04 November 2004	Thursday	20 Ramazan 1425

KARACHI, Nov 3: The growth of the Sindh Institute of Urology and Transplantation (SIUT), the most prestigious and successful public-sector health facility in the country , is in danger of slowing down because of depleting financial resources, it is learnt.

Its annual patient population is more than 275,000, including 125,000 who visit its outpatient department every year. Each one of its patients is treated free of cost, which has compelled its administration to dip into its endowment fund.

The one liver and 1,700 kidney transplant operations, which have been carried out at the SIUT so far, show that its doctors are working at the cutting edge of technology. The SIUT also plans to open an Institute of Transplantation and Biological Sciences within the next few years, where several kinds of transplant operations are planned to be undertaken.

In other words, the SIUT plans to go where no other Pakistani healthcare centre has gone before. What is heartening, it is viewed as possessing the capacities needed to scale the heights it aspires for.

Despite these achievements, a pall of frustration seems to loom large over the administration of the institute today. Its director, Prof Adibul Hasan Rizvi, is particularly anxious. The reason: the SIUT's increasing patient population (which includes liver donors and recipients), coupled with its refusal to charge for the services it renders, may soon transform it into a cash-strapped organization. Should such a thing happen, the area where it will have to cut back on first is expansion.

To be sure, Prof Rizvi is not disappointed. Far from it. But he seems to be frustrated at having to worry about finances, in addition to steering his institute towards new technological frontiers.

True to his track record, Prof Rizvi is fighting every inch of the way. But his success depends on the support he gets from the public as well as the authorities because the SIUT now needs funds more than ever.

The other day he told Dawn that the SIUT's endowment fund was shrinking fast. In 1996, the fund generated a record Rs15 million as return on investment. In 2000 this figure dipped to Rs14.34 million.

Since then, because of a low rate of return and shrinking endowment fund, the return on investment has been declining. "As of now, the endowment fund has almost been exhausted," he acknowledged.

Prof Rizvi said the SIUT, at its current level of operations, needed an endowment fund of Rs1 billion. Answering a question, he said the government, especially the prime minister, wanted to help out the SIUT. "But there's a limit to what the authorities can do for us."

He was of the opinion that the masses as well as the philanthropists, as they had done so often in the past, would come to his aid.

In an upbeat tone, he said: "The people have helped this institute grow from an eight-bed facility in the early '70s to the biggest public sector hospital in the country today. Our past 28 years show that almost anything is possible.

"In the past not only did the SIUT meet its expenses but also continued to grow. Why can't this be achieved now." Prof Rizvi suggested that a sizable piece of prime land could be handed over to the SIUT, which could provide it with a steady source of income.

"This is one possibility which the government, especially Prime Minister Shaukat Aziz, should look into. Pieces of land have been given to several organizations in the past. Why can't this be done in the case of SIUT too."

Nothing troubled him more than the suggestion that the SIUT should start charging small amounts from patients to generate at least a portion of the Rs500 million that is needed every year to run the SIUT, he said. "Look, there should be at least one centre in the country which provides care absolutely free of cost to the masses.

"Secondly, we should consider the negative impacts of such a move. On an average, dialysis costs Rs20,000 per patient per month. If we start charging this amount, a person who is dialysed and who belongs to the middle class will become poor within six months.

"The family in question would have to ask all its members to contribute money in order to meet the cost of dialysis. As a result, the sons would have to leave school and work at some mechanic's shop somewhere.

"The daughters would also stop going to school. What is this if not a recipe for disaster for the whole society."

In response to a question, Prof Rizvi said Sohaib, the country's first and only transplant baby, was hale and hearty. "He is fine but it's a shame that we cannot go for more liver transplants."

He said the British surgeons who had helped the SIUT undertake Sohaib's historic operation had been invited to visit the country in the recent past to ensure that further progress was made in this area. "But due to the poor law and order situation, they refused to come over to Karachi."

Kishwer Zehra, a philanthropist who has been working with the SIUT for many years, told this reporter that the institute was now planning to concentrate on people who were likely to donate between Rs250 and Rs1,000. "As we all know every drop counts."

She said a poor patient, who would otherwise die if there was no SIUT, made its administration very happy when he or she prepared to go home after being treated by them. "The satisfaction that the staff get on such occasions, cannot be bought or earned in any other way. It is priceless."