HEART Disease is rampant in Pakistan. The entire South Asia has been labelled as a high prevalence region for Coronary Artery Disease (CAD), Hypertension and Diabetes Mellitus.
There has been tremendous advancement in the diagnosis and treatment of the entire spectrum of heart diseases over the past two decades. Modern Pharmacological, Interventional and surgical modalities have revolutionized the total out look of these potentially fatal diseases.
In addition to the acquired heart diseases we also have congenital heart diseases (CHD). Unlike acquired heart disease these are usually complex and require sophisticated surgical and interventional procedures.
Most of the congenital cardiac defects which are compatible with early life can be easily and routinely corrected. However some of the complex CHDs are not compatible with life and such children die in early infancy or at a young age. However a good number of such complex defects can also be corrected either totally or partially to prolong the patient’s life or even to restore the normal functioning of the heart.
Recently there was news about a young girl travelling to India (Banglore) for a heart operation which was successfully accomplished. The impression given by the media on both sides of the border was as if facilitates for heart operations do not exist in Pakistan and that an extra ordinary life saving procedure was performed at Banglore.
The Indian media made a big issue out of this and used it to promote Indian medical expertise. This is expected of India but unfortunately Pakistan’s media also joined in with their Indian counter parts, reinforcing that erroneous impression.
This particular news item has appeared in the print and electronic media repeatedly with the whole matter given a political colour. It was projected as a great humanitarian gesture on the part of the Indian medical profession.
As a senior cardiologist of Pakistan I feel responsible for setting the record right for the benefit of the common man. With the rise of heart diseases as well as the public’s growing awareness, facilitates for treating cardiac patients, both medically and surgically, have progressed phenomenally over the past two decades in Pakitan. This has happened both in the public as well as the private sector and the process continues.
Pakistan was the first countary in the entire region to have a heart institute where all sorts of surgical, interventional and medical techniques evolved and were employed successfully. Today there are three heart institutes and five major Cardiac departments in the public sector fully equipped to undertake all sorts of surgical and interventional procedures. While in the private sector there are at least ten hospitals with such facilities.
Most congenital heart diseases are successfully operated in these centers. Though the above facilities do not match our needs and more are required, at least we do have adequate facilities to cater for most of the urban population. Certainly we have a long way to go and there is no case for being content with the current state of affairs.Yet we have treated and operated upon thousands of patients from Afghanistan, Iranian Balochistan and even the Gulf. Unfortunately we are poor in marketing and the media. No one has ever mentioned in the media the Afghan patients treated in Pakistan’s hospitals mostly free of charge.
But there are serious shortcomings and problems that we face in cardiac surgery. We have excellent surgeons but lack in nursing and technical staff. Unfortunately we have failed to evolve a healthy nursing culture in Pakistan. Without good nursing and technical support, cardiac surgery cannot be that successful. The situation in private hospitals is however better.
Whereas every patient has the right to go to other countries for their treatment. The state and the cardiac community has the responsibility to see what facilities exist or are lacking at home to make sure that inadequacies and problems are resolved.
Certainly India is much ahead of us in all scientific fields and research but one should appreciate the efforts made by our people in different fields including medicine under adverse circumstances.
Is it not true that we have failed to attract highly qualified, trained Pakistani cardiac physician and surgeons who are now rendering excellent services abroad? The difficulties faced by these doctors in getting a job in Pakistan is a sad story. The salaries offered is another sad story. There are trained cardiac surgeons sitting in some of cites which donot have cardiac surgical departments.
Research is our lowest priority. There is no reward for people who contribute in the academics and research. Indians as a nation have an evolved educational and intellectual culture at home which still does not exist in Pakistan.
We can learn a lot from India where, perhaps, treatment is provided at affordable prices. Our doctors and hospitals have to take into account the level of poverty that exists and should come up with a treatment protocol and packages which an ordinary citizen could afford.
Also, as a community, we have the responsibility to look into the needs of the patients and set up more cardiac centres.. Special attention needs to be given to the field of Paediatric Cardiology and Paediatric Surgery to deal with the burden of CHD.
