government is applying to the social sectors the Smithsonian principle under pressure from the Western-dominated financial institutions. As such very little money has been set aside in the public sector for the human resources development of the people of Pakistan.
After the nation’s experiment with the nationalisation of education in the seventies, the pendulum has now swung to the other end. The government wants the private sector to shoulder the responsibility of meeting the people’s health and education needs. Hence the relentless drive to get the private sector to open schools, colleges, clinics and even universities. Continue reading “Privatisation of social sector: what it means in Third World context”