I AM writing with serious disapproval and concern at the launch of da Vinci robotic surgery at the Sindh Government Qatar Hospital, Karachi. This is yet another prime example of how valuable and limited resources are mismanaged in our health care system.

Robotic surgery at this time is a luxury that we simply neither need nor can afford. When millions of people in Pakistan each year have no access to basic surgical care and hundreds of thousands die each year due to lack of surgeons and basic surgical facilities in the country, we must ask ourselves which avenues we should invest our money in?

We must appropriate our resources judiciously and not extravagantly. Where patients are not provided with essential medicines and they have to buy their own surgical sutures, where our public hospitals struggle to provide even clean bed sheets on hospital beds, how is this huge expense justified?

Robotic surgery has some benefit towards patient safety but what is its role in Pakistan? Its impact will be minimal and extremely cost-ineffective. We do not even have adequate hand-washing facilities in our surgical wards. There are numerous examples of low-cost and simple interventions that have an impact many times larger than that of what robotic surgery offers. The poor people of Pakistan for whom this intervention is being projected to cater for are the ones who are going to suffer the most because of this impractical investment.

Millions of Pakistanis will continue to die or be disabled by the lack of surgical care and this robot is not going to make a grain bit of difference. It is not what the population of Pakistan needs and the government has to be blind or heavily influenced not to realise this.

DR SYED NABEEL ZAFAR Department of Surgery, Aga Khan University Karachi

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