Flashback: Health and humanity
When Dr Adibul Hasan Rizvi feels depressed, he turns on the monitor installed in a seminar room at the ground floor of the five-storied Dewan Farooq Medical Complex, and watches the feed transmitted from his recently inaugurated SIUT satellite centre for kidney ailments at Sukkur.
As he excitedly points to doctors and para-medical staff running up and down the halls, managing and looking after a throng of patients in the backdrop, there is a sense of jubilation about him. The journey to raise a full-blown centre for urology, oncology and transplants from an eight-bed ward in the Civil Hospital back in 1970 to now a 450-bed facility has paid off. Today, the SIUT has many satellite centres in various cities that “reach out to the population to provide free medical care at their doorstep”, he claims, a dream of his that many once considered out of reach.
Director and founder of the SIUT, Dr Adibul Hasan Rizvi confesses that he had never planned all this in life. “Not at all”, he emphasises. His futuristic approach towards medicine is thoroughly immersed in a strong sense of humanism that is part and parcel of his being. For he deems, “a doctor is a patient’s advocate and not a businessman.”
In building the Sindh Institute of Urology and Transplantation (SIUT) to become a world class state-of-the-art centre and the largest in Pakistan, Dr Rizvi realised his dream that medical care should be free for everyone, and should be imparted with dignity, “for medical care is the basic right of every human being” he says. His dreams dwelt upon observations early on in life that he earnestly cherishes.
As most of his student life — at DJ Science College, Karachi, Liaquat Medical College, Hyderabad and then Dow Medical College, Karachi — was mostly spent living in hostels, even during Eid and other occasions, Dr Rizvi used to spend a lot of time with patients.
“Once an old woman approached for help as her ear was bleeding profusely. I quickly placed gauze on her ear and asked her what had happened. She said that she had been trying to remove her earring; since she had been wearing it for years it was stuck in the flesh of her earlobe and in removing it, the ear had started to bleed. She said she wanted to sell it to buy medicines for her sick son,” he narrates.
Such observations left a deep impact on Dr Rizvi’s mind as a student. He and his friends would collect money and buy medicines for patients and not charge them for medical care. “I was fortunate to have very good teachers who encouraged us to do so,” he remembers. Before he graduated in 1961, he came across the Democratic Student Federation which he found most relevant to promote the views that he had fostered. “They believed in human rights, that every human being is equal, and that education, health and employment is the birth right of every human being,” says Dr Rizvi. “I found this to be the perfect platform to foster my views and opinions.”
Dr Rizvi remembers how people made fun of his idea that medical care should be free for all. “There is no such thing as a free lunch or dinner, people would say. You had to work for it”, he remembers. “But I did believe that there should be a system that offers free medical care to the common man”.
He wasn’t sure how to go about it until he landed in the United Kingdom on a fellowship in 1962 and came across the National Health Service there. “I realised that the system was very close to what I had dreamt of, but there was a difference. Citizens there paid through their taxes or insurance once they were employed. In Pakistan, unfortunately, almost 55 per cent of the population was disfranchised, as I call it. They could not pay. On returning to Pakistan, I decided to try my idea and see how it worked,” Dr Rizvi says.
In 1970, Dr Rizvi set up an eight-bed urology ward at the Civil Hospital. “I was at the right time with the right people.” With a devoted and selfless team at his disposal, Dr Rizvi began testing his idea. “I remember many arguing with me that I should screen patients if they could afford to pay and that they should be asked to pay at least a portion of the treatment. I was totally against the idea of screening patients.”
He foresaw a sense of embarrassment and mental torture for a patient once he is screened. “Imagine if a patient approaches us with his ailment and before any diagnosis or treatment, we have him stand in front of unknown faces and answer strange questions like, ‘so if you can’t afford to pay for treatment, how are you wearing that expensive watch on your wrist!’ I may treat the patient physically, but I would not be able to treat the mental torture that I caused the patient in a hundred years of practice,” says Dr Rizvi.
As he began setting up the urology ward back then, there was a dire need for a back-up support staff that exactly understood the nature of investigations required before surgery or transplant. “All this came in response to the need of the patient,” he says. In 1972-73, a dialysis facility was opened. Though many patients came at an end stage and couldn’t be saved, the few patients that were saved was an encouraging sign for the team. In 1991, the SIUT was upgraded to become an institute by an act of the parliament. The Trust was established in November 2005 “as a charitable Trust for the benefit of the public and to provide services, medical treatment, medical education and financial assistance to patients suffering from end stage organ disease, related conditions and other renal ailments”.
Soon the SIUT team realised that patients could not depend on machines forever.
“We reckoned that there was a dire need for transplants,” Dr Rizvi recalls. Thus SIUT carried out its first kidney transplant in November 1985; to date it has conducted 3,600 kidney transplants. Liver transplant was next on the list. “When the first liver transplant was successfully carried out (in 2003), we saw how badly we needed a dependable back-up support for services like imaging, tissue typing, X-rays, blood, etc. If a patient came with, say, stones in his kidneys, he could not be turned away for lack of such services. The doctor has to be the patient’s advocate, provider and guide, for he is the hope that the patient banks on.”
Dr Rizvi and his team tapped students who could not make it to medical colleges either due to lack of finances or because of slightly low grades. “We have them trained in a programme called the Physicians’ Assistant Programme that runs in India and the US as well. The Masters’ degree programme is free of charge. This trained staff is our biggest back-up support today”, he says proudly.
While he regrets the acute poverty that most of our population lives in, Dr Rizvi considers the “disfranchised” people of Pakistan as “the most caring and generous people in the world.
They have supported us with even the most meagre funds through our endeavours.” This support, he believes, will continue if the SIUT is able to work with a sincere commitment and delivers on efficiency, accountability and transparency.
“Every organ in the human body is transplantable,” claims Dr Rizvi. He wants to prepare for future medicine which he claims will see a vanishing of cancer, diabetes, Alzheimer’s, blindness, injuries of the backbone, etc. With such breakthroughs in modern medical sciences, especially the stem cell regenerative medicine, cells will be repaired and replaced. “We are still almost 60 to 70 years behind modern medicine. If we don’t prepare from today, we will not be able to deal with the challenges of future medicine,” he warns. One can bank on Dr Adibul Hasan Rizvi and his team to make history again.