Larkana now has a paediatric surgery ward in the children’s hospital, bringing relief to the people. A lot still remains to be done though
The establishment of Chandka Medical College in Larkana had brought great relief in terms of medical facilities to the people of upper Sindh and the adjoining areas of Balochistan. Yet there was still no paediatric surgery department in the teaching hospital and people had to bear the brunt of a long journey to Hyderabad and Karachi for the facility. The expenditure of board and lodging transportation fares, doctor, charges, etc. laid a heavy mental and financial stress on the locals. For want of money, they were forced to sell their cattle at low prices or obtained loans with exorbitant interest rates.
When Dr Sikandar Ali Mughal did his FCPS in paediatric surgery in 1992, he decided to serve the people of his area and joined as Assistant Professor in the children’s hospital of the CMC hospital, Larkana. For the first time a paediatric surgery ward was established in the children’s hospital bringing relief to the people.
Few doctors at first were interested in doing their house jobs and serving in the department as it did not have a separate budget and still required equipment. But Dr Sikandar continued to struggle and motivate the hospital administration which allowed the department some requisite facilities.
Later, with the effort of the commissioner of Larkana, Azar Hussain Mahar, the health department established a separate paediatric surgery department in the People’s Youth Centre which was previously lying unused. The necessary funds were provided and now after some additions and changes it has emerged as a beautiful well-equipped institution. The former Governor Sindh, Muhammadmian Soomro inaugurated the department on September 30, 2002.
The department is a 40-bed unit with five wards where only female attendants are allowed. It has three operation theatres, a 24-hour emergency service. Besides, the department has an ICU, a burns ward, a neonatalogy ward, and an auditorium hall which is under construction where academic activities would be promoted such as seminars, symposia, workshops, etc.
The lush green lawn and an open terrace provide recreation to the patients and their attendants. However, an area for patients to play with toys is being earmarked. The small library is used by doctors and house officers to keep themselves updated on their subject, but, the library still needs more up-to-date books for which efforts are underway. Blood testing facilities for the patients are available at the adjacent Z.A. Bhutto laboratory while a proposal for x-ray machines has been sent to the health department which is hoped to materialize soon.
Fifty per cent of the requirement for drugs is met by the department itself. If the patient is too poor, philanthropists and pharmaceutical companies are requested for help. For those patients who can afford it the hospital administration has fixed a user charge. Seventy five per cent of the collected income is aimed to bespent on the maintenance of the department and equipment. Whether the amount is spent is dubious as this amount is not audited. A check should be kept on this amount to avoid any misappropriation of funds.
The government of Sindh has been reported to have approved of Rs.50 lakhs for the purchase of equipment such as incubators, monitors, X-ray machine, enoscope to improve the department’s functioning further.
However it is sad to note that although there are a good number of affluent people living in the district who can spend a lot on feasts for politicians and bureaucrats, there is still a dearth of philanthropists who can spare a thought for the welfare of ailing humanity.
Dr Sikander revealed that 1,500 operations of various kinds are carried out each year besides the 6,000 OPD cases. A major ratio of the cases consist of stones in the urinary bladder, intestine obstructions, cleft palate and lips, abnormal urinary opening, burns, traffic accidents, deformity, etc.
He has operated upon many cases in which the infant had the organs of both sexes where the parents prefered to retain the male. A baby with three legs was successfully operated upon. He recently operated upon congeno-twins whose ribs, urinary system, liver and intestine were fused. As the other was already paralysed one of them was separated but the second also died after a few days as he did not have a fully developed system. A baby with a double head has recently been admitted for operation whose chances of survival are ninety per cent.
Talking about abnormalities in newborn children the doctor said that it stemmed from genetic defects, the use of drugs, environmental pollution, and malnutrition of the expectant mothers. Abnormalities of any kind could be removed before birth if sophisticated equipment was available as science and medicine had now developed to allow foetus operations for the removal of abnormal defects after diagnosis through ultrasound. For this an endoscope and laproscope and other latest equipment and training for doctors and para-medical staff was required to allow such operations. Expectant mothers were, however, advised to be careful about their nutrition, and were advised to avoid visiting quacks while regularly continuing with medical check-ups and vaccinization before the baby’s birth.
However, a post for Associate Professor and Professor of Paediatric surgery still does not exist while Dr Sikander, due for promotion, has not yet been promoted. The college administration has recommended the redesignation of the post of general surgery to paediatric surgery as otherwise no doctor would be ready to serve in this department. Although the paediatric surgery has been recognized for FCPS in CMC but because of the current situation no one dares to do FCPS except Dr Sirajuddin Soomro who has cleared his first year and would appear for part II.
The Health Department, Government of Sindh is requested to create posts in paediatric surgery and fill the other 21 vacant posts of Associate professors of various departments to improve the working of Chandka Medical College and its medical cover facilities as well as to streamline Larkana’s teaching hospital, particularly its paediatric surgery department. A separate budget needs to be allocated to this important department and it is felt that for the general public, most of whom belong to the lower income bracket, user charges be withdrawn.
Larkana now has a paediatric surgery ward in the children’s hospital, bringing relief to the people. A lot still remains to be done though 
