By Zubeida Mustafa
The light at the end of the tunnel for Karim Dad is growing dim. He is a 36-year-old farm worker from Tando Jan Mohammad and has lived on dialysis for the last five years. A patient of end-stage kidney failure, Karim Dad could not have survived had he not been visiting the Sindh Institute of Urology and Transplantation, Civil Hospital, Karachi, twice a week to be hooked on to the dialysis machine which removes impurities from his blood. (This function is normally performed by the kidneys in a healthy person.)
SIUT has spent Rs.400,000 on Karim Dad so far and not charged him a penny. In the private sector, Karim Dad would have had to pay Rs. 1,000, 000 for dialysis to stay alive – something beyond his means.
Nizamuddin, a 30–year vegetable vendor from Orangi Town, is in the same boat. A patient of kidney failure, he has been coming for free dialysis to SIUT since July 1990.
There are many factors which cause kidney disease which is common in Pakistan than is generally realized. Prompt treatment helps for end stage renal failure leads to inevitable death, unless the patient is dialyses or survives on a transplant.
The moot point now is whether SUIT which has provided dialysis to Karim Dad, Nizamuddin and 846 other patients free of cost in 1995 will be in a position to continue providing services to the thousands of patients who visit it every year? Unless its funding is boosted, the Institute will find this a formidable challenge.
The Institute’s recurring budget has grown from Rs. 7.5 crores in 1990 to Rs. 12 crores in 1995 (the number of patients has more than doubled from 37,000 to 75,000 in the same period). But the government’s funding has remained stagnant at approximately Rs.4.8 crores. It is public generosity that has sustained SIUT.
The prospects are not too happy now. The inflow of fund has not been growing as it was before. This is not a good time for the financial pinch.
“The Institute is in the process of expansion,” says Dr.Adibul Hasan Rizvi, SIUT’s director who has nurtured the institution from an eight-bed urology ward of CHK in the seventies to the 150 – bed autonomous institute that it is today. Shortly it will be shifting to the six-storey Dewan Farooque Medical Complex which will expand its capacity five fold.
Giving the break-up of SIUT’s spending in 1995, Dr. Anwar Naqvi, the Deputy Directors, said, “Nearly Rs. 2.2 crores were spent on dialysis, Rs. 2.7 crores on transplantation, Rs. 1.5 crores on lithotripsy, Rs. 1.6 crore on the laboratory services, Rs. 1.5 crore on the operation theatre and Rs. 2.5 crores on the establishment,” Significantly, sixty per cent of this sum was raised from donations and private zakat. Running costs will grow this year – inflation and the growing number of patients in need of treatment will ensure that. The government’s share in the Institute’s budget has, however, been falling.
With one in 15 persons suffering from kidney disease in Pakistan and thirty per cent of the population living below the poverty line, Pakistan can ill-afford to neglect an institution of this kind.
Thus last year alone it conducted 28,000 dialysis sessions, 450,000 lab tests, 5826 minor surgeries and 2747 major operations, 2000 lithotripsies and 90 transplantations.
Two cadaveric transplantations were also carried out with the organs coming from Eurotransplant Foundation in Lieden, Netherlands, which went a long way towards enhancing the credibility of SIUT.
This is a significant beginning for a public sector health institution which does not charge the patients for the high-quality services it provides.
Without SIUT’S mission of providing the best medical services to all without any economic distinction, Karim Dad and Nizamuddin and many others like them would not have been alive today.
But neither could SUIT have done so much without the dedication of its staff and the donors who keep it going.
Source: Dawn 20 January 1996