Key NICVD services restricted to emergency, influential patients

Published September 7, 2019
Shortage of funds and ‘liquid dye’ are said to be the reason behind limited service. — APP/File
Shortage of funds and ‘liquid dye’ are said to be the reason behind limited service. — APP/File

KARACHI: Faced with serious management issues, the National Institute of Cardiovascular Diseases (NICVD) has limited its two key services to only critical patients reporting at the emergency department and ‘well-connected’ patients, sources told Dawn on Friday.

The two key services — primary angiography and angioplasty — earlier provided to all patients free of cost were no longer available to those reporting at the outpatient department (OPD), the sources said.

Administrative officials at the NICVD were repeatedly contacted for their version but they did not respond.

Shortage of funds and ‘liquid dye’ are said to be the reason behind limited service

Speaking on condition of anonymity, doctors at the NICVD offered different explanations when asked about the suspension of the two services for OPD patients.

Some cited shortage of funds as a possible reason while others said that the healthcare facility faced an acute shortage of a ‘liquid dye’ used in angiography, a procedure followed by an angioplasty, if needed.

“Primary angiography and angioplasty, a costly procedure, were earlier offered free of cost to all patients and it ultimately led to funds’ shortage,” a lady doctor said, suggesting that the administration should have ensured judicious use of these two key services and offered them free or at discounted rates to only those who could not afford.

According to her, these services would be restored as soon as funds are available with the hospital administration.

Asked about the ‘shortage of a liquid dye’, a doctor explained that an angiography could not be done without it and the NICVD administration did not import the dye in sufficient quantities, which led to the present crisis.

“An angiography is an imaging test that uses X-rays to view blood vessels. To create these images, a liquid dye is injected into the body that makes the blood flowing inside the vessels visible on an X-ray and shows any narrowed or blocked area in the blood vessel,” he said.

He linked the issue with poor management and claimed that it had nothing to do with funds, the Drug Regulatory Authority of Pakistan or the recent ban on Indian medicines (as the dye is reportedly imported from Europe).

The sources said that the angioplasty was sometimes used as an emergency treatment for people who have had a heart attack.

“A heart attack is caused by a blocked artery and it is very important to open the artery as quickly as possible and restore the blood supply to the heart,” said a doctor, adding that the life-saving procedure was quite costly and the poor had been gravely affected by the suspension of its service at the NICVD, the only facility offering it free of cost.

PMA demands immediate restoration of services

Commenting on this situation, the Pakistan Medical Association (PMA) said that while one should appreciate that the NICVD was providing primary angiography and angioplasty to patients in need of emergency care, the healthcare facility must restore them immediately for OPD patients as well.

“This suspension of services is affecting hundreds and thousands of patients who could not afford private treatment due to a hike in the prices of basic commodities,” it said, adding that cardiovascular diseases were common and affected large sections of society.

According to the sources, it’s reportedly the first major lapse of service at the NICVD after it was handed over to the Sindh government along with the National Institute of Child Health and the Jinnah Postgraduate Medical Centre over a month ago by the federal government after a prolonged legal battle.

Civil society activists were appreciative of the decision which they said was in line with the 18th Amendment.

They also welcomed working of these healthcare facilities under the Sindh government which, they said, had improved their services and provided them free of cost.

The NICVD has extended its services to other parts of Sindh where independent satellite centres have been established in Sukkur, Sehwan, Mithi, Nawabshah, Khairpur, Hyderabad, Tando Muhammad Khan and Larkana.

It has also established chest pain units at prominent roundabouts and under flyovers in Karachi to provide accessible emergency services to the masses.

These 24/7 chest pain units are located under Gulshan Chowrangi flyover, Gulbai flyover, Qayyumabad Chowrangi flyover, Malir Halt flyover, Nagan Chowrangi flyover, Railway Road, opposite Miskeen Gali near I. I. Chandrigar Road, Sindh Government Lyari General and Teaching Hospital, Landhi and Karimabad flyovers.

Published in Dawn, September 7th, 2019

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