A lot more is needed to be done to help enhance the capability of the most important heart centre in the country
The National Institute of Cardiovascular Diseases in Karachi, is the oldest and the largest cardiac hospital in South Asia. It provides heavily subsidized medical care to 70 per cent of its patients while the poor, who account for 10 to 15 per cent of the patients, get free treatment. Others pay to cost.
On the whole the hospital serves over half a million heart patients in its in-patient, out-patient and emergency services every year.
These observations were made by Prof Azhar Masood A. Faruqui, the Executive Director of the NICVD while discussing the challenges the institute faces and its response at a time when the care, especially of heart patients, has become prohibitive and incidence of cardiac troubles has assumed epidemic form.
He says that there has been an alarming increase in the number of heart patients in the last half-a-century because of lifestyle changes as a result of increasing prosperity, decreasing physical work and urbanization. While for the last half a century cardiovascular diseases have been the number one cause of death in developed countries, it is now also the number one cause of mortality in developing countries, including Pakistan.
On an average the NICVD out-patient department manages between 1200 to 1600 patients every day, while 300 and 500 patients are seen in the emergency room — an increase of 1,000 per cent in the number of patients in the last three decades.
This large volume of work has not only resulted in a severe congestion in terms of physical facility but also a tremendous pressure on its financial resources. This is so because the NICVD provides heavily subsidised care to its general patients. The other patients pay for their care at cost while federal government employees are entitled to special privileges.
The NICVD has devised both short term and long term plans to try to meet the challenges. Immediately, funds are being raised and projects being undertaken with help from various donors. Also the federal government has been steadily increasing its grant in aid. The number of staff including doctors and faculty has been slowly increased while for the long run a Master Plan has been developed to significantly expand the physical facility and service being provided.
Speaking about the training programme available at the NICVD, Dr Faruqui says it has comprehensive training programmes in all sub-specialities of cardiology. There are also training programmes for cardiac nursing and cardiac technologists. Over the years NICVD has trained doctors from all over the country and many doctors from neighbouring countries. Doctors who are not Pakistanis have to apply through their respective governments. The NICVD has also visiting students and post graduate trainees rotating both from within and outside the country.
The budget for the NICVD for the year 2005-2006 is Rs479 million. From the next year, the federal government has promised to raise its grant in aid to Rs200 million; the remaining amount will have to be raised by the NICVD itself through its Trust Fund Income, token charges and donations. Dr Faruqui has appealed to philanthropists, especially those living and earning in the US and Gulf countries to donate generously to the institute in the larger interest of Pakistan and to lessen the sufferings of their compatriots.
The Institute provides all non-invasive and invasive diagnostic faculties to every patient irrespective of their paying power. Medical and surgical treatment is also available for all patients requiring such treatment irrespective of their paying power. While the NICVD is able to provide every heart patient who walks into its facility medical and surgical treatment, the tremendous increase in workload has resulted in waiting list. These waiting lists are relatively short in some diagonistic and therapeutic departments and longer in other departments.
In his concluding remarks Dr Faruqui stated: “The NICVD is the oldest cardiac facility in the SAARC region. It has trained the bulk of cardiac specialist manpower for Pakistan. It trains medical students, nurses, paramedical staff and foreign doctors and students. Because of the large and unrestricted increase in the volume of patients and the resultant budgetary constraints, the quality of care and the promptness of care can surely be affected. While it is imperative that other hospitals and centres providing care to heart patients are developed in the city, the NICVD itself must be ungraded to meet the challenges of the 21st century.
“It is important to realize that cardiac wards and clinics must be built in every multi-speciality hospital in the city and the country. Care must be provided close to the patient’s home. However, the training and research work that needs to be continued can only be done at a centre with the volume and the staff that only an institution like the NICVD can provide.”
Started in 1970 as a non-government organization, NICVD was nationalized by the government of Pakistan in January, 1979, into an autonomous body under the Federal Health Ministry.
A lot more is needed to be done to help enhance the capability of the most important heart centre in the country
This large volume of work has not only resulted in a severe congestion in terms of physical facility but also a tremendous pressure on its financial resources. This is so because the NICVD provides heavily subsidised care to its general patients. The other patients pay for their care at cost while federal government employees are entitled to special privileges.
