December 1, 2005

When Dr Shershah Syed is not in his doctor’s gown or sitting with friends or off on a marathon or cycling, or even writing short stories, he’s busy taking the government to task and speaking his mind on the high level of maternal mortality, writes Zofeen T. Ebrahim

He comes across as a man driven, always in a hurry. If he’s not carrying out C-sections, or repairing obstetric fistulae, or even organizing free gynae camps for poor patients in the far flung areas of Sindh, the Punjab and Balochistan, he will be in a ward talking to his women patients — usually from the poorest sections of society that he’s most at ease — asking them if they have been to school or explaining to them how to cook a healthy diet, at a minimum cost. It is at that time you notice the compassion in Dr Shershah Syed’s eyes.

At midday you can see him at the PMA House, with a group of eminent doctors, chatting away. They hardly seem like doctors then –– talking politics, cricket, sharing prose and verse. At times Dr Syed will join in, but most times he will be busy reading something or the other, fiction, poetry or a medical journal. Often you will see him taking down notes, oblivious to the guffaws around him. It’s easy to get to know him. He’s affable and informal. And that is why you call him Dr Shershah and not the more formal Dr Syed. It just doesn’t suit his demeanour.

And yet there are facets to this 53-year old-man who manages to enjoy life to the hilt, that leave you completely befuddled. His love for art lies in sufi music, qawwali and folk songs. He has even tried his hand at flute playing.

A vegetarian by choice, he abhors the way we treat animals in Pakistan and respects the Hindu and Parsi communities in Karachi who take care of stray animals.

He loves to write and even while working in the earthquake-affected areas, where he’s been going regularly since it struck, he’s managed to write over a dozen stories. “I like to write short stories which are based on my experiences and spread health awareness messages as well as awareness about human and women’s rights in the process.” He’s already written four books and the fifth one is in the pipeline.

About his personal life, all he says is that he’s been married happily for 15 years now to a successful pediatrician who resides in Atlanta, US, and they visit each other whenever they can take time out from their busy schedules. “I like it here and feel my debt to this country has not been fully paid and it never will be. On the other hand, she says she can’t work in this environment steeped in corruption and I don’t quite blame her,” he says.

The PMA has been organizing a marathon every year around the Haleji Lake, on the last Sunday of November, for the past 17 years and Dr Shershah has not missed it once. “It’s a small one with about a 100-150 participants.” But there is another, bigger one that is held in Karachi on the last Sunday of January and is very popular. “The city mayor is the chief guest and that draws a crowd of almost 6,000!”

But when he’s not in his doctor’s gown or sitting with friends or off on a marathon or cycling, or even writing short stories, he’s busy taking the government to task and speaking his mind for the high level of maternal mortality.

And that perhaps is the reason why he’s always in trouble with the authorities, he says. “For why would my posting order at a government-run hospital, in Orangi, be withdrawn with immediate effect and with no replacement and specially when the ward I’m in-charge of, was doing so well?” he says knowingly. One cannot help but say that in this particular case there are no winners but many losers, specially the poor and sick women of Orangi.

While the technical and monetary assistance of the government of Sindh and Unicef’s collaborative — Women’s Right to Life and Health –– project, gave the hospital a new lease, with various schemes in place, it was really a team of senior doctors with Dr Shershah at the helm, steering a huge number of his post-graduate students, who were officially posted there, that the 24-hour emergency section worked like clock-work and without any hiccups. Now the system has all but come to a screeching halt.

It was his father, who taught Dr Shershah the virtues that he still carries with him wherever he goes and which may have enriched his personality tremendously, but have, many times come in the way of lucrative financial offers.

Dr Sherhah’s becoming a doctor is not without incident. “I never wanted to be a doctor. I wanted to be a journalist. So when I got a second division in my intermediate, while my parents were disappointed I rejoiced as I knew I wouldn’t get admission in a medical college. My father would hear nothing of this and demanded I appear again or leave the house. I could muster no support for my own career choice from any quarters, not even my mother.”

So the young Dr Shershah sat for all the 10 papers and this time got first division. “I and 13 other students still didn’t get admission in Dow. We pleaded our case before Z.A. Bhutto and told him how the CM had ensured admissions for those who’d scored third divisions. The fracas we created got us into the medical college but I was still not happy with having been forced into medicine.”

He may not have been a brilliant student, but he got his share of eminent senior doctors who polished his rough edges and led him towards a path he began to enjoy. But most importantly, they taught him the value of human life rich or poor. They taught him the importance of being humble.

“When Zia ul haq came into power, all medical students after completion had to serve the military. Since I didn’t want to, I left my house-job and went off to Kenya, and began another round of house job at the Aga Khan Hospital there. I met Dr Kehar, a Sikh gyneacologist from King Edwards Medical College, Lahore, who told me I was wasting my time in surgery since I have the hands of an obstetrician. So I shifted my department and liked the work. It was a happy place where we had a regular supply of cakes and mithai, where patients were young, healthy and happy. I had no clue there was such a thing as maternal death.”

With that behind him, Dr Shershah went to the UK to sit for his PLAB. “I failed so ran off to Ireland to do my MRCOG Part1.” There he had the good fortune of working with Dr C.J. Carr who influenced him a lot. “He was an honest doctor and instilled in me the qualities of responsibility and compassion. He was a staunch Catholic but was for pro-choice. He showed me how to be a counsellor, how to talk to pregnant women specially those suffering, and showing respect for their decisions,” remembers Syed nostalgically.

Next, he went to Trinity College Medical School in Dublin as a lecturer and a registrar in the obs and gynae department. Here he learnt the art of teaching from people like John Bonner and R.F. Harrison. “Those were good times,” he recalls. It was in Ireland with R.F. Harrison that he and Dr Ruby Faiz, now in Peshawar, worked on infertility.

His first awakening about the issue of maternal deaths came as a rude shock, in 1990, when he came back to Pakistan and went to Dr Sadiqua Jaffery for a job. She asked him to join the JPMC. “The job was an honorary one and it was there that I saw, for the first time expectant mothers being brought in dead on arrival, infant deaths and fistula. I realized the insignificance of my three years of work in infertility when everyday mothers were dying.”

Today he is not only the greatest champion for women’s rights, specially their reproductive rights, he is also the first Pakistani doctor to get trained in fistula repair in the early 1990s. It was in 1992 when he went to the famous Addis Ababa Fistula Hospital for a six-week course on repair fistula on a scholarship of 1,400 pounds from the Royal College of Obstetrics and Gynaecology, London.

Since then he’s been organizing four to five free fistula camps every year, over the last eight years, and he and his team that includes doctors like Aziz Abdullah, Nasir Suleiman, Saeed Qureshi, Mudabbir Hussain and Altaf Hashmi, along with theatre technicians and anesthetists have given some 500 women reason to live again.

He is busy setting up a fistula training centre which will be funded by the UNFPA that will start functioning in December.With a maternal mortality ratio of 540 per 100,000 live births, and 80 per cent of the births taking place at home by dais, he underscores the importance of training of midwives. And if Dr Shershah, had a say he would fill all the rural health centres with midwives. “Doctors, specially lady doctors, don’t want to go in these remote areas from where we are getting the maximum number of maternal deaths –– the villages. We need about 40,000 midwives for the 65,000 villages or so that we have.” He has trained one general surgeon to perform C-section and a few midwives to be able to carry out normal as well as vacuum deliveries and also assist as theatre technicians.

It is his ambition to select certain midwives and train them to be able to perform even C-sections “on the same model as that designed by the famous professors Staffenbergstrom and Guinilla Lindmark,” in Uppsala University, in Sweden, where he’d gone on a fellowship, in 1994, when he’d become interested in studying the causes of maternal mortality.

However, over the past four years there has been a fresh interest in midwifery. Dr Sheshah can rightfully claim credit for some. He has helped set up schools of midwifery in Orangi, Soldier Bazaar, Manghopir, New Karachi, Liaqatabad in Karachi and one each in Hala and Shahdadpur as well as translated some books on midwifery into Urdu to be used as course books.

“The girls were studying old notes of their seniors and there were no prescribed books. So I decided to get the ‘Text Book of Midwifery’ by Margaret Miles, the WHO’s ‘Emergency Obstetrics for Midwifery and Basic Midwifery’ by Hesparin Foundation, translated into Urdu. We also got a book illustrating the various aspects of practical midwifery, for which I’m very grateful to the team of illustrators and Urdu translators who helped me tremendously. These are not only cheap but easily available,” he says adding, “this is one achievement I am truly proud of.”

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