KARACHI, May 5 Serving the downtrodden for almost three years now, the Dowites' 78 Operation Theatre Complex at the Civil Hospital Karachi is in desperate need of government and private support in order to continue provision of the free-of-cost quality treatment.

Built three years ago at a cost of Rs300 million, the Dowites' 78 OT Complex has state-of-the-art facilities for cancer, paediatric, eye, general, laparoscopic, colo-rectal and gastrointestinal, gynaecology, ENT, head and neck, facio-maxillary, vascular and plastic surgeries.

The OT complex has 14 well-equipped operation theatres and is being managed by the Dowites' 78 Operation Theatre Welfare Society (DOTS) in collaboration with the CHK's administration. Last year, a fully-fledged endoscopic and gastrointestinal unit was also opened where all types of endoscopies, gastroscopies and colonoscopies with interventional procedures are available.

The unit also has the facility for an Endoscopic Retrograde Cholangiopancreatography (ERCP), a technique that combines the use of endoscopy and fluoroscopy to diagnose and treat certain problems of biliary and pancreatic ductal systems. Fifty surgeries are daily performed at the complex.

Speaking to Dawn, Dr Shafiq-ur-Rehman, a senior surgeon and the man in charge of the OT complex, said that there was a dire need to develop a sustained and secured system for continued supply of funds.

“The poor doesn't pay a single penny for any treatment here. But, someone has to pay so that quality service could be delivered. We are looking for help not only from the government, but also from philanthropists in order to maintain the treatment standards and move into other critical areas,” said Dr Rehman.

'A dream comes true'

A dream project of the graduates of the 1978 batch of the Dow Medical College, the OT complex finally opened in September 2007. Its construction was a big effort undertaken by the Dowites' 78, their friends, and philanthropists, from home and abroad, along with contributions from national and international organisations.

Tracing the events that led to the establishment of the OT complex, Dr Rehman said that the motivational force was the people's misery. “I could never forget an incident which left an undeniable mark on me. There was a girl I was treating for a complicated intestinal problem at the CHK in the 1990s. Her survival chances were grim. Every time his old father came, we used to hand him over a list of medical items required to move on to the next treatment step. While the girl survived, his father died of a heart attack in the process. I discussed the incident with my friends and we agreed that there should be a facility where we can independently take care of all the patients' needs and do not ask relatives for any help as they are already under stress,” he recalled.

At that time, the CHK was facing serious shortage of surgical facilities; operation theatres were in very poor shape and didn't fill aseptic standards. Thus, the post-operative infection rate and post-operative mortality rate was very high.

Due to the high infection rate, doctors administered and prescribed high doses of antibiotics, which caused not only financial burden on poor patients but the practice also exposed them to secondary infections as regular use of antibiotics suppresses the immune system, according to Dr Rehman.

“The main objective was to do complicated, costly surgeries free of cost in a modern environment. And, we have achieved that,” Dr Rehman said proudly.

Regarding the centre's needs, he said that support was needed in every area. People could sponsor a surgery and donate medical accessories. “We do organise fund-raising activities for the purpose, but there has to be a constant supply of resources to meet the ever growing list of expenses as we want to maintain our standard and expand our services. Government help is crucial,” Dr Rehman said.

Though the centre has been set up for planned surgeries only, it is now planned to attend to emergencies in case of disaster in the city. “We don't want to repeat the episode of chaos that happened in the aftermath of the Ashura blast here. Therefore, the CHK administration has made a disaster management plan and our responsibilities have been defined,” Dr Rehman said.

Over 19,500 surgeries in three years

So far, around 19,512 major and minor surgeries have been performed at the OT complex that has modern sterilisation, a dire need at the CHK that annually attends thousands of patients from all over the country.

The OT complex is also serving as a hub of continuing medical education and training and a series of workshops have been held for professional development.

A unique aspect of the OT complex is its eye care centre that covers both medical and surgical aspects of eye care. The facilities include fluorescein angiography, optical coherence tomography, RetCam for evaluation of paediatric retinal problems like cancers of the eyes and problems in premature newborns and electro diagnostic tests.

“Ours is the only centre in Pakistan which has a complete eye care set-up with comprehensive software updates of this kind. Most expensive surgeries of retina in complex cases are routinely performed here. The service is free of charge and can only continue if the government and the community feel the responsibility of sharing the ongoing expenses by their generous donations,” Dr Idrees Adhi said.

It needs to be mentioned here that major projects in the CHK, for instance, the cardiac surgery unit, surgical intensive care unit, the refurbishment of department of obstetric and gynaecology and the Sindh Institute of Urology and Transplantation are shining examples of public-private partnerships.