HYDERABAD: Hundreds of patients requiring vital life-saving surgeries have been affected by the unavailability of consumables used in such surgical procedures at Liaquat University Hospital (LUH) Hyderabad for nearly a year.

This is despite the fact that budgetary allocations of Rs275m for 2025–26 are available under the relevant head of expenditure in LUH’s annual budget.

With the ongoing fiscal year due to end next month, the hospital’s tendering process — cancelled last year — has not been re-initiated. This year’s tenders have already been delayed for one reason or another.

The LUH completed its tendering process for various heads, but the one dealing with the availability of consumables for urology, gastroenterology, orthopaedic surgery, cardiology and neurosurgery wards was cancelled last year, bringing the required procedures to a halt. This year’s allocation of Rs275m under this head is set to lapse amidst mounting complaints from departments. The LUH is Sindh’s second largest hospital and the only tertiary facility in the lower region of the province.

Funds available in 2025-26 budget likely to lapse as tendering process for essentially required equipment takes time

“Our device [scope] has been out of order for nearly a year, and I have placed this on record. One ERCP scope and four upper gastrointestinal bleed machines have remained out of order. As a result, we are using one damaged device and one scope that is otherwise used in paediatric endoscopy,” said Prof Akram Bajwa, head of gastroenterology at LUMHS, who oversees the 60-bedded gastroenterology ward. According to him, one ERCP scope (duodenoscope), four gastroscopes, one endoscopy tower, and two further gastroscopes are out of order, bringing procedures in these cases to a standstill.

Private surgery through an ERCP scope, he noted, costs between Rs100,000 and Rs150,000. “Patients who required these surgeries as emergencies have not been able to undergo these procedures since last September. I have informed both past and present medical superintendents in writing,” insisted Prof Bajwa. He confirmed that one machine for colonoscopy remains functional, adding, “The damaged scopes need repair, but payment for the repair work is not being made.”

Like the gastroenterology department, the hospital’s urology ward has been among the worst-affected, with urologists having performed over 9,000 surgeries for stone removal between 2021 and 2025. Procedures came to a halt after the machine became dysfunctional in June 2025. “We performed 7,099 procedures for stone removal through the ESWL procedure using a lithotripsy machine, whilst a further 2,008 stone-related surgeries were carried out separately, bringing the total number of procedures to 9,007,” explained Dr Zakir, sharing figures from 2021 to 2025. He said kidney and bladder stones of varying sizes were removed through different procedures, including PCNL (Percutaneous Nephrolithotomy) and ESWL (Extracorporeal Shock Wave Lithotripsy).

Consumables such as guidewires and stents have not been supplied to the urology ward. According to one urology expert, stone disease is the third most common cause of renal failure if not treated in a timely manner. Pakistan has 30 million cases of renal failure, with stone disease contributing significantly to around 10 million of these. ESWL, URS (Ureteroscopy), and PCNL procedures are therefore vital in saving patients’ lives.

In the cardiology ward, an angiography machine was restored to working order with the assistance of private technicians arranged by the department head, Prof Dr Mohammad Kashif of the LUMHS. The LUH administration bore the cost of the repairs. However, angioplasty procedures have not fully resumed.

“We carried out one or two angioplasties because consumables such as the wires used for inserting balloons and stents are unavailable. The LUH provided a small number of wires and dye over the past month, which were wholly insufficient given an annual requirement of approximately 2,000 wires. Patients in need of such procedures do present themselves regularly,” said the cardiologist. He added that since the tendering process has not been initiated, consumables remain unavailable. “I arranged the repair of the angiography machine through private technicians, but the UPS [uninterrupted power supply] remained out of order for 25 days,” he said.

Available funds diverted to clear liabilities

“I partly accept the point that various units of the hospital where these surgical procedures are performed are being run on an ad hoc basis. We are still endeavouring to meet the demand for consumables in wards such as gastroenterology and cardiology,” LUH Medical Superintendent Dr Ershad Kazmi candidly admitted when questioned by Dawn on Monday.

“LUH’s head of expenditure known as ‘cost of others’ carries an allocation of Rs275m, but it remains unutilised for want of tenders. The tendering process was cancelled last year because identical requirements were to be drawn up for the LUH — and unfortunately, that has not been done,” the MS said. He noted that some requirements for cardiology’s angioplasty procedures had been met — albeit in small measure — through arrangements under a separate head of expenditure. The angiography machine became operational last month, so its requirements would now be addressed.

Similarly, he said, the machine in the gastroenterology ward was in need of repair and might be restored shortly for endoscopy, with the ward’s issues expected to be resolved in due course. He explained that the outgoing MS had utilised budgetary estimates of Rs10m under the head of ‘generic consumables’, whilst funds under another head of ‘equipment’ had been diverted to settle outstanding liabilities with various vendors.

The LUH regularly receives trauma cases owing to its proximity to the National and Indus Highways. Orthopaedic doctors, requesting anonymity, said that patients were being asked to purchase the implants required for their own orthopaedic surgeries.

Published in Dawn, May 12th, 2026