HCV Research and News: The great doctors on a mission

March 16, 2012

The great doctors on a mission

By Dr. Saif Ur Rehman - Mar 16th, 2012

Today, about 500 million people worldwide – one in 12 – are infected with chronic viral hepatitis B or C. Pakistan is currently home to around 15 to 18 million patients suffering from Hepatitis B and C.One out of every 10 Pakistanis suffers from either Hepatitis B or C. Unsafe drinking water, unscreened blood transfusions and used syringes have made Hepatitis one of Pakistan’s greatest health concerns. Current estimated prevalence of Hepatitis B is 3-4% and Hepatitis C is 5-6%. Though, there are many different causative agents of Hepatitis, but Hepatitis B, C and D are lethal, which if not cured in time; can be fatal.

Alarming rise in hepatitis cases in Pakistan, made the big wigs of the country to pay heed and address this issue. And this way, The first phase of the Prime minister’s programme for Hepatitis prevention and Control was launched in August 2005, this programme (2005-10) was launched to decrease substantially the prevalence, morbidity and mortality. The projected cost of the first phase of programme was Rs. 2.594 billion. Official statistics shows that there was substantial reduction in prevalence, morbidity and mortality due to viral hepatitis infections in the general population, up to 50% reduction in number of new cases; aimed by 2010.

After successful completion of of the first phase, federal government allocated Rs14 billion for the second phase of the project which started in November 2010 and will end in 2015. Second phase of this programme has five components, including programme management and surveillance, case management and care, prevention; training, education and awareness, and research and publication.

The establishment of Centre for Liver Diseases and Liver Transplant at PIMS is a step forward towards the achievement of this objective. Establishment of Centre for Liver Diseases and Liver Transplant at PIMS for treatment of hepatitis patients was announced by the Prime Minister on 4th November 2010 on the occasion of launching ceremony of second phase of Prime Minister’s programme for hepatitis prevention and control. On April 18, 2011, Prime Minister Syed Yusuf Raza Gilani directed the Ministry of Health to ensure operationalization of the 1st “Liver Diseases and Transplant Centre” in Pakistan by the end of May 2011.

He desired that the 1st liver transplant operation be conducted in the centre in June 2011. The Prime Minister issued the above directions during a presentation made by the Ministry of Health here at the Prime Minister’s House on the establishment of the first Liver Diseases and Transplant Centre at the Pakistan Institute of Medical Sciences (PIMS), Islamabad. The Prime Minister directed that the centre for liver diseases and liver transplant (LDLT), PIMS, must have the state of art medical facilities which should essentially meet the international standards. He further directed the Ministry of Health that the best professionals should be hired for this medical facility (LDLT) to provide quality health care to the hepatitis patients. The Prime Minister directed that the poor and needy patients suffering from hepatitis should be given free treatment at (LDLT).

In order to identify the genuine needy and deserving, he said that a board be constituted with eminent individuals from various fields including professionals. The establishment of the centre for Liver Diseases and liver Transplant (LDLT), is a landmark project of the present government having local/indigenous expertise to manage the centre and perform the liver transplant surgeries.
Initially 200 million rupees grant was released to further this objective and there were also directions to set up a separate building for centre for liver diseases and liver transplant (LDLT) within the PIMS premises.

Afterwards another grant of 99 million rupees was issued. But some questions arise that why still there is no separate building for this objective? Why there is non- serious attitude on the part of administration? Why employees of LDLT are deprived of their salaries despite that existing employees are punctual, hard working and they are doing their best for this project as per available place and facilities by administration…! Which forces are hell bent on to fail this project of Prime minister? Is Al-Qaeda active or Al-Faeda is playing its role to make prime minister’s program a great blunder? A billion dollar question; where did the money go? and last but not the least, what about the ultimate goal that is liver transplant? To unearth the answers of these questions, we have to go back in may 2011, this is the month in which we were called for our written tests and interviews and all the inductions were made on merit contrary to the wishes and pressure of the administration of PIMS, because the top management wanted their people to be recruited but their proposal was turned down. Since then to date we are being punished, our sole crime is that we were inducted on merit; we are deprived of our salaries.

But still we are determined to render our services for the national cause, we all employees are working day in day out to make this project successful. World’s most difficult task is to work without pay for a long time. But we have made history our dedication to the national cause is matchless. At the moment treatment of Liver diseases is underway at PIMS Hospital providing indoor and outdoor treatment
including the provision of equipment, drugs and minor surgeries. Hepatitis B and C patients are provided complete set of third generation Hepatitis drugs.

I bet, take any sort of work, even a daily wager will not come to his work next day if he is not paid his wage at the end of day. Lets move little ahead, if salaries of employees of any private or government institution do not meet their demands they go on strike, refuse to work and shut their offices. They do not care for losses to national exchequer and plight of common people due to their strikes. We have recent so many practical examples of such incidents, don’t go away, just take the example of our own community of doctors. Over rise of salaries issue there were back to back strikes. But we have made the history, we have never ever gone on a single minute of token strike over deprivation of our salaries, which is our due and fundamental right too. Because we are thinking bigger, we prefer national interest to our due.

I would like to pay rich tribute to my all colleagues who are most revered, honest, sagacious and dedicated to the national cause and we all have strictly followed the Hippocratic oath. We believe that our profession and our hippocratic oath is based on strong spirit of dedication to patients. Even we can risk our lives for to save patients’ lives. I would like to share basis of hippocratic oath which entails breath taking fact in terms of Greek mythology, it is as following “Apollo, the god of healing, fell in love with a human, Coronis. In his absence, Apollo sent a white crow to look after her.

When the crow informed Apollo that Coronis loved another man, Apollo’s rage turned the crow black. To avenge her brother, Apollo’s sister shot Coronis with an arrow and, as she lay dying , Coronis told Apollo that she was bearing his child. Although Apollo could not save Coronis, he rescued the unborn child, Asclepius. Hygieia, the goddess of health, and Panacea, the goddess of cures, are the daughters of Asclepius.

According to legend, Hippocrates was a descendant of one of Asclepius’ sons”. This is the basis of hippocratic oath and each and every doctor is bound to follow it. To work without pay is a great deal indeed. But we have worked and we will keep on working. Fact is that we are on mission, we are focusing to eradicate hepatitis from the country and provide state of the art medical facilities to patients. Prime Minister Yousaf Raza Gilani who wanted to provide a liver transplant facility in the capital so those patients needing this costly procedure would not need to go abroad.

This is our beloved homeland and it is the duty of each and every pillar of the state to go with national interest. Would that PIMS administration were sincere! My humble request to Prime minister of Pakistan and all top officials of peoples government and Chief Justice of Pakistan is that kindly look into this matter before it is too late.