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
By Zubeida Mustafa
KHALID, who lives in Shikarpur, suffers from end-stage kidney failure. His ailment was diagnosed at the Sindh Institute of Urology and Transplantation, Karachi. I met Khalid at SIUT, Sukkur, where he was on dialysis. He is fortunate to have a donor — his younger brother. But Khalid has to wait for a few months more till his sibling comes of age.
Until SIUT, Sukkur, became operational in 2012, patients like Khalid had to visit Karachi for dialysis, and camp out on the streets. Today, the travel time has been cut immensely saving patients a lot of hassle. This is what the director of SIUT, Dr Adib Rizvi, terms “taking medical facilities to the people’s doorstep”. Had it not been for the SIUT’s presence in Sukkur, Khalid would have become a victim of homelessness as well.
Establishing SIUT, Sukkur, was an innovative response to the need of the people of Sindh. Since SIUT holds human life valuable and healthcare as the people’s birthright, the Khalids of society “are not allowed to die because they cannot afford to live”. Dr Rizvi anticipates the needs of his patients and responds accordingly.
To make dialysis accessible, he conceptualised a network of satellite centres in various localities of Karachi to save patients the trouble of commuting from far-flung places for this procedure twice a week. When records showed that 60pc of the patients were travelling from outside the city, mostly from Sindh, in the absence of similar facilities closer to home, the quest for a solution was launched.
This took the SIUT team to Sukkur where the Chablani Maternity Home was discovered in a decrepit state. The Sindh government was approached and much planning, renovation and reconstruction transformed this medical facility into a modern hospital that is a miniature version of SIUT, Karachi, with similar facilities and commitment to service.
This was in line with the SIUT’s need-driven approach and its philosophy of not turning back any patient who comes in search of relief from pain. With the patient-load growing as the incidence of disease in Pakistan escalates, SIUT, Sukkur, has proved to be a welcome addition to Sindh’s healthcare system.
When I visited it recently, I found it to be an oasis of modernity with state-of-the-art equipment in a sea of squalor and neglect. You enter the gate, which is barely visible in the flood of encroachments outside, and you are in another world of peace and horticultural beauty.
Many of the facilities that SIUT, Karachi, boasts of are also present in SIUT, Sukkur, which is a full-fledged 36-bed hospital that reported 1,256 indoor admissions in 2012. That year 33,918 patients went to the thrice-a-week outpatient clinic, 16,403 dialysis sessions were performed, 2,400 patients received lithotripsy, the laboratory carried out 111,913 tests and 4,254 surgeries were performed supported by diagnostic radiology services
The only conspicuous omission is transplantation. Dr Iqbal Daudpota, who volunteered to move to Sukkur as the coordinator, assures me that transplantation surgery can be started any time it is needed. As is the case in SIUT, Karachi, all services are provided free of charge with dignity.
Since a key feature of the SIUT model is the professionalism, dedication and compassion of the staff, the postings are controlled by Karachi. The staff is posted in Sukkur by rotation from Karachi. Dr Adib Rizvi, who leads by example, travels by train to Sukkur every Wednesday night for his OPD on Thursday, to return to Karachi the next day. Some of the surgeons in his team stay on to return home a week later. Thus the rota goes on.
SIUT, Sukkur, has reinforced the belief that the government-community partnership model that Dr Rizvi has been advocating is possible. The SIUT’s ethos has impressed the community in Sukkur which has responded generously with donations.
Two donors, Zahid Iqbal Choudhri and Munawwar Khan, have never let the institute down in times of crisis which are common occurrences in Pakistan. As for the patients who have never experienced such compassion and care from the medical profession ever before in their life, the SIUT is a blessing. What is important for many of these downtrodden people is that the SIUT’s philosophy facilitates excellent services without imposing any charges on them.
The SIUT model is doable if health professionals imbibe the ethos needed to provide the best services for no charge and with compassion and dignity. This calls for adopting cost-cutting strategies and shunning ostentation that make an institution self-sufficient. This is how the SIUT has won the confidence of the community in Pakistan which is reputed internationally for its generosity in philanthropy.
The writer is the author of The SIUT Story: Making the ‘Impossible’ Possible
By Zubeida Mustafa
THE health sector in Pakistan is in a crisis. Various reports and surveys paint a bleak picture which is not surprising given the breakdown in the healthcare infrastructure.
If the country has a high infant mortality rate, if polio cases have taken an upwards turn and the state of health is abysmal, prompting observers to warn that the Millennium Development Goals are unachievable, the root causes are obvious. Continue reading In a diseased state
By Zubeida Mustafa
ONE major flaw in the education sector in Pakistan that hardly ever figures in popular discourse is the deeply rooted inequity which denies underprivileged children access to academic excellence. This is not a one-time phenomenon. It is a self-perpetuating one.
The offspring of middle-class parents face a formidable challenge when they seek admission to a public-sector medical university, let alone the elite private institutions which charge a forbidding fee. Even government institutions now impose heavy tuition charges that are unaffordable for the majority of the people. Denied education of good quality, can these children ever hope for upward mobility which comes with a good job? Continue reading Opportunities for all
By Zubeida Mustafa
HAS the illicit organ trade that gave Pakistan such a bad name in the world of medicine made a comeback? We do know that for about a year after the Transplantation of Human Organs and Tissues Act was adopted in 2010 there was a lull and we were celebrating the end of this crime against humanity in our country. But one cannot be sure about that now.
Today reports trickle in that the clandestine sale of human organs is thriving. The scale of the operation is not known but the exploitation of the poor remains unabated.
With such a reputation, it was not really surprising when five days after the bombing of the All Saints Church in Peshawar last month, a website, Agenzia Fides, that has been described as the news agency of the Vatican, carried a shocking report linking the incident with the problem of organ trafficking. Continue reading Give the gift of life
By Zubeida Mustafa
THE SIUT’s Centre for Biomedical Ethics and Culture (CBEC) holds interesting forums periodically where renowned scholars are invited to address the members. Since ethics is a wide-ranging subject the thought-provoking speeches on a variety of subjects delivered there provide the audience some issues to chew upon.
In July, Dr Arifa Syeda Zahra, who teaches history in a Lahore college, was a guest of the CBEC and the point she drove home very forcefully and convincingly was that those who destroy history do it with the purpose of erasing the collective memory of a people. The idea behind this act of vandalism is to pre-empt change, which Dr Arifa Zahra describes as the most difficult process in individuals and societies. Continue reading Fabricating history
By Anil Datta
Glowing and touching tributes were heaped on the Sindh Institute of Urology and Transplantation (SIUT) Director, Dr Adeebul Hassan Rizvi, and international award winning journalist Zubeida Mustafa, the former for having rendered yeoman’s service to the sick, the needy and the underprivileged across the length and breadth of the country, and the latter for having brought these achievements on record through her book, “The SIUT story: making the ‘impossible’ possible”.
The occasion was the launch of Mustafa’s above-noted book at the Mohatta Palace Friday evening.
Ghazi Salahuddin, noted journalist and columnist, recalled the time when Dr Adeebul Hassan Rizvi was a student leader and paid him tribute for not having let his idealism wane and for remaining true to his ideals for the betterment of society.
“There’s lots of talk in our society about human dignity but in actual practice, there is none. We are a terribly class-riddled society, utterly apathetic to the travails and needs of our fellowmen. Dr Rizvi’s devotion to human dignity is so very evident in his institution. The SIUT’s stress on human dignity is not based on charity. Rather it is based on the natural rights of all human beings”, said Ghazi Salahuddin.
Having been her colleague for a long time, he praised Zubeida Mustafa and said that Zubeida had introduced a totally new research-oriented approach to journalism, something that hitherto had not been there. This, he said, made all the information so very profound and authentic.
Former Commissioner, Karachi Divisions, Shafiqur Rehman Piracha, in his very touching and emotional tribute to Dr Rizvi, talked about the “divine madness” of Dr Rizvi that had made the inception of an institution as altruistic as the SIUT possible where human beings were accorded their natural right to things that could make life a pleasurable experience for them. He said that everyone was treated with dignity at the SIUT without having to pay for it.
In a tribute to Rizvi’s altruistic simplicity, Piracha narrated how there was a concerted effort by the country’s most powerful segment of the bureaucracy to induce Rizvi to accept the post of federal health minister and what a hard time Rizvi had warding them off till they gave it up. He narrated how even these days, Rizvi travelled by train once a fortnight to Sukkur and its environs along with his medical team to perform surgeries and transplants absolutely free of cost.
He lauded Mrs Mustafa for having authored such a book on a subject as vital as healthcare and set the record straight for posterity.
Dr Adeeb Rizvi, acknowledging the accolades, and in his tribute to Zubeida Mustafa, recalled his first encounter with her and narrated how she was constantly grilling him with the questions: “How will you render such advanced medical care for free?” “How will you carry out dialysis for free?” and said that he was always hard put for a ready answer. “Ultimately, we made up and Zubeida joined us in our tissue transplantation campaign”, he said.
Zubeida Mustafa, acknowledging all the tributes, thanked the Support Trust (one of the sponsors of the book launch) for their cooperation in her painstaking venture.
“I wanted everyone to know that there are as many good people in our society and good works being done and that our society is not just bloodshed and killing”, she said.
The SIUT, she said, was not a charity organization but one where all humans got their rights with dignity. “That’s what I wanted to convey”, she said. She went on to state that all citizens had a right to education and healthcare and even though today’s liberal economics had turned things upside down, the SIUT still abided by its noble philosophy.
Kishwar Zehra, a thriving businessperson and a committed social worker who devotes of her time for voluntary work in the institute, lauded the most selfless service to society by Dr Rizvi and praised Zubeida Mustafa’s journalistic acumen in putting the story together for posterity.
Nusrat Ali Khan and Hassan Jameel, trustees of the Support Trust, outlined the aims and objectives of the Trust which, in a nutshell, could be summed up as publicizing all the work being done on a voluntary basis in various walks of life in the country and augmenting the mission of altruistic organizations. Nusrat Ali Khan proposed that copies of Mustafa’s book be sent to all diplomatic missions in the country and to all Pakistani diplomatic missions overseas to disseminate knowledge about the reservoir of selfless and noble individuals in our society.
Noted TV journalist compered the function and lauded Zubeida’s press crusade against the deficiencies in our healthcare and social systems.
Source: The News
By Shazia Hasan
KARACHI, June 14: “I was only following my emotions but she had the backing of research and proper data before asking me to explain how exactly I intended to offer free treatment to my patients. I was at a loss,” recalled Dr Adibul Hasan Rizvi at the launch of The SIUT Story — Making the ‘Impossible’ Possible while referring to its author Zubeida Mustafa at the Mohatta Palace Museum here on Friday.
“When we started our free dialysis work, she was back on the request of her editor at Dawn newspaper, Ahmad Ali Khan sahib, firing more questions that I didn’t have the answers to,” he shared.
“Our first kidney transplant was done quietly. We kept it from the media and when she found out, she was mad at us for being so secretive,” he laughed, adding that then it was Mrs Mustafa herself who also helped guide them on ethical things and how to tackle the issue of tissue transplantation, etc.
“Thank you for writing this book, which immortalises our philosophy that every human being has the right to healthcare and dignity,” Dr Rizvi said.
Senior journalist Ghazi Salahuddin said that he knows Dr Rizvi from the time when he was a young student at DJ Science College actively involved in students’ union. “He still believes in the dreams he had back then,” he said.
Praising the author of the book, he said that Mrs Mustafa came to Dawn from an academic background. “Not just this book but all her well thought out writings over the years are the product of extensive research and data collection,” he said.
“It is great that she could do this for SIUT now. The book is like a revolution in a society where there is no value of life leave alone the concept of human dignity,” he added.
Former Karachi commissioner Shafiq Paracha called Dr Rizvi’s passion to help people gain health regardless of their being rich or poor or belonging to any religion or belief “Divine Madness”.
He narrated an incident from former President Pervez Musharraf’s time when Dr Rizvi’s name came up for health minister and the doctor was determined to make the government officials drop the idea. “He took us on a round of the hospital trying to explain how much he was needed there only until one of us understood that it wouldn’t be wise to spoil one kind of good to start another,” said Mr Paracha.
“Dr Rizvi is that island of hope which balances our society,” he added.
About the author, he said that he was grateful to her for introducing us to the people who make the “impossible possible”.
Finally, Mrs Mustafa said that in Karachi where losing lives had become a common occurrence there was the Sindh Institute of Urology and Transplantation that is dedicated to saving lives. “It gives us hope. It had to be celebrated,” she commented.
She said, “I am glad that I wrote this book now after doing so much research on this place. The research I did over the years has helped settle all my doubts about its running. It is not just any charity hospital. It is a model hospital and the philosophy behind it can help build other such institutions.
“Being part of the public sector, there is also no element of commercialism attached to it. The treatment offered at the SIUT boasts foreign standards. The technology brought here from the West is also adjusted to local needs. It is laudable that they started from eight beds and have become what they are today through need-based extensions.
“The experts at the SIUT were just normal people who received proper training before putting it to good use. Foreign experts come here as well to train the doctors here. They also treat the patients at the hospital. It is compassion of the people working here that has raised the value of humanity at SIUT. But this team works so well because it has a great leader,” she said gesturing towards Dr Rizvi.
Meanwhile, it was suggested that an Urdu edition of the book also be brought out so that it can reach a bigger readership. Mrs Mustafa said that she would consider the suggestion.
By 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