DESCRIBING his experience of blindness, Prof John Hull of Birmingham University and author of On Sight and Insight, says that people see blindness as an attribute. Hull, who lost his vision more than 30 years ago, thinks differently. According to him, the blind have their world as the sighted have theirs. But those who can see exclude the blind from the world of the sighted. The two worlds do not meet. Hull has a strong yearning to “overcome the abyss which divides the blind from the sighted”.
This fact is something not everyone understands. Those who do are inclusive and work to bridge this gap. One such institution that is exemplary in this context is the Almaktoom Centre in Islamabad. Since 1982 this school has been enrolling children with visual disability to provide them education to enable them to become self-reliant adults. Continue reading Bridging the abyss→
WHILE going to the Karachi Press Club to attend a press conference called by the Citizens Trust Against Crime, I noticed heavy traffic moving in the wrong direction on a one-way street. When I asked Amjad, who was driving me, about this waywardness, he succinctly commented, “Bibi, aap ko pata naheen yeh Pakistan hai. Yahan koi poochnay wala naheen.” (This is Pakistan. No one checks).
A while later this was confirmed by the CTAC, a not-for-profit trust, when speaking of infringements of the law that are common in Karachi. What is worrying is the nexus between crime and the instruments of crime. The key facilitators are unlicensed weapons, illegal vehicles and untraceable SIMs.
According to the CTAC, these three often come together “to form a lethal arrangement that breeds and promotes crimes of all shades”. Continue reading An unequal battle→
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.
Picture courtesy: sukkurblog.blogspot.comTo 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
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→
A SPARK has been lit in a 3,500-strong community living in the backwaters of Larkana district. Known as Khairo Dero, the place was the antithesis of what its name implies: it was one of the most depressed goths in the area. A turning point came in 2004. A young female journalist touring rural Sindh was deeply moved by the neglect and apathy she witnessed, especially in Khairo Dero, her ancestral village.
That was Naween Mangi, today the Pakistan bureau chief of Bloomberg, a premier American business and financial news channel. It took her four years to internalise the despondency of her people and think of a strategy to breathe new life into their existence. Thus she hoped to bring about the ‘silent revolution’ she had begun to dream of. Continue reading The human touch→
