Experts lament no mention of surgery in National Health Vision

KARACHI ; As geographic, socio-economic and political reasons have rendered Pakistani people unable to avail satisfactory healthcare facilities, around 17 million required surgeries are not carried out in the country annually, which include life-saving caesarean sections, orthopaedic surgeries that prevent lifelong disabilities, and simple procedures to treat cataracts, clubbed feet and cleft palates that dramatically enhance a person’s quality of life.

This information was shared at the fourth Annual Surgical Conference held at Aga Khan University (AKU), Karachi. The conference was titled ‘Global Surgery: Bridging the Gap’. Speaking at the event, surgeons and interventionists said people belonging to lower socio-economic strata and those living outside major cities faced the greatest challenge regarding accessing emergency and essential surgical and anaesthesia care.

“Pakistan suffers from widespread disparities in surgical care caused by geographic, socioeconomic and political dynamics,” said Dr Sadaf Khan, conference chair and an associate professor of surgery at the AKU. “These intricate and interlinked challenges are key contributors to the annual backlog of surgical procedures and call for researchers, practitioners, academics and policymakers to come together to develop interdisciplinary, innovative solutions.” Speakers at the four-day event noted that while the country’s National Health Vision 2016-2025 recognised the need for addressing such inequalities and inequities blocking the people’s access to healthcare, the strategy did not mention the role of surgery and anaesthesia in achieving the country’s public health goals. The lack of emphasis on surgery in the health vision, according to the speakers, was surprising since four of the seven leading causes of deaths in Pakistan – cardiovascular diseases, injuries, cancer and diabetes – could be reduced through access to timely, safe and affordable surgeries at different points of a person’s life.

The experts lamented that most hospitals outside the country’s major cities lacked trained surgeons, anaesthetists, and the infrastructure to treat various common diseases and conditions.

The speakers also referred to the recommendation of ‘two-hour access’ of the Lancet Commission on Global Surgery, which was about the availability of a hospital that could conduct surgeries in an emergency within two hours. Timely surgical procedures are particularly important in cases of cardiac illnesses, or cases of life-threatening bleeding often caused by traffic accidents.

It was asserted during the conference that ensuring timely access to healthcare was vital.

The speakers also stressed the need for addressing capacity constraints. While there may be a hospital nearby in case of an emergency, it may not have a trained surgeon or an experienced anaesthesiologist available, the experts said, adding that such a situation resulted in delays in receiving healthcare and forced patients and his attendants to restart their search for a hospital.