ISLAMABAD: The politics swirling around former prime minister Nawaz Sharif’s health has pushed the situation to a dangerous edge and those who realise the stakes involved are terrified.

On Wednesday evening, Law Minister Farogh Naseem and Special Assistant to the Prime Minister Shahzad Akbar told the media that the government had given Nawaz Sharif a one-time waiver from the Exit Control List (ECL) and he could travel abroad for treatment after depositing a surety bond of Rs7 billion.

What the minister did not say — or could not say — was that the government was torn between the requirements of Sharif’s health and Prime Minister Imran Khan’s political compulsions. The idea of the indemnity bond is the government’s attempt to balance the medical issue with the political issue.

This is easier said than done.

The story of Nawaz Sharif’s medical ordeal morphing into a political wrestling match is a story riddled with chance discoveries, missed opportunities and miscommunications. It is a story that began unfolding a year ago as Nawaz Sharif grappled with his health in jail. But it was three weeks ago that the red light began to flash furiously.

It was a balmy Lahore evening on Oct 21 when a vehicle carrying a famous patient veered into the Services Hospital. The National Accountability Bureau had recently taken custody of Nawaz Sharif and shifted him from jail to the NAB headquarters. It was here that his personal physician, Dr Adnan, noticed his deteriorating health and asked for his blood test to be done.

The test results came the same day and showed his platelet level at 16,000 (count under 145,000 is considered dangerous). When the NAB authorities realised what this meant, they informed the Punjab government that they were immediately rushing him to the Services Hospital. There was genuine panic for genuine reasons.

The vehicle offloaded the patient and he was wheeled in for emergency tests. Later in the night the platelet count had dropped to 10,000. By this time gravity of the situation had begun to dawn on high-ups in the government.

Ill-informed and ill-timed

But the worst was yet to come. Fresh tests in the day time on Oct 22 showed that Nawaz Sharif’s platelets had plummeted to 2000. This was as dangerous as it could get.

While this medical crisis was unfolding in the Services Hospital, a political counter-narrative was finding its way on to the media. Vocal government spokespersons and cabinet members began to underplay the gravity of the situation and mock reports of Sharif’s medical condition. This attack was ill-informed and ill-timed. It betrayed a lack of communication between Islamabad and Lahore and it added fuel to fire.

If the fire was being lit in Islamabad, it was partially doused in Lahore by Dr Yasmeen Rashid. As Punjab’s health minister (and a respected doctor herself), Dr Yasmeen began to manage and supervise Sharif’s treatment. She also kept Prime Minister Imran Khan apprised of the situation in as much detail as possible.

On the third day, she went to see Nawaz Sharif. By now the prime minister was worried and he told her to convey his concern to Nawaz Sharif and assure him of the best available treatment.

Dr Yasmeen sat with Nawaz Sharif for half an hour and conveyed the prime minister’s message. She says he was satisfied with the treatment.

There was, however, a gnawing matter. Was the accurate condition of Nawaz Sharif’s health not conveyed to other senior members of the government? Or was there a deliberate choice made by officials to hammer away on the political narrative despite the unambiguity of his medical situation?

These questions kept reverberating in public discourse over the last three weeks, but took on a grim tone with the arrival of reports from private and government medical boards.

It were these reports that the law minister waved in his Wednesday evening’s press conference. He quoted these reports to say that the condition of Nawaz Sharif was serious, and it was this seriousness that convinced the cabinet to give him a one-time waiver from the ECL. These reports came in the wake of open whispers within official circles that the medical condition of Sharif was not “that serious” and that it was being “hyped” to justify some sort of a deal.

These whispers — that germinated rumours and conspiracy theories — had also reached the Services Hospital. In fact, responsible people double- and triple-checked the results of Nawaz Sharif to verify and re-verify that all data was in order. In one instance, a senior doctor took Sharif’s blood for testing and in front of many people put the blood sample into the machine that takes the reading.

The results were genuine. There was no tampering.

And yet this was only one aspect of the larger medical problem. The reports that the law minister quoted on Wednesday include many details that paint a picture of a man who is very unwell. These reports spell out the following:

a) Nawaz Sharif is a high risk patient; b) he has a past history of three coronary bypasses; c) he has multiple stents in his heart; d) he suffers from a kidney ailment; e) he suffers from Atherosclerosis in which plaque builds up inside arteries, narrows them and limits the flow of oxygen-rich blood to vital organs.

After weeks of treatment, the reports paint a grim picture. The initial management of the platelets has failed to improve his condition and the underlying cause is still undiscovered. The reports then went on to say that at present platelet count, many medical procedures become unmanageable in public sector hospitals. Finally these reports — referring to the complicated medical history of Nawaz Sharif — say that coronary, renal and arterial complications can be life-threatening.

The members of the federal cabinet have seen these reports.

But there is yet another problem, and this is perhaps peculiar to Pakistan: every person who is associated with Nawaz Sharif’s treatment, or who could be associated, is scared. Very scared.

Many specialist doctors from the private sector declined to take up the case because of the high profile of the patient. No one wants to take any responsibility in case anything goes wrong.

Many recall that the police officer who managed the murder site of Benazir Bhutto ended up in jail. “Did he kill her?” asks a cabinet member with a flourish. “Of course not, and yet he was imprisoned.”

The politics however tells a different story. The government is concerned about bleeding its political capital if Nawaz Sharif is seen to have been let off.

The indemnity bond issue may end up in courts as the PML-N has rejected it outright. This may suit the government. No one wants to take a decision as big as this. And yet each passing day elevates the stakes of the medical-political crisis to critically dangerous levels.

Published in Dawn, November 14th, 2019