Category Archives: Organ Transplant

Gift of sight

By Zubeida Mustafa

THE exercise in philanthropy about which I write today began 34 years ago. Two successful businessmen who were close friends decided to launch a project in their post-retirement life to serve humanity. Being compassionate, they understood the burden of disease for the poor in terms of financial costs and loss of productivity. Hence they opted for healthcare, which is the most neglected of the services sector in Pakistan. As one of them had lost his vision in one eye, a hospital for eye diseases was their natural choice. Continue reading Gift of sight

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Desperately seeking donors

By Zubeida Mustafa

As the country teeters on the brink, many of the socio-economic and political evils of yesteryears are making a comeback in a big way. One of them is the reprehensible organ trade. Rearing its ugly head at the turn of the century, the sale of kidneys was somewhat suppressed when the Transplantation of Human Organs and Tissues Ordinance was promulgated in 2007. This criminalised the sale of human organs and tissues. Thereafter, the opponents questioned it on several grounds, leading to yet another round of legal struggle.

This ended successfully with Parliament enacting the Transplantation of Human Organs and Tissues Act in 2010, amidst a lot of rejoicing. Its credibility was established when some rogue elements in the medical profession and their accomplice vendors were arrested. Thus, good was deemed to have won over evil. One didn’t realise at the time that this was a case of misplaced hope.

Some recent reports (especially two write-ups by Naziha Syed Ali) in Dawn made it clear that the criminals were back in business. This time they were careful and  avoided media publicity. The papers were not flooded, as they were a few years earlier, with images of rows of people in rural areas photographed with their shirts pulled up displaying the incision marks across their torsos – the tell-tale sign of surgery for kidney harvesting.

Matters came to a head when Dr Adibul Hasan Rizvi, director of the Sindh Institute of Urology and Transplantation (SIUT),   wrote to the Supreme Court and drew its attention to what was happening, mainly in Punjab. In support of his contention, he sent the emails he was receiving from foreign doctors complaining about their patients having travelled to Pakistan  and having been trapped by the organ traders. They had returned home mortally ill.

Under the coordination committee set up by the Supreme Court, the SIUT organised a seminar and workshops last month to formulate recommendations to step up deceased organ donation (DOD). Dr Rizvi believes this  to be necessary to change the pattern of demand and supply of organs and thus the economics that drives the heinous trade. Since human organs are in short supply, they can be sold at fabulous prices to desperately ill, wealthy patients. There is grinding  poverty in some regions of the country, in many cases created by exploitative landlords and brick kiln owners, leading to the compulsion for impoverished people to sell their organs. There are also surgeons whose greed knows no bounds and they have chosen to forget their Hippocratic Oath to serve ailing humanity. These three factors have combined to give rise to   perfect conditions for the commercialisation of organ transplantation in Pakistan.

What is equally appalling is the minimal public awareness about health and illness and the general apathy towards the burden of disease among the people. It is only when a person falls ill that he begins to learn a thing or two from his own experience. With a media that has forgotten its key function of educating the people, it cannot be expected to take too passionately to  health education programmes that have little commercial value. This public ignorance provides the medical profession its huge clientele. The fact is that the burden of disease in Pakistan can be considerably reduced by taking a few preventive measures. Spread more public awareness about healthy living. Provide sanitation and potable water to the people. The healthy environment thus created will cut down the incidence of disease.

That would explain why kidney problems are on the rise in the country. Since the deceased organ programme has not taken off, the demand and supply gap has widened making organ trade  such a lucrative venture.

Will  this exercise of drawing up recommendations produce any fruitful results? It all depends on the will and the capacity of those working for the implementation of the suggested measures.  The transplantation law that was drafted by the late Justice Sabihuddin Ahmad is still believed to be a good law. Changes in the rules could finetune it further. As for putting a halt to the odious  organ trade,  the present law is sufficient for the police to take action and for the courts to act if they want to.  The crime is committed so blatantly, that concerned authorities can crack down on the criminals – even those with powerful connections – if they want to.

The SIUT’s conference and workshops, however, served a useful purpose in another way. They underlined the need to change our social attitudes and culture towards organ donation which Zehra Nigah, our top ranking poet, described as “Tuhfa-e-Hayat-e-Nau” (Gift of a new life) in the poem she recited on the occasion.

There is, undoubtedly, a need to create the infrastructure, train medical professionals in how to handle life-and-death issues, in communicating with the patients and their relatives, and also define, in layman terms, issues like brain death. The recommendations address all these.  Dr Rizvi also brought up the issue of capacity. He pointed out that  the existing number of ICU beds in Pakistan cannot provide sufficient organs – even if consent has been given – to meet the needs of the country. Setting up a centralised registry for donors and patients in need, would facilitate the smooth and efficient working of a transplant programme in Pakistan.  This can be accomplished by the numerous professional medical bodies, working closely together and with the government.

The real challenge is to create public acceptance of deceased organ donation. In this context, the recommendations for the media and for education campaigns to create public awareness and popularise legal organ donation, are most pertinent. Some suggestions for the media, such as integrating the subject of organ donation in TV plays and programmes and including the theme in school textbooks, has the potential to be effective.

The need is to analyse the basic factors that have hampered the awareness of deceased organ donation. Religion is no longer an obstacle. Islamic scholars in Pakistan, and in other Muslim countries, unanimously agree that deceased organ donation  is sanctioned by Shariah.

Superstition, ignorance and the fear of death that have given rise to a negative attitude to deceased organ donation in our society. People need to be told about death and grieving – especially of the need to talk about these phenomena. There is a need to help people see the beauty in the idea of saving lives.

What better strategy can be adopted than what the SIUT itself opted for, when it needed to popularise organ donation by living donors related to each other. Initially, this idea was too radical for people to accept. The battle had to be won if the SIUT’s kidney transplant programme, that was launched in 1985, was to succeed.

After the first few patients and their families had been persuaded to accept this miracle of modern medicial science, it became easy sailing. The patients and their donors became motivators for those who followed. The high rate of recovery of those with transplanted kidneys, along with the care and compassion the patients and their donors received, and the guarantee of life-long free medical cover, proved to be major incentives.

I remember Rasheed, Transplant Patient #1 who came from Azad Kashmir with his brother, who was the donor. They became the agents of change for patients visiting SIUT. There was Rukhsana, the medical student and Transplant  #9, whose sister helped her out. She went on to become a doctor.

Such cases became an inspiration for other patients and their families. There was a lot of interaction among the various patients and donors, but there were also the unfortunate ones who didn’t have a donor. How could their lives be saved?  The answer was:  by  deceased organ donation.

That is what the SIUT’s conference was all about. Pakistan has had five deceased organ donors,  now rightly described as  national heroes by SIUT. The first such donor was Naveed Anwar,  a student who was fatally injured in a  road accident. When he was certified as brain-dead by a team of neurologists, his family – progressive and enlightened – decided to fulfil his oft-expressed wish to be an organ donor if he met such a fate. Dr Razzaq Memon was another and his family also donated his organs in keeping with his will, in spite of some reservations from the biradari.

I mention these two because I have met their families and they have repeatedly endorsed deceased organ donation and their own role in the programme. And so it was that deceased organ donation made a debut in Pakistan. It should be noted that the first three donations were made even before Parliament had passed the law, which certainly helped in promoting the concept.

The inspiration provided by the five heroes, needs to be brought to the fore. The families should lead this campaign. They have experienced the pain of losing a loved one. They have also felt the inner satisfaction and peace that comes from saving a life. Their words will carry weight, just as the SIUT’s presence on a high moral ground in Sindh has kept the organ traders away from this province.

Zubeida Mustafa is a senior journalist. She writes on a variety of subjects but her i

By Zubeida Mustafa

As the country teeters on the brink, many of the socio-economic and political evils of yesteryears are making a comeback in a big way. One of them is the reprehensible organ trade. Rearing its ugly head at the turn of the century, the sale of kidneys was somewhat suppressed when the Transplantation of Human Organs and Tissues Ordinance was promulgated in 2007. This criminalised the sale of human organs and tissues. Thereafter, the opponents questioned it on several grounds, leading to yet another round of legal struggle.

This ended successfully with Parliament enacting the Transplantation of Human Organs and Tissues Act in 2010, amidst a lot of rejoicing. Its credibility was established when some rogue elements in the medical profession and their accomplice vendors were arrested. Thus, good was deemed to have won over evil. One didn’t realise at the time that this was a case of misplaced hope.

Some recent reports (especially two write-ups by Naziha Syed Ali) in Dawn made it clear that the criminals were back in business. This time they were careful and  avoided media publicity. The papers were not flooded, as they were a few years earlier, with images of rows of people in rural areas photographed with their shirts pulled up displaying the incision marks across their torsos – the tell-tale sign of surgery for kidney harvesting.

Matters came to a head when Dr Adibul Hasan Rizvi, director of the Sindh Institute of Urology and Transplantation (SIUT),   wrote to the Supreme Court and drew its attention to what was happening, mainly in Punjab. In support of his contention, he sent the emails he was receiving from foreign doctors complaining about their patients having travelled to Pakistan  and having been trapped by the organ traders. They had returned home mortally ill.

Under the coordination committee set up by the Supreme Court, the SIUT organised a seminar and workshops last month to formulate recommendations to step up deceased organ donation (DOD). Dr Rizvi believes this  to be necessary to change the pattern of demand and supply of organs and thus the economics that drives the heinous trade. Since human organs are in short supply, they can be sold at fabulous prices to desperately ill, wealthy patients. There is grinding  poverty in some regions of the country, in many cases created by exploitative landlords and brick kiln owners, leading to the compulsion for impoverished people to sell their organs. There are also surgeons whose greed knows no bounds and they have chosen to forget their Hippocratic Oath to serve ailing humanity. These three factors have combined to give rise to   perfect conditions for the commercialisation of organ transplantation in Pakistan.

What is equally appalling is the minimal public awareness about health and illness and the general apathy towards the burden of disease among the people. It is only when a person falls ill that he begins to learn a thing or two from his own experience. With a media that has forgotten its key function of educating the people, it cannot be expected to take too passionately to  health education programmes that have little commercial value. This public ignorance provides the medical profession its huge clientele. The fact is that the burden of disease in Pakistan can be considerably reduced by taking a few preventive measures. Spread more public awareness about healthy living. Provide sanitation and potable water to the people. The healthy environment thus created will cut down the incidence of disease.

That would explain why kidney problems are on the rise in the country. Since the deceased organ programme has not taken off, the demand and supply gap has widened making organ trade  such a lucrative venture.

Will  this exercise of drawing up recommendations produce any fruitful results? It all depends on the will and the capacity of those working for the implementation of the suggested measures.  The transplantation law that was drafted by the late Justice Sabihuddin Ahmad is still believed to be a good law. Changes in the rules could finetune it further. As for putting a halt to the odious  organ trade,  the present law is sufficient for the police to take action and for the courts to act if they want to.  The crime is committed so blatantly, that concerned authorities can crack down on the criminals – even those with powerful connections – if they want to.

The SIUT’s conference and workshops, however, served a useful purpose in another way. They underlined the need to change our social attitudes and culture towards organ donation which Zehra Nigah, our top ranking poet, described as “Tuhfa-e-Hayat-e-Nau” (Gift of a new life) in the poem she recited on the occasion.

There is, undoubtedly, a need to create the infrastructure, train medical professionals in how to handle life-and-death issues, in communicating with the patients and their relatives, and also define, in layman terms, issues like brain death. The recommendations address all these.  Dr Rizvi also brought up the issue of capacity. He pointed out that  the existing number of ICU beds in Pakistan cannot provide sufficient organs – even if consent has been given – to meet the needs of the country. Setting up a centralised registry for donors and patients in need, would facilitate the smooth and efficient working of a transplant programme in Pakistan.  This can be accomplished by the numerous professional medical bodies, working closely together and with the government.

The real challenge is to create public acceptance of deceased organ donation. In this context, the recommendations for the media and for education campaigns to create public awareness and popularise legal organ donation, are most pertinent. Some suggestions for the media, such as integrating the subject of organ donation in TV plays and programmes and including the theme in school textbooks, has the potential to be effective.

The need is to analyse the basic factors that have hampered the awareness of deceased organ donation. Religion is no longer an obstacle. Islamic scholars in Pakistan, and in other Muslim countries, unanimously agree that deceased organ donation  is sanctioned by Shariah.

Superstition, ignorance and the fear of death that have given rise to a negative attitude to deceased organ donation in our society. People need to be told about death and grieving – especially of the need to talk about these phenomena. There is a need to help people see the beauty in the idea of saving lives.

What better strategy can be adopted than what the SIUT itself opted for, when it needed to popularise organ donation by living donors related to each other. Initially, this idea was too radical for people to accept. The battle had to be won if the SIUT’s kidney transplant programme, that was launched in 1985, was to succeed.

After the first few patients and their families had been persuaded to accept this miracle of modern medicial science, it became easy sailing. The patients and their donors became motivators for those who followed. The high rate of recovery of those with transplanted kidneys, along with the care and compassion the patients and their donors received, and the guarantee of life-long free medical cover, proved to be major incentives.

I remember Rasheed, Transplant Patient #1 who came from Azad Kashmir with his brother, who was the donor. They became the agents of change for patients visiting SIUT. There was Rukhsana, the medical student and Transplant  #9, whose sister helped her out. She went on to become a doctor.

Such cases became an inspiration for other patients and their families. There was a lot of interaction among the various patients and donors, but there were also the unfortunate ones who didn’t have a donor. How could their lives be saved?  The answer was:  by  deceased organ donation.

That is what the SIUT’s conference was all about. Pakistan has had five deceased organ donors,  now rightly described as  national heroes by SIUT. The first such donor was Naveed Anwar,  a student who was fatally injured in a  road accident. When he was certified as brain-dead by a team of neurologists, his family – progressive and enlightened – decided to fulfil his oft-expressed wish to be an organ donor if he met such a fate. Dr Razzaq Memon was another and his family also donated his organs in keeping with his will, in spite of some reservations from the biradari.

I mention these two because I have met their families and they have repeatedly endorsed deceased organ donation and their own role in the programme. And so it was that deceased organ donation made a debut in Pakistan. It should be noted that the first three donations were made even before Parliament had passed the law, which certainly helped in promoting the concept.

The inspiration provided by the five heroes, needs to be brought to the fore. The families should lead this campaign. They have experienced the pain of losing a loved one. They have also felt the inner satisfaction and peace that comes from saving a life. Their words will carry weight, just as the SIUT’s presence on a high moral ground in Sindh has kept the organ traders away from this province.

Source: Newsline May 2018

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Syed Adibul Hasan Rizvi: Book Review

By Zeenat Hisam

THE reading habit needs to start being cultivated in early childhood through stories of fantasy, fairy tales and folk sagas as these ignite the imagination and the curiosity of children. Every culture and every language has its own heritage of such stories. And so does Urdu. However, what was missing was biographies of renowned people written for younger readers in Urdu.

The Oxford University Press is now filling in this gap by bringing out a few series devoted to the genre. Under the series Azeem Pakistani and Tasveeri Kahani Silsila, biographies of notable figures highlighting their contributions to the country have been published. Roshni kay Meenar is the third series focusing on biographies of prominent personalities of Sindh who have made valuable contributions either before Partition or since. The three biographies published earlier under this series presented the lives and works of Mirza Qaleech Baig, Hasan Ali Effendi and Ruth Pfau. Continue reading Syed Adibul Hasan Rizvi: Book Review

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Organ donation

index 2

By Zubeida Mustafa

ABDUL Sattar Edhi, the iconic humanitarian, who passed on recently, has been highly eulogised all over Pakistan and beyond. He has also received accolades for something more. He donated his corneas after death which bestowed the gift of sight on two visually impaired people.

Edhi’s donation was of immense importance. Coming from a person held in such admiration by all, his example has inspired many. That is what we need today — heroes who lead by example and not words alone. As it is, Edhi was a man of few words. Continue reading Organ donation

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A 40-year journey

By Zubeida Mustafa

siut9THIS week the Sindh Institute of Urology and Transplantation (SIUT) is holding an international symposium to celebrate 40 years of its existence.

The logo designed for the occasion sums up its philosophy: “Every human being has the right to access healthcare irrespective of caste, colour or religious belief, free with dignity.” At SIUT you actually see this happening.

For long, it was the dream of its founder, Dr Adibul Hasan Rizvi, to create a nucleus that would evolve into an equitable and inclusive healthcare system that would be accessible to all. Continue reading A 40-year journey

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A new venture

By Zubeida Mustafa

AWAY from the bustle of downtown Karachi in a remote area of Korangi bordering Ibrahim Hyderi, where our fishermen eke out a hazardous living, an experiment in social engineering is taking place. It is expected to be a milestone in the history of healthcare in Pakistan.

This new venture — the Mehrunnisa Hospital — is seemingly a modern hospital for the poor like any other, waiting to open its doors fully to patients. They are bound to visit it in droves once the bus routes are adjusted to make it accessible by public transport.

Built by a philanthropist — businessman Haroon Abdul Karim — it was donated by him to the Sindh Institute of Urology and Transplantation in January 2013. Abdul Karim’s obsession was that patients be provided services absolutely free of charge. He visited hospitals incognito and felt that the SIUT alone met his criteria.

What makes Mehrunnisa so different that it is expected to be a model? Continue reading A new venture

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Pakistan’s healthcare history: a unique chapter

guest-contributorBy A.B. Shahid

June 15, 2013
When devotion overtakes every other consideration what one ends up doing is setting an example that inspires others to follow suit with even greater zeal. The story of Sindh Institute of Urology & Transplant (SIUT), very ably and comprehensively narrated by renowned journalist Zubeida Mustafa in her book entitled “The SIUT story”, too is about the admirable devotion and commitment of those who run the SIUT.

What is particularly commendable about the book is its coverage of every aspect of SIUT with relevant details. Besides, the book is a ‘must read’ for all physicians, surgeons and hospital attendants because it gives them important message – humanity must be served without any distinction, and the most deserving are the poverty-stricken; serving them is the route to salvation and Professor Adibul Hassan Rizvi is a living example thereof.

How in 1972, an eight-bed unit of the Civil Hospital, Karachi was transformed into SIUT – an internationally recognised medical centre – is the story of a remarkable struggle that succeeded because of the commitment of Dr Rizvi and his team, to serving humanity, especially the down-trodden, and at the same time steadily raising the standards of care in many fields besides the delicate area of kidney-related illnesses.

The book highlights in detail the success of SIUT, given a historic background wherein healthcare never got the importance it deserved in a country like Pakistan that has the reputation of having one of the world’s highest rates of population growth. The book begins, and very rightly so, by summarising this sad track record to show how inspite thereof SIUT made the ‘impossible’ possible.

The author sums up the philosophy of SIUT very well when she says “The idea is to be as self-sufficient as much as possible and provide the institution with state-of-the-art technology without any ostentation.” That’s why there are no private wards in the SIUT, nor do its senior doctors have private offices. This profile has been hugely helpful in SIUT benefiting from the world’s top-ranking medical institutions, physicians, and surgeons.

Organ donation is imperative for transplant, which can be exploited as an irreligious act by those who place saving lives – the prime human obligation – at a low priority. SIUT was able to pre-empt such a disastrous move back in 1998 by obtaining legal and religious support for it when the father of a diseased young man set a great tradition by deciding to donate the organs of his son to give the ‘gift of life’ to those who needed them.

This great act and many thereafter, provided the beginning for SIUT’s transplant service in which it made great strides and has now become a world renowned institution. This initiative convinced institutions abroad about the sincerity, commitment and futuristic approach of the team at SIUT in reaching new heights in medicare and making it a truly humane service.

The support SIUT receives from global medical experts has been dealt with extensively by the author giving both the details of the experts from the US to Australia helping SIUT, and their very encouraging assessment of the services the SIUT offers, as well as its achievements in this context. Some of the messages coming from top-notch medical specialists assure you that not everything is wrong with Pakistan’s medical services.

Encouraged up by global support and the commitment of its physicians, surgeons and paramedical staff, SIUT now offers a variety of treatments and therapies including dialysis, endoscopy, oncology, nephrology, ultrasound, haematology, renal failure, lithotripsy, prostrate surgery, organ transplant, and more and has elaborate diagnostic expertise and requisite technologies therefor.

The ability to offer a variety of therapies is rooted in a knowledge sharing base – teachers, laboratories and libraries – building which has been an ongoing task. Besides setting up teaching facilities, a library with over 5,000 books and subscribing to 125 medical journals, a landmark was the setup of Zainul Abideen Institute of Medical Technology. In 2009, HEC too recognised SIUT as a degree awarding education institution.

In spite of all the negatives that Pakistan has been suffering from, SIUT has earned global recognition as a forum for global conferences. In 1994, SIUT organised the first International Symposium on Urology, Nephrology and Transplant. Since then SIUT has been hosting international conferences that are attended and addressed by renowned foreign medical experts, and add to the knowledge-base of SIUT’s team.

Besides medical treatment, SIUT has set up the Centre for Biomedical Ethics and Culture (CBEC) – a forum of physicians and sociologists devoted to designing the core values of the profession. Until CEBC’s setup, in Pakistan the need for institutionalising a forum to define and impose ethical practices in the medical profession was not realised. CEBC now holds regular sessions for physicians as well as for visiting students.

Education programmes and publications of the CBEC forum led to global recognition of this centre, and Dr Farhat Moazam and Dr Aamir Jafery of the CBEC were elected to global forums on biomedical ethics. More importantly, CBEC also helped the WHO Task Force on this subject in upgrading its global guidelines on organ transplantation – no small achievement for a Pakistani institution.

The author has allocated a chapter to the role played by donors, both big and small, without whose help SIUT could not become what it is, given the consistent inadequate funding of the health services by the state. Among institutional donors, the first to begin contributing back in 1980 was the Bank of Credit & Commerce Int’l Foundation (now called the Infaq Foundation), under the leadership of the late Agha Hassan Abedi.

Besides many reputed contributors special reference is made to Suleman Dawood, the Haroon family, the Cowasjee Foundation, and to Dewan Farooq who financed the setting up of Zainul Abideen Institute of Medical Technology. Then there are thousands of donors in Pakistan and abroad who regularly donate sums to the SIUT besides helping in acquisition of medical equipment.

This wide scale of public support is the manifestation of the peoples’ confidence in the way SIUT is run by Dr Rizvi and his team. To institutionalise the recording, accounting and appropriate use of donor funds, back in 1986, SIUT had established the Society for the Welfare of Patients of Urology and Transplant, which is overseen by an independent Board of Governors.

The book concludes with comprehensive indices about virtually every aspect of SIUT services, expert opinions thereon, SIUT’s connections and affiliations and, very rightly, also includes a roll of honour listing the many national and international awards bestowed upon Dr Rizvi and his team of able physicians, surgeons and paramedical staff who performed with unmatched commitment and devotion to serve humanity.

Source: Business Reorder

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Hope for the Children

Philip Ransley (L) and Jeeta Dhillon
By Zubeida Mustafa

A boy — seemingly healthy — is born to a young couple and there is much rejoicing in the family. But little do the parents know at the time that tragic news awaits them. The infant has urethral valve obstruction at birth and if he is not treated in time he will head for kidney failure.Today there is hope for the infant, thanks to the Sindh Institute of Urology and Transplantation (SIUT), Karachi, which is the only medical facility in Pakistan that has a unit for paediatric urology. Dr Philip Ransley, a paediatric urologist from the UK, who helped in the establishment of a paediatric urology unit in SIUT, finds it ‘crazy’ that there is no other unit of its kind in a country of 180 million where 45 per cent of the population is under 15.

The parents of the children — 20,000 of them who visit SIUT’s biweekly paediatric clinic every year — have much to be thankful for. They are provided the best state-of-the-art treatment free of charge by specialists trained by world renowned urologists in an environment that is child friendly. Bladder extrophy, spina bifida, and traumas caused by accidents that could become the cause of much anguish to children and their parents no longer lead to despair. There is hope.

The silver lining in Pakistan’s dark cloud of the public health sector is the SIUT which is the creation of the iconic Dr Adibul Hasan Rizvi who recently received a standing ovation in the National Assembly where every political party head lauded his efforts.

It was his vision — he always speaks of having a dream and then goes after it like a driven man — that saw the birth of the paediatric urology unit in 2002. The significance of this was driven home to me by Mr Philip Ransley who was in Karachi last week to conduct the Second International Paediatric Urology workshop. Mr Ransley retired a few years ago from London’s Great Ormond Street Hospital where he had trained under Sir David Innis, the legendary father of paediatric urology in Britain. He has made it his life mission to help the children of Pakistan and says, “Like many other areas of medicine, urology is a discipline that requires specialists trained for children. A urologist who operates on adults cannot really treat children’s urological problems with the expertise needed for it.”

“When I first started coming to Pakistan (he has been here dozens of times) my idea was to do surgery to rescue children from problems which no one could do here. Then following the dictum ‘give a man a fish and he feeds himself for a day but give him a fishing rod and he feeds himself for life’ I decided to pass on my expertise to the surgeons in Pakistan. The essence of our success is that SIUT’s paediatric urologists now take care of the vast majority of cases themselves — they have been quick on the uptake. They are even doing bladder reconstruction surgery which they had never done before,” Philip Ransley comments.

That explains the importance of the four day workshop held at the SIUT last week. The idea was to transfer knowledge of the new techniques that are continuously emerging in the world of medicine. Along with Philip Ransley and his colleague from London, Jeeta Dhillon, a perinatal urologist, the workshop was conducted by a guest faculty of four from France, the US, Germany and Italy.

Run with “amazing organisation of a military nature” (in Ransley’s words), the workshop was found “mind-blowing” by Jeeta Dhillon. There were three operation theatres running simultaneously throughout the workshop — unheard of in any surgical workshop anywhere in the world — ensuring continuity and intensive interaction. It also allowed the faculty to introduce the participants (about 150 of them from all over Pakistan) to different techniques. Laproscopic surgery, the latest entry in the field of paediatric urology and practised the world over, topped the agenda. Another area of interest was reconstruction of the bladder — a complex and time-consuming procedure.

What made the workshop so successful was not just the minute-to-minute scheduling done by Jeeta, the wonder woman of the exercise, but also the care and time taken in the selection of the 17 children operated upon — a nine-month process undertaken by Dr Sajid Sultan and the paediatric unit of the SIUT he heads. Jeeta pointed out that urologists don’t get to see so many cases in any workshop — and all free.

It was therefore a pity that the delegates from abroad — excepting the Turks — didn’t turn up. It is the image of Pakistan being an unsafe place that put them off. But the faculty who came were so pleased with their experience in Karachi that, as Philip Ransley hopes, they will talk about it and more people will visit.

Not surprisingly, WHO has decided to select SIUT as its collaborating centre for organ transplantation in the eastern Mediterranean.

Source: Dawn

Continue reading Hope for the Children

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SIUT carries out country’s first cadaveric kidney transplant

 

By Zubeida Mustafa      

: Pakistan joined the ranks of a number of other Islamic countries in medical technology when the first cadaveric kidney transplantation was carried out at the Sindh Institute of Urology and Transplantation (SIUT) on Thursday.

Although Pakistan has had a transplantation programme (thanks to (SIUT) for more than a decade now, and organs from cadavers have been obtained from Europe, this was the first case of a cadaveric donation in the country.

Navid Anwar, a young man of 24, the son of Anwarul Haq Fatmi, made history by becoming the first cadaveric donor. A student of Chartered Accountancy, Navid was critically injured in a road accident on Saturday. He was admitted to the ICU of the Liaquat National Hospital where he was put on a ventilator. Despite the best efforts of the neurological team, Navid could not survive. He was pronounced brain dead by the neurologists there.

On the family’s request his kidneys and corneas were donated for transplantation. The transplantation team of SIUT grafted the kidneys in two patients who were being dialyzed at the Institute for the last two years and had no family donors. Wajid (25) and Farhan (19) were selected as the recipients on the basis of tissue matching. There are 500 or so patients of renal failure at the SIUT who need transplantation but have no donors. Farhan became the 647th transplantation recipient at the SIUT. Mohammad Rashid from Azad Kashmir had been the first in 1986.

Navid’s grief-stricken family are aware of the importance of organ donation to save the lives of patients with endstage renal failure. They thought of donating his organs when they were told that this young man could not survive.

“We knew how it felt to lose a family member in the prime of his life. We wanted to save other families from this agony by saving the life of some other young person. Now we have the satisfaction of knowing that my brother will live on through the four other people who have received his organs,” Navid’s sister, Shazia, said.

About 35,000 people suffer from endstage kidney failure in Pakistan every year. Only a fraction of them (nearly 100 every year at SIUT) receive an organ from a live related donor. The other survive on dialysis but the quality of their life remains poor.

In other Muslim countries such as Saudi Arabia, Iran, Oman, Jordan, Turkey, Lebanon, Egypt, Tunisia, Kuwait and Bahrain, which have national cadaveric organ donation programmes, transplantologists obtain organs from cadavers to meet the need of their patients with endstage renal failure. Pakistan has been slow in this respect. Though some corneal donations have been made in the country, until now no case of cadaveric kidney donation has been recorded.

According to neurologist, nearly 150 people are admitted to the ICUs of the public hospitals in Karachi every year who are declared brain dead. If people could be motivated to donate cadaveric organs, the transplantation programme could be expanded and liver, heat and lungs could also be transplanted. At present the kidney transplantation programme depends on live related donors whereas the Eye Bank imports corneas from Sri Lanka.

Source: Dawn, 6  November 1998,

 

 

 

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