November 09, 2006

As chairperson of the Department of Obstetrics and Gynaecology of a private university and hospital, Dr Rubina Hussain is not only wedded to her work, she is also in touch with Pakistani medical colleges either as an examiner, visiting faculty or in some other related capacity, writes Naushaba Burney

If you are a patient you can get an appointment with Dr Rubina Hussain much more quickly than if you are trying to interview her. When I finally managed to see her –– on a Sunday –– more than once she says, “My patients come first.”

Listening to her daily schedule as she reels off her teaching and clinical assignments arching from her faraway Clifton hospital and medical college to the North Nazimabad one, leaves me breathless. Fortunately, her home, built by her grandfather in the Sindhi Muslim Housing Society, is almost midway between her two hospitals.

A friend talking about her at nine at night says, “If she’s not answering her cellphone at this hour, it means she’s in the operation theatre.” As Chairperson of the Department of Obstetrics and Gynaecology of the Ziauddin Medical University and Hospital, Dr Hussain is not only wedded to her work, she is also in touch with Pakistani medical colleges either as an examiner, visiting faculty or in some other related capacity.

She attends conferences and workshops all over the world. So what do her patients do when she’s off on one of her trips? She makes sure that they know her travel programme and also that they’ll be well looked after while she’s away. She has just returned from Bhopal where she presented a paper on post-partum haemorrhage at a meeting of the prestigious Federation of Obstetrics and Gynaecology Societies of India.

Doesn’t she find being always on the go a bit too much? “A doctor must be busy,” she insists, and adds with a big smile that she doesn’t at all resent being woken up in the middle of the night by a patient. “I really enjoy my work. If God were to give me nine lives, I’d still do what I am doing,” she states with deep conviction.

Dr Hussain specialises in menopause and runs a clinic for it. She believes that Pakistani women needlessly suffer the discomforts it can entail. As president of the Pakistan Menopause Society she wants more local studies on this change of life. At Chandigarh she attended a meeting on the subject where research papers were read. She senses that there is more tolerance for pain among the women of the subcontinent, although now prophylactics are available and should be utilised.

For women in this stage, Dr Hussain suggests a change in lifestyle, involving a healthier diet with less fat and more calcium, or calcium supplements, more exercise and of course that favourite remedy of doctors for all ailments: weight loss. She also mentions no smoking. Referring to osteoporosis caused by the loss of hormones that accompany menopause, she lists wrist, spine and femur neck as being particularly susceptible to bone density reduction. She strongly recommends regular weight bearing exercises for menopausal women.

This warm and friendly woman fast throws in bits of her personal beliefs as we touch complex medical topics. The former Secretary General and currently Treasurer of the Society of Obstetrics and Gynaecology, Pakistan, (SOGP), maintains that God has given us one life in which we get our share of trials and tribulations. Being God fearing is a great help but being a good human being is as important as being a good Muslim. “You have such a short life, make the most of it by doing good, by being a considerate human being. My objective is to help patients,” she says.

Whatever one’s problems, women must focus on their children’s education she believes. She has done exactly that and one of her two sons has just joined London’s famous King’s College’s medical school, where admission for non-British students is a near impossibility. Her other son moved away from his mother’s vocation and is studying in the United States at University of Pennsylvania’s Wharton School, while her youngest daughter, is in school.

A granddaughter of Dr Ziauddin, a mathematician and Vice Chancellor of Aligarh University at the time of partition, Dr Hussain says the hospital in his name was founded by her mother to provide affordable healthcare to the sick. Her mother Dr Ejaz Fatima to date charges Rs30 as her consultation fee at Ziauddin Hospital.

Rubina is a Sindh Medical College graduate, an FCPS from Karachi and a Fellow of UK’s Royal College of Obstetrics and Gynaecology.

Rather uncomfortably she describes what a revelation her visit to England’s Greenwich Hospital was where the senior doctors taught her painstakingly and methodically, making sure that she grasped the minutest of details. Comparing medical teaching and training in the UK with our own, she says diplomatically that over there outstanding professors meticulously follow a correct training procedure. What she doesn’t say, but one can read between the lines, I feel, is that in our own hospitals effective training procedures and systems either don’t exist or are not followed.

Dr Hussain has sent some of her own trainees to Greenwich which has since closed but she is still in touch with her consultant in England. She wants the standard of education in Pakistan to rise so high that parents wouldn’t want to send their children abroad.

Does she think that medicine is too demanding a line for girls, one that conflicts with family responsibilities? Doesn’t the lady doctor’s profession or her home get neglected? “My mother is a full-time gynaecologist but we never felt ignored or uncared for,” replies Dr Hussain. She explains that both she and her mother spent quality time with their children. “It is a question of time management,” she insists.

She protests that too high a percentage of girls drop out of the medical profession under family pressure. Others who could have truly devoted their time to this life-saving calling are deprived of seats in medical colleges by such girls.

According to Dr Hussain, in Pakistan at least, it is imperative that dedicated young women go for medicine as many pregnant women refuse to be attended by male gynaecologists. She agrees that for this reason perhaps fewer male students choose gynae as their specialty, particularly in Sindh. In Punjab the proportion of males in gynae is better. What work could be more exciting than bringing a new life into the world? Imagine introducing a new human being with all his/her innocence and potential to mankind, she says.

With medicine and its technology changing almost faster than you can blink, is it possible for Dr Hussain to keep up with the latest advances? She reassures readers, or should I say, patients, by calmly stating that the medicine programme is the same for doctors everywhere. So if there is a will, no physician or surgeon need be left behind. Updating conferences are frequently held. Besides countless international workshops and symposia, medical literature and the Internet all provide information on the latest discoveries and developments in the medical field.

Dr Hussain expresses her sincere commitment not only to her patients but to her students also. “I enjoy teaching. I love it,” she exclaims but concedes, “You just have to have the right attitude for teaching...” She actively participates in medical seminars and symposia organised by her hospital. She was in Hyderabad recently and says that the gynae and obstetric teaching profession is a very small group with a great deal of interaction. She and her trainees are involved in research and have many ongoing projects. She mentions in particular a study focusing on Hormone Replacement Therapy doses.

Noting her total absorption in her profession I want to know if she misses not having time for her special interests and leisure activities. The high-spirited doctor answers in her exuberant style that socialising and getting together with family and friends is what she loves best and for that she always makes time. With a twinkle in her eye she announces that she is still in contact with all her class fellows. Also, as taught by her mother, she tries never to miss a wedding or a funeral. “You have to organise your time.”

Feeling a bit guilty at taking up so much of a busy physician’s time, I ask her one final question. The maternal death rate in Pakistan continues to be horrifying. Even in Bangladesh maternal mortality figures have come down but not here. Can’t something be done to prevent young mothers from dying in such massive numbers during childbirth? Dr Hussain starts with a one-word answer: Education. She says expectant mothers need a healthy diet and iron supplements. We also have so many myths, don’t eat this, don’t eat that, its effect is warm or it is cold. Dates so rich in iron are often forbidden as they are supposed to be warm. She gives the example of Sri Lanka with its 90 per cent literacy and an excellent safe childbirth rate. “Our young mothers are so subdued and ruled by others, while in Sri Lanka it is the government that plays a positive role,” she says.

Above all, she mentions the absence of timely referrals of complicated cases to tertiary hospitals. Small, ill-equipped centres keep such patients for too long and refer them to hospitals when it is too late to save their lives. She highlights the importance of patient counselling, considered so important abroad but ignored here.

Watching her standing at her gate cheerfully waving goodbye, I think of the lives she has saved and will continue to save.

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