KARACHI, July 23: The disabled find that artificial limbs or prosthesis available in the market are getting more and more costly. Mohammad Ayub, a clerk who fell off from a moving train and lost his leg in 1968, was able to get a wooden limb in the market at the cost of Rs225. Today, this stiff and uncomfortable artificial limb is for Rs20,000, way beyond what he can afford.
Usually, victims of traffic and industrial accidents, particularly in soap and textile factories, and victims of vascular diseases, most particularly diabetes, turn to Jinnah and Civil hospitals for the prosthesis, if they need one. These are being provided here at no-profit-and no-loss basis, even at subsidized rates.
The Jinnah Hospital provides some 100 prostheses every year. About half of the patients procure these from the Zakat funds. The difference in prices from the market rates is considerable.
“Above the elbow is available at Rs80,000 in the market whereas we provide it at Rs 20,000,” says Dr Moeed Kazi, head of the department of physical medicine and rehabilitation. Below the knee is provided at Rs3000, whereas it is available at Rs15,000 to Rs20,000 in the market.
The hospital manages the low rates even though the prices of imported components required in the prosthesis have gone up considerably. For instance, sach foot, which was Rs540 in the early 80s, now costs Rs7,245. The wait in Jinnah hospital, however, is somewhat long. It takes about three months for patients to get their prosthesis.
With above-the-knee prosthesis, the patient can walk and climb steps, but sitting on the ground may pose some problems. As most low-salaried patients who come to the hospital cannot apply for Zakat funds and neither can they afford to pay the hospital rate. Dr Kazi is considering setting up a “non-Zakat running fund”. However, this can materialize only if an NGO comes forward to extend help to meet the expenses of the poor patients. “At present, we have no NGO helping us,” he says.
Dr Kazi would also like to see the number of workers in the workshop increased by twice the number. “This would help us to increase production and make the prosthesis ready at a shorter time,” he says.
The department of orthopaedics, Civil Hospital, was upgraded in 1998 under Prof Yunis Soomro. He succeeded in attracting generous donations in kind from philanthropists which greatly helped in this endeavour. One lady alone has donated Rs40 lakhs to import the needed machinery.
Another NGO of doctors and non-doctors, the OrthoRehab Society, has helped to upgrade and renovate the centre, including the operation theatre, providing the latest equipment. Help in kind is also extended to poor patients. “We encourage all donations in kind and take no money from the government,” says orthopaedic surgeon, Dr Sabir Memon. Yet another NGO that is extending some help is Khadim Insaniyat, which provides free medicines to two patients of every ward. Dr Memon adds that imported material was used in the prosthesis if it improved comfort. Below the knee prosthesis cost Rs7000 compared to the Rs20,000 to Rs 30,000, the market rate.
One problem that hampers treatment is that some accident patients come late for treatment. “They turn to bone-setters, which sometimes aggravate the problem. Treatment is crucial in four to six weeks after trauma.” What the city really needs, Dr Kazi says, is an orthopaedic and trauma institute for early treatment of trauma patients. “If such a centre cannot be set up by the government alone, a private-government partnership could help.” It is difficult to ascertain to what extent are the two hospitals meeting the needs of the disabled, most particularly the poor and low-salaried. Dr Kazi says that no survey has been carried out to this effect. There is no doubt that the disabled in the interior have to do with rudimentary aids, such as a cane.
One positive development in this regard is that qualified orthopaedic surgeons have recently trained in the Civil Hospital and returned to their hometowns in Larkana, Nawabshah, Sukkur, Mirpurkhas and Hyderabad to serve the poor. Their link with the hospital means that if the patients in the interior require prosthesis—or any other aids or treatment—they can be referred to the hospital in Karachi and receive early treatment.
The disabled have also been turning in comparatively smaller numbers to the Association of the Physically Handicapped Adults (APHA), a welfare organization. This centre provides the lower limb prosthesis, the well-known Jaipur foot, for Rs4,500 for above the knee, and for Rs3,500 for below the knee. President APHA, Shariful Muzaffar, said, “An eight-member team from India visited us, bringing along with them not only free artificial limbs, but also the needed tools and implements. They taught our workman here, Mohammad Ashraf, to make the rubber and fibre Jaipur foot which is quite light and durable.” Now the APHA provides the Jaipur foot-after just a one-week wait to all who come to the organization. “Those who cannot afford to pay are helped through Zakat funds and donations.”
Till recently, it was issuing four lower limb prostheses a month. However, Indo-Pakistan tensions have led to problems. Now APHA is facing difficulties in procuring the rubber foot from India. “We are planning to set up a plant which will cost Rs600,000 to Rs800,000 thousand when we get the sponsorship.” The government is providing Rs10,000 to Rs15,000 as funds, which can only meet a small part of the expenses.
One satisfied customer of the APHA is Muhammad Ayub. He says that the APHA is offering the plastic and fibre foot at one forth the market price. “Not only is the prosthesis light and flexible, it is also durable,”.