I most give credit to PPP for not playing politics, they know their own performance to say something.
Sans burn units, patients forced to seek treatment outside K-P
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PESHAWAR:
Though the Pakistan Tehreek-e-Insaf-led provincial government claims to revolutionise the health sector, it has failed to provide one very important facility. In a province where blasts and explosions are very routine, hospitals there have no isolation wards and burn units.
The province’s lone 120-bed burn unit at Hayatabad Medical Complex (HMC) is still under construction, though it was supposed to be completed four years ago through the Workers Welfare Fund (WWF). According to insiders privy to the matter, the only reason why it could not be completed was that WWF failed to release Rs600 million to get the equipment for the unit.
Just a room
Since viral diseases like Congo and dengue keep plaguing the province, basic isolation set-ups are established time and again to prevent patients from infecting others. Sometimes, patients with contagious infections are shifted to private rooms.
Shrouded in terror: Blast victims burned beyond recognition
However, this very basic system poses a serious threat to patients, their attendants, visitors, and medics. Without isolation wards and rooms which have methods of decontamination, everyone involved remains at risk; specially burn victims whose nerves and other organs are often exposed in the absence of skin.
“I wonder why the K-P government doesn’t address this issue, even though we have a dire need of isolation wards what with seasonal influenza in winter and dengue in March, April, October and November every year,” a senior health official told
The Express Tribune. “Besides, there is no place to treat patients who come from Afghanistan, tribal areas and other regions, potentially carrying viruses,” he added.
Exposed and vulnerable
The official, who requested anonymity, said the provincial government has not built a burn unit in K-P as yet. “Although we have burn wards where we provide them with basic care, we don’t have a single unit where we can provide specialised treatment to patients with second degree burns, if not more,” said the official.
All patients with more than 20% burn injuries are advised to go to Kharian in Punjab or Pakistan Institute of Medical Sciences (PIMS) in Islamabad.
Dr Muhammad Tahir, a plastic surgeon at HMC and the project head for the Burn and Trauma Unit to be built there, said a Memorandum of Understanding (MoU) had been signed with WWF Islamabad. Under the MoU, WWF had promised to provide funds to construct the building and purchase equipment for treatment. The government had also promised to provide land and manpower and run the facility once it becomes operational.
“Since over 80% of the structure has been completed, Rs600 million are still required to purchase equipment. However, WWF has yet to release the funds,” Tahir told
The Express Tribune. “WWF will release funds when it holds a governing body meeting but the meeting has not been held until now for unspecified reasons,” he added.
Acid attacks: Need for post-trauma care of victims stressed
“We currently [treat patients with burn injuries up to 20%] just because we have no other option,” said Tahir, adding over 6,000 people from Peshawar were treated annually at HMC. K-P Secretary for Health Jamal Yousaf told
The Express Tribune the issue of establishing a burn centre was under consideration with the prime minister and the chief minister has already issued a letter to the PM in this regard. However, the funds have yet to come. “We treat people in isolation whenever the need arises. However, we cannot convert an existing ward into an isolation one as that’ll cause problems,” he said.
Published in The Express Tribune, January 26th, 2016.
PIMS burn centre coping with KP influx
islamabad - Asima Bibi was playing in the kitchen when she suddenly fell into the cauldron filled with boiling water her mother had just removed from the fire.
Asima, two years old, sustained severe burns on her back, buttocks and lower limbs. Cursing themselves for inflicting pain to their only child, the parents shifted Asima to a private hospital of Hangu, Orakzai Agency.
But misdiagnosis of the severity of her burn injuries and inappropriate burn care deteriorated her condition. The treatment cost was also a financial burden for the poor father, Muhammad Arif, who is a khateeb in a local mosque of Hangu. So, the worried parents shifted their child to Civil Hospital Hangu, where doctors, after examining her wounds, referred her to the Department of Plastic Surgery and Burn at Lady Reading Hospital, Peshawar, for specialised burn care.
But despite claims of having the first burn unit of Khyber Pakhtunkhwa, providing state of the art burn care, as claimed on the hospital website, the hospital staff further referred Bibi to Burn Centre of Pakistan Institute of Medical Sciences (PIMS) in Islamabad, saying that ‘the hospital in Peshawar has no facility to treat burnt patients’.
The Burn Centre of PIMS, which has a limited capacity, was already teeming with patients when the distressed parents, along with their ailing daughter, reached Islamabad. Their ordeal was not over yet. Their daughter was refused admission in the centre.
The poor parents, who had reached the federal capital all the way from the war-stricken region of FATA, sat on the road in front of the centre, refusing to go back.
“This country has no place for us? Where should we go?” Mohammad Arif, Bibi’s father, said. “The ambulance has also gone back now and I have no money to go back. It does not matter if she dies here or at home.”
Finally, doctors, on humanitarian grounds, finally admitted Asima Bibi in intensive care unit where two children were already admitted, accommodating her in a bed with another burnt child against the protocols. She was lucky. Most of the other patients are forced to go back to their native towns and villages.
Bibi’s predicament is just a tiny glimpse of the pain and agony patients with burns and their families go through due to dearth of specialised burn care facilities. There are only a couple of burn centres offering acute burn care for the general public in north Pakistan but most of them are non-functional, putting the patient load of the whole region on PIMS centre. PIMS burn centre has the capacity to admit about 24 patients but on average over 28 patients are accommodated against its capacity, says Dr Ashar Pervez, clinical and therapeutic nutritionist and burn centre’s spokesperson. “Still protests and using political influence to pressure the staff for admissions is a routine here,” he said.
Though, PIMS’ burn centre receives patients from Azad Jammu and Kashmir to Lahore, even from South Punjab, but majority of them are from Khyber Pakhtunkhwa, due to its close proximity, severe weather conditions and its precarious law and order situation, doctors say.
With the advent of winter season, the number of burnt patients has increased due to gas loadshedding and cylinder blasts.
According to centre’s data, nearly 15 to 20 patients with burns come daily to the emergency, most of them from KP with totally unattended wounds, without even a basic dressing.
In the last week of December, a family of five, including a woman and two kids, who were severely burnt in a gas cylinder blast in Peshawar, was shifted from Lady Reading Hospital to the burn unit of PIMS. Officials say they were under immense pressure from a PTI MNA to admit the family. The family was admitted but it still led to scuffle and protests. Later, the whole family expired.
Shaukat Ali Yousafzai, secretary information of Pakistan Tehreek-i-Insaf and former health minister KP, maintains that the burn unit of Lady Reading Hospital does not offer specialised care. A 100-beded burn centre is under construction in Hayatabad, which is funded by the federal government.
Though health is now a provincial matter after devolution, still the provincial minister blamed the federal government for not supporting health projects in the province.
“The development work on Hayatabad centre is stalled because the federal government is not fulfilling its commitments,” Yousafzai said.
The other burn unit that caters to the whole north region is Burn and Reconstructive Surgery Department at Jinnah Hospital, Lahore. But it is also not fully operational.
Prof Dr Moazzam Tarar, head of Burn and Reconstructive Surgery at Jinnah Hospital Lahore, insisted that the department is functional except its intensive care unit. He refused to comment further when asked about the patients referred to Islamabad, saying ‘only one unit is not sufficient for a city with a population of 12.5 million’.
Although Combined Military Hospital, Kharian, and Nescom hospital have small burn units yet they charge heavily from civilians.
People in rural Pakistan suffer tremendously because they are unable to find appropriate burn care on time, said Ihtasham Akram, a health policy expert. “Burn care is neither a priority of the governments nor it’s a part of health reform initiatives because such reforms are not need-based rather technocratic driven.”
Every province should have at least five burn centres at equal distances by dividing districts into clusters, he said, especially the KP and FATA, which have endured the highest number of terror attacks and still reeling from it.
Bibi’s wounds had gangrened with infections and she was severely dehydrated when she reached at the centre, after almost 15 days wrapped in unclean blanket. Most of the patients reach the centre after 24 hours totally unattended with dehydration, infection and hypothermia and at that point not much could be done to treat them, said Dr Ashar.
“At least doctors working in the primary healthcare centres must be given some basic trainings to give initial burn care if the governments cannot build more burn centres,” he said.
KP Burns Hospital unfinished 13 years on
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Peshawar: Under construction for more than a decade now, Peshawar’s only Burn Hospital has yet to open in a city of 1,785,000 people. If completed, the Burn Hospital will also be the first in the Khyber Pakhtunkhwa province – of which Peshawar is the provincial capital – with a population of 26.9 million.
Marble Slab on Burn, Trauma and Reconstructive Surgery Centre: Photo by News Lens Pakistan
A marble slab fixed to the incomplete building of the ‘Burn, Trauma and Reconstructive Surgery Centre’ at the Hayatabad Medical Complex (HMC) in Peshawar shows that the project was initiated in July 3, 2003. It was inaugurated by the former chief minister Akram Khan Durrani at the time when Muttahida Majlis-e-Amal (MMA) – a coalition of 6 religious parties – was in power in Khyber Pakhtunkhwa (KP). However, thirteen years since its inauguration, the province’s only burn centre awaits completion of its construction work to operate.
Since 2003, a number of political figures that came to power in the interim have re-inaugurated the facility, says an official at the Workers Welfare Board (WWB), bringing funds to build the hospital and renewing hopes that the facility would be completed during their governments.
“Besides A.K.Durrani, other officials and politicians have held curtain-raisers for the same project,” the official told Truth Tracker on the condition of anonymity because he was not authorised to talk to media. “They include former-president Asif Ali Zardari, former-chief minister Ameer Haider Khan Hoti and recently Zahir Ali Shah, a former member of provincial assembly,” the official added.
According to the Memorandum of Understanding (MoU) signed between the Health Department of KP and the Workers Welfare Fund (WWF), the former was to provide land for the hospital and the latter would construct and hand over the 120-bed hospital. The Health Department would have then operated the hospital bearing its expenses.
“The hospital is being constructed by WWB with the Workers Welfare Fund but its completion has been long delayed due to red-tape at the federal and provincial level,” said the official.
Asif Majeed, Director Works at WWB, noted that the delay in construction of the Burn Hospital was due to various reasons. He said the construction did not start right after its inauguration but in August 2010 due to lack of interest from the authorities and the dissolution of WWF governing body.
The 18th Amendment to the Constitution (2008) resulted in decentralisation of many federal entities to the provincial governments. The devolution of WWB to the provincial government was another reason for the delay, said Majeed, leaving the department in disarray because it had to start afresh at the provincial level. “Due to this the project was put on the back-burner,” he added. This didn’t just delay the launch of the only Burn Hospital in a province but has had financial implication for the completion of the project. Majeed said due to the inordinate delay in constructing the hospital, the total cost of building the hospital had increased by Rs.233 million – from Rs.532 million in 2003 to Rs.765 million now.
However he was optimistic about the early completion of project as. “More than 80 per cent of the construction work has already been done,” he said adding, “We have now submitted a revised proposal in December 2016 to WWF to seek funds. We are hopeful that it will be approved soon and will be followed by construction work.”
Doctors that Truth Tracker spoke to in the two leading hospitals in Peshawar stressed the need for an exclusive Burn Hospital in the province. They said people with burn injuries suffered tremendously due to the absence of such a facility.
Muhammad Tahir, in-charge of Burn Unit at Khyber Teaching Hospital (KTH), said the annual statistics at the unit indicated that the number of burn cases had been increasing every year. But the only burn-care facility available to patients in the entire province, he said were small Burn Units at the Lady Reading Hospital and the Khyber Teaching Hospital.
“Both units lack specialized facilities essential for patients with burn injuries,” said Tahir. “Even a patient with a second degree burn cannot be treated in either of these centres. They have to be referred to Pakistan Institute of Medical Sciences (PIMS) in Islamabad or the burn-care unit of Combined Military Hospital in Kharian.”
Both of these hospitals have limited capacity, said Tahir, and are overburdened with local patients. “Mostly patients are admitted only if they have come with a reference from doctors that they need intensive care. Other patients are discharged after provision of basic first aid treatment.”
Asked about construction work on the hospital, an official at the provincial Health Department who didn’t want to be named said in keeping with the MoU signed with the WWB, the department had nothing to do with the project until it was completed and handed over to it.
Tahir said the health authorities at these hospitals approached the WWF and the provincial Health Department several times to ask for expediting the work on the burn hospital. “We have informed them of the situation but to no avail,” said Tahir.
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There isn't one in KP, all of them come to punjab government hospitals on daily basis but never seen PML-N playing politics over it.
