HYDERABAD, March 19: After a gap of five years, doctors performed the first open-heart surgery on a 30-year-old woman successfully at Liaquat University Hospital (LUH) city branch in four hours on Tuesday.

She is talking and stable in the intensive care unit (ICU) of the cardiology department, according to Surgeon Dr Raheel Hussain who performed the surgery despite the fact that the department still needs approval of schedule of new establishment (SNE) from the provincial finance department. “I did it very slowly because my entire team is new [in this field] so I wanted to make them feel comfortable and confident when they were part of it. Our patient Qamarunnisa had a big hole in her heart,” he said.

The surgery was started at 10:30am and completed at 2pm. According to him, initially they would continue with “low-risk” cardiac surgery cases. Dr Khalid Channa, Dr Sharjeel Dahiri, Dr Aftab Mallah, Dr Abid, and perfusionist and anaesthetist Dr Tahir Kaimkhani assisted the surgeon in the operation.

The multi-storey department was established recently. Its SNE is yet to be officially approved to accord official recognition to it, otherwise the hospital administration would keep diverting resources in terms of manpower and funds from other departments to meet its requirements.

The department needs sanctioned posts, resources and budget so that the hospital administration may not have to face financial constraints in future.

Dr Raheel Hussain, appointed by Liaquat University of Medical and Health Sciences (LUMHS), is also optimistic about approval of the SNE. He has been personally pursuing it with the officials concerned.

The first ever open heart surgery was conducted in LUH city branch on March 16,2008, when a team of doctors from Aga Khan University Hospital arrived here. Cardiac surgeon Dr Mudassir Aziz, appointed by LUMHS, looked after the ward for some time before it was closed. He quit after facing unfriendly attitude of the then LUH administration.

Dr Raheel Hussain has formed a non-governmental organisation (NGO) to handle open heart surgeries regardless of the fact that the government stops releasing funds or doesn’t approve the SNE. He is resident of this city and has served as one of the cardiac surgeons in the Civil Hospital of Karachi.

He said: “I feel that staffing and other facilities are not ideal here [in the department], but you know we are not going to have an ideal environment in near future too for heart surgeries in the cities like Hyderabad. Since the city is close to Karachi, health practitioners are hardly interested in Hyderabad. They prefer Karachi,” he argued while emphasising that LUH had to develop its own system to win confidence and trust of people.

The ground-plus-three-storey cardiology department has a long history of its establishment and shifting from the old to new ward. At last it has started working. The department has sections for angiography, angioplasty and cardiac surgery with two operating theatres, one of them is ready.

“Three technicians [from LUMHS] and one junior surgeon are made available to ward to go ahead with surgery cases while paramedics and other doctors are provided by the hospital administration,” said Dr Hussain.

He believes that local doctors need to be trained to give them confidence. “I’ll work with a raw team and train them gradually. That’s why we have started with low-risk cases like that of Qamarunnisa today before taking up high-risk cases that have cardiac arrest history or paediatrics surgery,” he said.

LUH’s cardiology unit has two bedded intensive care unit (ICU) as well. The ward’s scheme was conceived in 2003 and then it went through different phases before the new building was built on the hospital’s premises. The hospital has angiography facility too, but its services have been suspended for one year after the machine developed some technical fault. The hospital administration is said to have floated tenders to hire services for its repair/maintenance.

The surgeon pointed out that in fact LUH did not develop its own system of surgeries. His idea behind forming an NGO is to financially support dedicated staff of the department and to help some needy patients.

Dr Hussain seems to be heavily banking on the NGO. “It [NGO] will keep system going. We have collected around Rs2.5 million so far before start of surgery. Imagine how would people respond when we start functioning,” he said.

According to him, it does not make any sense that he should keep waiting for approval of SNE by the government before starting surgeries. At least four to five anaesthetists, six to eight doctors with speciality in surgery, 20 nurseries and 12 technicians for ICU are needed as per requirement of the ward. These posts were to be filled once SNE was approved, said the surgeon.

Resources like paramedical staff, technicians or other items are provided to the cardiology unit by the hospital administration after withdrawing such resources from other departments.

The Sindh government has not approved yet SNEs of around 10 departments established over the years in the hospital like those of burns, urology, nephrology, paediatric surgeries, plastic surgery.

“We have made resources available to the cardiology department and we are hopeful that the government will approve the SNE in 2013-14 budget,” said hospital MS Dr Khalid Qureshi. Required logistics are given and some staff is hired on daily wages.

“We will run the department through funds generated in the hospital,” he said. In fact, added the MS, equipment matter the most which was available whereas the finance department’s response for approval of the SNE was encouraging.

“We have submitted a PC-I of Rs100 million for paediatric cardiac surgery too,” he said.

Out of order Though the hospital has started cardiac surgery, it has not been able to make angiography machine functional in the last one year. Cardiac patients mostly opt for private health facilities for angiography which is done for Rs3,500 against private fee of Rs15,000 to Rs20,000.

LUMHS’s associate professor of cardiology Dr Fasih Hashmi said a tender had been floated by the hospital administration, but it was cancelled for unspecified reasons. “Tenders were floated in the past but the problem was not resolved. We have been witnessing that only one company participates in the tendering process, but things don’t settle. I am not aware of its reasons,” he said.

A company of Peshawar has shown interest in tenders and it was ready to make a separate machine available for continuing angiography till the hospital gets its machine repaired. “But that party was not encouraged,” he said.

Cardiac surgery would certainly be a good omen for people of Hyderabad and other interior Sindh districts. Patients would not have to travel to Karachi to bear additional lodging and boarding expenses. “Given the present condition of Karachi, people avoid visiting Karachi,” he said.

Another hospital doctor relating to the cardiology department said that if cardiac surgery facility started working, it would help local patients much. “But we need team spirit and collective decision which seems to be missing,” he said.